Screening Flashcards
Describe screening for kids with obesity concerns
if BMI over 85% with risk factors or over 95, screen for diabetes
if BMI over 85%, screen for hyperlipidemia (treat to get below total below 170)
if over 95%, screen for steatosis
What are the screening recommendations for osteoporosis?
women over 65
What are the screening recommendations for colon cancer?
Fecal occult blood testing (FOBT), collected at home annually, Colonoscopy every ten years, Flexible sigmoidoscopy every five years with FOBT every three years
How should you screen for depression?
Over the past 2 weeks, have you ever felt down, depressed, or hopeless?
Over the past 2 weeks, have you felt little interest or pleasure in doing things?
What are the features of a good screening test?
can be treated (A) and have a latent phase of a disease (B) enabling early detection and more timely treatment, impacting the outcome of the disease.
The screening test should be acceptable to patients (D) at reasonable cost
When is lung cancer screening indicated?
does recommend screening for lung cancer in patients 55-65 years old with 30-pack-history of smoking by low-dose CT scan
Is screening for COPD recommended in all patients?
not if asymptomatic
When are mammogram screenings initiated?
Biennial screening mammography for women aged 50-74 years
What are the screening guidelines for diabetes according to the USTSPF?
screen anyone with BP > 135/80
Describe screening for colorectal cancer in a patient who has an affected first degree relative
take the first degree relative’s age, subtract ten. that’s when you start screening
What age do you start screening a woman with a first degree relative with breast cancer/
35
Name whom to screen for a AAA
male smokers 65 - 75
What are the CAGE questions for alcohol abuse screening?
- felt the need to Cut down your drinking?
- felt Annoyed by criticism of your drinking?
- had Guilty feelings about drinking?
- taken a morning Eye opener?
Who
Are the patients that should be screened with Low res CT
30
Year pack year history,
Age
Between 55 and 74
Who should be screened for lipid disorders?
women over 45 with risk factors
men over 35
Who should be screened for chlamydia?
All sexually active non-pregnant women 24 and younger, non pregnant women older than 25 at increaed risk, all pregnant women 24 and younger
What screenng should be conducted for women looking to become pregnant?
Folic acid supplement, Carrier screening, HIV
Syphilis, Recommend regular moderate exercise
Avoid hyperthermia (hot tubs, overheating)
Caution against obesity and being underweight
Screen for domestic violence
Assess risk of nutritional deficiencies (vegan, pica, milk intolerance, calcium or iron deficiency)
Avoid overuse of Vitamin A (recommendations are to 750 mcg (2500 IU per day) with daily upper intake limit of 3,000 mcg (10,000 IU))
Avoid overuse of Vitamin D (recommendations are 600 IU per day, tolerable upper intake is 4000 IU)
Caffeine (limit to the equivalent of two cups of coffee or six glasses of soda per day)
Note: the sugar intake in six glasses of soda is not recommended.
Hepatitis B immunization, Occupational exposures: Material Safety Data Sheets from employer, Diabetes: optimize control, folic acid, 1 mg per day, off ACE-inhibitors
Hypertension: avoid ACE inhibitors, angiotensin II receptor antagonists, thiazide diuretics
Epilepsy: optimize control; folic acid, 1 mg per day
DVT: switch from warfarin (Coumadin) to heparin
Depression/anxiety: avoid benzodiazepines
Household chemicals: avoid paint thinners and strippers, other solvents, pesticides
Smoking cessation: bupropion (Zyban), nicotine patches (Nicoderm)
Screen for alcoholism and use of illegal drugs
Preconception immunizations (rubella, varicella) Toxoplasmosis-avoid cat litter, garden soil, raw meat Cytomegalovirus, parvovirus B19 (fifth disease)-frequent hand washing, universal precautions for child care and health care
What are good questions to ask adolescent patients?
Home Education / Employment Eating Activities Drugs Sexuality Suicide / Depression Safety / Violence
When should patients be vaccinated for HPV?
ages 11-18, no evidence for 19-26
What are the routine immunizations we give to people over 65?
shingles, DTAP, flu, pneumovax
What are the required immunizations for most school students?
Hep B - 4 DTAP - 5 Polio - 4 MMR - 2 Varicella - 2
Who should be screened for chlamydia?
all sexually active women aged 24 and older
NO MEN
What are some of the predisposing factors for testicular torsion?
congenital abnormality, undescended testis, exercise, trauma
What are the risk factors for testicular cancer?
Genetics, Family history, Cryptorchidism, Environment, Prior testicular cancer
Describe the epidemiology of grave’s disease (who gets it, what triggers it)
Women are five to ten times more likely than men to get it.
Peak incidence is between ages 40-60.
Often occurs with family history of thyroid disease; can also be associated with other autoimmune diseases.
Triggers include stressful life events, high iodine intake, or a recent pregnancy.
What are the key components of a diabetic foot exam?
testing for loss of protective sensation
assessment of pedil pulses
inspection for wounds and breaks in the skin
What cancers are at higher risk if you have an elevated BMI?
non hodkins lymphoma, multiple myeloma,
What are the risk factors for CHD?
Cigarette smoking
Hypertension (BP ≥ 140/90 or on antihypertensive medication)
Low HDL cholesterol (<65 years of age)
Age (men ≥45 years, women ≥55 years)
What are the risk factors for childhood obesity?
high birth weight (B) and maternal diabetes. obese parent ,
What can be used to screen for secondary hypertension in kids?
Umbilical Arterial or Venous Access
Placement of an umbilical arterial or venous line during the perinatal period may predispose to renal vascular disease.
Urinary Tract Infection
Although less common in boys, UTIs in childhood are one of the leading causes of hypertension and renal insufficiency later in life. This is due to renal scarring following the infection.
Catecholamine Excess
Although some children with catecholamine excess, e.g., pheochromocytoma or neuroblastoma, may not have symptoms such as flushing or sweating or palpitations, a positive response to a screening question in a hypertensive child would merit urine catecholamine testing.
Family History of Renal Disease
Ask about family history for hypertension and kidney disease. Inquiring whether a family member has needed dialysis is a good screening question for severe kidney disease.
Coarctation of the Aorta
Some children with coarctation of the aorta may go undetected until presenting with hypertension at a school-age visit. On exam, pay special attention to the femoral pulses and consider documenting BP measurement in a lower extremity.
