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Preventive And Social Medicine II > Risk Factor Assessment and Screening Procedures > Flashcards

Risk Factor Assessment and Screening Procedures Flashcards

1
Q

Common modifiable risk factors:

A

PUT

Physical inactivity
Unhealthy diet
Tobacco and alcohol use

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2
Q

Intermediate modifiable risk factors:

A

ROAR

Raised blood sugar
Raised BP
Abnormal blood lipids
Overweight/obesity

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3
Q

Common risk factors of major NCDs

A

Raised BP
Raised Bld sugar
Abn blood lipids
Overweight/obesity
Smoking
Unhealthy diet
Physical inactivity
Stress

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4
Q

Raised BP Prevalence

A

25.4%

  1. Single BP determination of 140/90
  2. Questionnaire if there was previous diagnosis
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5
Q

Raised Blood Sugar Prevalence

A

7.1%

  1. High levels of FBS
    OR
  2. 2H-PPBS
    OR
  3. Diabetes Questionnaire
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6
Q

Abnormal blood lipids prevalence

A

Lipid profile:
- high T-CHOL (>240mg/dL) 10.2%
- high LDL (>160mg/dL) 11.8%
- high TAGs (>200mg/dL) 14.6%
- low HDL (<40mg/dL) 64.4%

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7
Q

Overweight/obesity prevalence

A

BMI:
3.2% in men
6.6% in women

Waist-hip ratio (WHR):
12.1% in men
54.8% in women

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8
Q

What is defined as a waist-to-hip ratio (WHR) of 1.0 and over in men, and 0.85 in women?

A

Central obesity

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9
Q

How do you assess the use of tobacco or smoking?

A
  1. Smoking status (smoker or non-smoker)
  2. Trend in client’s smoking practice
  3. Exposure to secondhand smoke
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10
Q

Comprehensive assessment of unhealthy diet:

A
  1. Detailed food recall
  2. Extensive questionnaire on food frequency
  3. Estimation of food nutrients using Food Composition Table and Food Exchange List

Ask about amount and frequency of food eaten s/a veggies, fruits, fat, Na, sugar or simple CHO.

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11
Q

How do you assess physical inactivity?

A
  1. Occupation
  2. Transportation
  3. Leisure (sports or formal exercise)
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12
Q

What are the 8 risk factors associated with the likelihood of developing a CVD?

A

Smoking
Physical inactivity
Obesity
Nutrition/diet
Alcohol use
Raised BP
Inc blood lipids
Inc bld sugar

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13
Q

WHO STEPwise approach to surveillance

A

Step 1: q based info about diet and physical activity, tobacco use, and alcohol consumption

Step2: standardized physical measurements on BP, ht and wt

Step3: blood samples for lipids and glucose status

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14
Q

What is the most sensitive indicator of adiposity?

A

Waist circumference

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15
Q

It is determined by using a non-extensible/non-stretchable tape measure placed around the waist.

A

Waist circumference

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16
Q

What are the 2 suggested points for waist measurement?

A
  1. Level of umbilicus
  2. Midway or between the last rib and supra iliac crest
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17
Q

This method, in very overweight people, the umbilicus level is what?

A

Low

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18
Q

Preferred because of more stable landmarks

A

Between last rib and supra iliac crest

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19
Q

feet to m

A

feet / 3.28

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20
Q

This is obtained by dividing the waist circumference at the narrowest point by the hip circumference at the widest point.

A

Waist-hip-ratio (WHR)

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21
Q

WHR =

A

Waist circumference (cm)/Hip circumference (cm)

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22
Q

What is a service component towards promoting healthy lifestyle and preventive interventions?

A

Screening

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23
Q

What is an important component of screening procedures?

A

Risk factor assessment

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24
Q

Collect minimum amount of info about diet and physical activity, tobacco use, and alcohol consumption and obtaining data on physical measurements such as BP and anthropometric measurements.

A

Risk factors assessment

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25
Q

What is the presumptive identification of unrecognized disease or defect by application of tests, examination or other procedures which can be applied rapidly?

A

Screening

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26
Q

What refers to the testing applied to one person considered to be at high risk for a dse or condition (e.g. Pap smear for possible cervical cancer, digital rectal exam for possible prostate cancer, etc.)?

