Risk Assessment Flashcards
To review for boards
What is PRIMARY prevention (P’s)
“PROMOTE” health PRIOR to onset of any recognizable PROBLEMS
Example of PRIMARY prevention (3)
- Education about healthy and safe habits (wear seatbelt, avoid smoking, healthy diet)
- Immunization
- Legislation to ban/control hazardous products
What is SECONDARY prevention (SS)
“Screening” - aims to reduce the impact of a disease that has already occurred
Examples of SECONDARY prevention
Exams to detect disease early (PAP, PSA, Lipids)
What is TERTIARY prevention
“REHAB” - aims to soften the impact of an ongoing illness or injury that has lasting effects
Examples of TERTIARY prevention (3)
- Cardiac/Stroke REHAB
- Support groups
- Vocacional rehab
When does a complete physical exam need to start for ADOLESCENTS (11-19)
between 11-14
How often does a complete physical exam need to happen for ADOLESCENTS (11-19)
3 times between:
11-14
15-17
18-21
HPV vaccines for females:
What are the 3:
Gardasil
Gardasil 9
Cervarix
HPV vaccines for females:
At what age
Gardasil - 11-26
Gardasil 9 - 9-26
Cervarix 10-25
When should a syphilis screening be done?
Start when sexually active
Then as needed or with PAP
When should males start testicular self exams? How often?
At adolescence - MONTHLY
When should screening for HIV?
Depends on level of sexual activity or IV drug use.
Assess knowledge of prevention.
When to start Tetanus-diptheria (Td)
As early as 7 years old
How often to do Tdap
Every 10 years
When does Meningococcal vaccines start
11-18 years old
Does Meningococcal need revaccinated?
Controversial:
only x 1 if HIGH risk after 5 years from last
When should the influenza vaccine be given
annually
Who needs the pneumococcal vaccine (4 populations)
> 65
19-64 IF smoker, asthma, COPD, diabetes, alcoholism
Immunosuppressed
Living in nursing home
When PPD screening should start? (ADOLESCENTS)
Once during adolescence
How often should PPD screening occur in ADOLESCENTS? (2)
Every 2 years if at risk.
With any exposure to TB.
How often should YOUNG ADULTS (20-39) and MIDDLE AGED ADULTS (40-59) have a complete physical exam?
Starting at 20 - every 5-6 years.
YOUNG ADULT - female: When should PAP smears start?
21
YOUNG ADULTS - female: When does clinical breast exam start?
Adolescence/NOW
YOUNG ADULTS (20-39) - female: How often for clinical breast exam?
Every 3 years
YOUNG ADULTS - female:
When should self-breast exams start?
21
YOUNG ADULTS and MIDDLE-AGED female: (up to 65)
What is tested with PAP smear (3) and how often?
Chlamydia and GC at 21
Cytology - every 3 years
HPV >30- every 5 years
How often should YOUNG ADULTS and MIDDLE-AGED ADULTS (40-59) blood pressure be monitored? (2)
With every visit OR
Every 2 years.
How often should YOUNG ADULTS and MIDDLE-AGED ADULTS - full fasting panel be checked?
Every 5 years
More often if > 200
When should ALL adults do a self skin exam?
NOW - and continue regularly.
How often should PPD screening occur in YOUNG ADULTS? (2)
Annual for high risk populations (Controversial)
How often should all ages have dental cleaning and checkup
Every 6 months to a year
Does the ACOG (american college of obstetrics and gyn) recommend a self-breast exam?
not >40
How often does the MIDDLE-AGED (40-59) women need clinical breast exam
Annually
How often does the MIDDLE-AGED (40-59) women need mammography per
ACS - American Cancer Society
USPSTF - US preventative Services Task force
ACOG - American College of obstetrics and gyn
ACS
45-54 annually
>55 - every 2 years
USPSTF
50-74 - every 2 years
ACOG
50-74 - annually
When should MIDDLE-AGED ADULT MALES (40-59) begin Digital Rectal Exam (DRE)?
at 40
When should MIDDLE-AGED ADULT MALES (40-59) begin Prostate Surface Antigen (PSA) screening?
at 40 IF family history or AA
otherwise - 50
How often are Digital Rectal Exams recommended?
Annually at 40 years old
How often are Prostate surface antigen screenings recommended?
Annually at 40 IF family history or AA
Annually at 50 for all others
When should an ECG be checked?
As indicated
At 40 with cardiac risk factors
Colorectal Cancer screening
When?
3 tests?
Starts at 50
Annual fecal occult blood test
Flex sig every 5 years
Colonoscopy every 10 years
What is the second leading cause of cancer deaths?
