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Secondary Prevention: Detecting preclinical disease Flashcards

1
Q

What is secondary prevention

A

early findings of asymptomatic disease using screening tests

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2
Q

Principles of secondary prevention

A

prevalence sufficient to justify screening
health problem has effect on life
target disease has long asymptomatic period
acceptable screening test available

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3
Q

Most accurate information about alcohol use

A

pos response to CAGE questions

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4
Q

CAGE questions

A

C: cut down on drinking?
A: annoyed by criticizing drinking?
G: ever felt guilty about drinking?
E: eye opener

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5
Q

Findings in a man with 10 year hx of alcohol abuse

A

elevated AST and ALT (3x normal)
mild macrocytosis (elevated MCV) without anemia (>3drinks/day women and >5/day men)
isolated hypertriglyceridemia

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6
Q

AST and ALT resolvent with sobriety

A

1-3 months

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7
Q

Macrocytosis resolvement with sobriety

A

2-3 months

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8
Q

Hypertriglyceridemia resolvement with sobriety

A

1-2 months

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9
Q

1 drink defined as

A

12 oz beer
5 oz wine
1.5 oz liquor

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10
Q

Legal alcohol limit for motor vehicle operation

A

0.08g/dL blood alcohol concentration

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11
Q

Is chest x-ray a screening for lung cancer?

A

NO

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12
Q

Hgb electrophoresis looks for?

A

sickel cell diease

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13
Q

Calculating pack year history

A

number of packs per day times number of years smoked

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14
Q

Highest risk for suicide

A

elderly males

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15
Q

Best statements to use when asking a pt something

A

“I” statements

I noticed the bruises are in the shape of a hand

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16
Q

Who is the author of the stages of change?

A

Prochaska and DiClemente

17
Q

Stages of change

A 
precontemplation
contemplation
preparation
action
maintenance/relapse
18
Q

precontemplation stage of change

A

pt may not be ready to change or aware of change that needs to occur

19
Q

contemplation stage of change

A

pt is considering change and looking at the pos and neg.

may report being “stuck” with the problem

20
Q

preparation stage of change

A

pt exhibits some change of behaviors or thoughts

may need assistance in tools to success

21
Q

action stage of change

A

the pt is ready to go forth with change

can be inconsistent with carry through

22
Q

maintnance/relapse of change

A

pt learns to continue change and has adopted and embraced healthy habit
positive reinforcement

23
Q

5 A’s with tobacco use

A 
Ask: ask about tobacco use every visit
Advise: advise quitting every visit
Assess: are they willing to quit
Assist: help with plan
Arrange: follow up
24
Q

Top leading causes of death in US

A

Heart disease
cancers
respiratory disease
cerebrovascular diseases

25
Q

Top cancer causes

A

Men: prostate, lung, colon, urinary
Women: breast, lung, colon, uterine

26
Q

Top cancer deaths

A

Men: lung, prostate, colon, pancreas
Women: lung, breast, colon, pancreas

27
Q

When guidelines have conflicting information

A

focus on the commonalities vs the differences

28
Q

Screening for breast cancer should begin at

A

age 20 with BSE and clinical breast exam
mammo starting at 40
MRI if younger

29
Q

Screening for colorectal cancer

A

begin at 50
colonoscopy every 10
fecal occult blood testing every year

30
Q

procedure for fecal occult blood testing

A

collect 2 samples from 3 consecutive specimens

digital rectal exam not adequate

31
Q

Screening for prostate cancer

A 
start at 50 in those who are expected to live at least 10 more years
start at 45 for those at high risk
DRE and PSA
PSA less than 2.5 retest every 2
PSA greater than 2.5 retest annual
32
Q

High risk for prostate cancer

A

African American

first degree relative dx earlier than 65

33
Q

Screening for endometrial cancer

A

women who are menopausal
any postmenopausal bleeding evaluated
those with colon cancer should be screened

34
Q

Screening for lung cancer

A

low dose CT

those 55-74 with >30pack year hx, current smoker or quit less than 15 years ago

35
Q

Screening for cervical cancer

A

start at 21
21-29 every year without HPV
30 every 3 years if three consecutive neg or every 5 if PAP with HPV
65 and older: no need for cytology

36
Q

Sensitivity defined

A

likelihood of true pos results with the disease

“neg helps to rule out”

37
Q

Specificity defined

A

likelihood of a true neg result in those who are healthy

“pos helps to rule in diease”

38
Q

Prevalence defined

A

proportion of sampled individuals possessing the condition at a given time

39
Q

Incidence defined

A

proportion of individuals to developed a condition over a defied period of time

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