A

INDIVIDUAL SCREENING

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27
Q

This refers to tests applied to a segment of population which portray any of the following situations:
- an increased incidence of a condition;
- a significant prevalence of the condition; and
- a recognized element of high risk within the group

A

GROUP OR MASS SCREENING

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28
Q

Disease-specific

A

Screening

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29
Q

A sustained elevation in mean arterial pressure which results from changes in the arterial wall s/a loss of elasticity and narrowing of BV, leading to obstruction in blood flow that can damage the heart, kidney, eyes, and brain.

A

Hypertension

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30
Q

200-239mg/100mL

A

Elevated may be at risk

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31
Q

> /=240mg/100mL

A

Elevated at risk

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32
Q

Characterized by airflow limitation that isn’t fully reversible.

A

COPD

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33
Q

Progressive and associated with abnormal inflammatory response of the lungs to noxious particles or gases.

A

COPD

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34
Q

An inflammatory disorder characterized by increased airway hyper-responsiveness manifested by a widespread narrowing of air passages, which may be relieved spontaneously or as a result of therapy.

A

Asthma

35
Q

Clinical manifestations of asthma:

A
  • paroxysm of breathlessness
  • chest tightness
  • breathing
  • coughing
36
Q

If risk factors are present,

A

Confirm
Explain
Educate
Monitor
Refer

37
Q

Retesting if needed and determine frequency of retesting

A

Confirm

Example: 140/90 BP stage I, confirm in 2 months

38
Q

For confirmation of diagnosis

A

Refer

39
Q

Detecting high BP is a form of SECONDARY PREVENTION in relation to

A

Hypertension

40
Q

Detecting high BP is a form of PRIMARY PREVENTION in relation to

A

Atherosclerosis
Coronary & brain strokes
Nephropathy
Peripheral vascular disease
Aortic aneurysms

41
Q

Seventh Report of the Joint Nat’l Committee key messages on High BP

A
  • in persons older than 50 years, systolic BP >140mmHg is a much more important CVD risk
  • risk of CVD beginning at 115/75mmHg doubles w each increment of 20/10mmHg; individuals who are normotensive at age 55 have 90% lifetime risk for developing hpn
  • individuals w systolic BP of 120-139mmHg or diastolic BP of 80-90mmHg should be considered as prehypertensive and require health promoting lifestyle modifications to prevent CVD
42
Q

Most accurate and reliable technique for indirect BP measurement

A

Auscultatory method

43
Q

CHOL increase, also increases the risk of

A

CHD coronary heart disease

44
Q

Where is CHOL produced?

A

Liver

45
Q

Cholesterol in food

A

Meat
Poultry
Fish
Dairy

46
Q

Recommended amount of dietary cholesterol

A

Not more than 300mg/day

47
Q

Cholesterol is carried in the bloodstream to the body’s cells by special proteins called

A

Lipoproteins

48
Q

What is the major cholesterol carrier in the blood?

A

LDL

49
Q

OGTT should be performed on all ppl who have a high

A

FPG 5.6-6.9mmol/L
RPG 5.6-11mmol/L

50
Q

CANCER WARNING SIGNS

A

CAUTIONUS

51
Q

Breast cancer is defined as the malignancy of the

A

Glandular epithelium

52
Q

Beginning the age of 20, women should have clinical examination every how many years?

A

Every 2-3 yrs, increasing to once. a year from the age of 40

53
Q

What do you assess in breast exam?

A
  • location
  • number of lumps or nodes (solitary or multiple)
  • consistency (soft or hard)
  • size
  • fixed or movable
  • tenderness along the area
54
Q

Screening must extend from where?

A

From the 2nd to 6th rib and from the lateral boarder of sternum to the mid-axillary line

55
Q

Part by part breast exam in a radial pattern from the periphery towards the nipple

A

Radial pattern (Alan Basset’s Technique)

56
Q

Left hand and right hand movements

A

Left: clockwise
Right: counterclockwise

57
Q

Radial position can be applied in 3 positions namely:

A
  • upright (standing or sitting)
  • supine (lying down on back)
  • oblique (lying slightly on side)
58
Q

Makes use of palpations search strategy and visual inspection techniques

A

Mamma Care Technique (Transverse or Vertical Lines)

59
Q

First circle
Second circle
Third circle

A

First circle: very light pressure
Second circle: press midway down to the breast tissue
Third circle: press down firmly into breast tissue as possible without causing discomfort