Colorectal cancer
When does glaucoma screening start? (with tonography)
at 40
How often for glaucoma screening?
annually
How often should ELDERLY ADULTS (>60) have complete physical assessment?
Every 2 years
When should PAP Smears be discontinued? under what conditions? (2)
> 65-70 with 3 consecutive normal cytology tests
AND
no abnormal test in 10 years
What is the ACS’s recommendation for discontinuation of mammography?
Continue as long as the women is in good health and expected to live 10+ years
How often should full fasting panel be checked in ELDERLY?
Every 2-5 years
More often in > 200
How often should ECG be check in ELDERLY ADULTS (>60) ?
Every 2 years with cardiac risk factors
Major causes of mortality with ADOLESCENTS (12-19)
6
- MVC
- Suicide
- Other accidents
- Homicide
- Malignancy
- Cardiovascular disease
Major causes of mortality with YOUNG ADULTS (20-39)
6
- MVC
- Homicide
- Suicide
- Injuries
- Heart disease
- AIDS
Major causes of mortality with MIDDLE-AGED ADULTS (40-59)
6
- Heart disease
- Accidents
- Lung CA
- CVA
- Breast and colorectal CA
- COPD
Major causes of mortality with ELDERLY ADULTS (>60)
5
- Heart disease
- CVA
- COPD
- Pneumonia and/or influenza
- Lung and colorectal cancer
What is the top 5 “killers” of adults in the US.
- Heart disease - CAD, HF
- Colorectal cancer
- Lower Respiratory Disease
- CVA
5.
What CANCER in WOMEN is responsible for the highest mortality?
Lung
What is the leading GYN-associated cancer “killer”?
Ovarian
Highest cancer incidence in WOMEN other than skin cancer?
Breast
What CANCER in MEN is responsible for the highest mortality?
Lung
Other than skin cancer, the 2nd most common CANCER in MEN and #2 cancer “killer”
Prostate
Leading CANCER “killer”?
Lung Cancer
2nd leading CANCER “killer”?
Colorectal Cancer
Healthy Nutrition.
How much of your plate should be fruits and veggies?
HALF
Healthy Nutrition.
Best type of milk?
Skim or 1%
Healthy Nutrition.
How much of grains should be whole grain?
at least HALF
Health Nutrition.
Should you vary your protein choices?
Yes
Dietary Recommendations.
% of Carbs
55-60%
Dietary Recommendations.
% of Fats
< 30%
Dietary Recommendations.
Protein
0.8-1 g/kg
Dietary Recommendations.
Protein
0.8-1 g/kg/day
Leading killer of women in US
Heart disease
What is the shingles (Herpes zoster) prevention
Zostivax
When is shingles (herpes zoster) prevention should start?
at 50
What happens to nutrition and protein needs with illness or trauma?
INCREASE
Exercise has positive effects?
- Decreases LDL
- Increase BMR
- Reduces STRESS
- Improves CV fitness
- Decreases signs of aging
Sensitivity
TRUE POSITIVE
The degree to which those who have a disease - screen positive
positive showing positive
Specificity
TRUE NEGATIVE
The degree to which those who do not have a disease screen - test negative
negatives showing negative
Incidence
The FREQUENCY with which a disease
The RATE in which NEW cases occur during a specific time period
EX: 20 cases of botulism per 500,000 people were reported in ALASKA during 2010
Prevalance
The PROPORTION of a population that is affected by a disease or disorder at a particular time
EX: the prevalence of lupus in women living in Illinois during 2019 was < 1%
Leading killer of AA in US < 40
AIDS
Leading killer of AA MEN in US < 35
Homicide
American Heart Association recommends that exercise should be performed for HOW long and HOW often?
30 minutes or more on most days of the week
Starting an exercise program over 35. What should be done prior to starting? (3)
- Complete history
- Physical Exam
- Exercise stress test
What is an antigen?
Induces a specific immune response
What is an antibody?
Molecules synthesized reaction to an antigen
What is active immunity
Conferred by antibody formation stimulated with a specific antigen
Tetanus toxoid
What is passive immunity?
Conferred by the introduction of antibody proteins
gamma globulin injections
-HBIg - given for known exposure
maternal immunity
Who should receive Hep A vaccine? (3)
Military personnel
Travelers to endemic areas
Men who have sex with men
Who should receive Hep B vaccine? (3)
Health care workers
High risk patients
Sexually active adults
Mumps vaccine clarification
Before 1957 - 1 dose
After 1957 - 2 doses