60
Q

Visual inspection for breast cancer:

A

Size: cancer may increase or decrease

Contour: distorted; as the cancer progress, it may pull the skin inward which causes loss of normal contour or may cause dimpling or skin depression

Nipple changes: point to different direction, inward nipp, non-healing ulcer or sore, bloody nipple discharge

Skin changes: rash, orange peel

61
Q

Breast: cause for concern

A

Single, non-painful lump

62
Q

Early warning signs if lung cancer:

A

Chronic cough or nagging cough
Dull intermittent localized pain
Hx of wt loss

63
Q

Early warning signs of cervical cancer:

A

Often asymptomatic
May cause abnormal vaginal bleed (e.g. post-coital bleeding)

64
Q

What is a screening test to examine cells collected from the cervix to detect cancer or abn cells that may lead to cancer?

A

Papanicolaou or Pap smear

65
Q

Pap smear for women in their 20s

A

Every 2 yrs

66
Q

Pap smear aged 30 and above who have had 3 normal Pap

A

Evry 3 yrs

67
Q

When is pap smear done?

A

In between menstruation (between 10-20 days after 1st day of LMP)

68
Q

What is an adjunct procedure to the routine Pap smear to improve detection of cervical dse?

A

Visual inspection of the cervix 1 minute after application of 3% acetic acid

69
Q

A condition in which cells lining the cervix canal extend beyond the os on the surface of the cervix.

A

Cervical ectopion (ectopy)

70
Q

In VIA, what is the interpretation of areas turned whitish (fades in 5 mins), identified for intermediate referral to hospital for colposcopy and biopsy if needed?

Also atypical BV
Irregular surface contour of cervix

A

Abnormal cervical areas, suspicious of cancer

71
Q

What are the early warning signs of prostate cancer?

A

Symptoms of urethral outflow obstruction such as:
- urinary frequency
- nocturia
- decrease in stream
- post-void dribbling

72
Q

Digital rectal examination

A
  1. Palpate male rectum; px lying in a lateral position or standing, hips flexed, and leaning over the table
  2. Begin w the right lateral surface and, proceed to posterior, left lateral and anterior surfaces
  3. While examining anterior rectal surface, lobes of the prostate and median sulcus separating them should be palpated for size, nodularity, and tenderness
73
Q

What is the normal prostate size?

A

Approx. 2 x 4 x 3 cm and enclosed in a smooth capsule

74
Q

What is a blood test that confirms the diagnosis of PC?

A

Prostate specific antigen (PSA) determination

75
Q

What are the early warning signs of colorectal cancer?

A

Change in stool
Rectal bleeding
Pressure on the rectum
Abdominal pain

76
Q

Screening guidelines for colorectal cancer

A

> 50y.o. - annual fecal occult blood test and flexible sigmoidoscopy every 5 yrs

Completely valid: repeated 3-6 times on different samples; diet should be free of meats, fish, vegetable sources of peroxidase activity

Consider occult bld in: diverticulitis, gastric carcinoma, and gastritis

Increased GI blood loss in normal and more bleeding in disease; Drugs are: salicylates, steroids, indomethacin, colchines, iron (massive therapy), and rauwolfia derivatives

F(+) in occult bld: borid acid, bromides, colchicines, iodine, inorganic iron, oxidizing agents

Liquid stool may cause F(-) w filter paper mtds

77
Q

Characteristic symptoms of COPD

A

Cough
Sputum production
Dyspnea upon exertion

78
Q

What is done to determine the degree of obstruction and can be diagnosed and categorized as having restrictive, obstructive or mixed pattern of ventilatory defect?

A

Spirometry

79
Q

How is airway obstruction evidently known?

A

If forced expiratory volume (FEV1) is reduced to <80% of predicted values

80
Q

What is the simplest test of lung fxn appicable to COPD and asthma?

A

Use of peak flow meter to measure peak expiratory flow rate (PEFR)

81
Q

Refers to the maximum velocity of air from the lungs when exhaled at maximum effort.

A

PEFR

82
Q

Correlate w degree of airway obs and FEV1 in spirometry

A

PEFR

83
Q

Its hallmark is the demonstration of reversibility of airway obstruction.

A

Asthma diagnosis

Preventive And Social Medicine II (32 decks)

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