USPSTF Guidelines/ UVA Questions Flashcards
Who gets screened for AAA
Men ages 65-75 who have ever smoked get one time screening with ultrasound
Men 65-75 who have never smoked…. screen for AAA?
No recommendation for or against
Who gets alcohol misuse screening?
All adults
?teenagers– not for or against
Who gets ASA for prevention of CAD?
Men 45-79
Women 55-79
At what % risk in men does the risk of CAD outweigh the risk of potential GI bleed caused by ASA use?
45-59: 4%
60-69: 9%
70-79: 12%
At what % risk in women does the risk of CAD outweigh the risk of potential GI bleed caused by ASA use?
55-59: 3%
60-69: 8%
70-79: 11%
Aspirin– under 45 and above 80?
NO
ASA/NSAIDs for the prevention of colon cancer?
NO
Bacterial vaginosis diagnosis/screening?
Dont screen unless symptomatic
If symptomatic…
pH above 4.7; clue cells; fishy odor
Treatment for BV
metro or clinda
When to screen for asymptomatic bacteruria?
All pregnant women
Principal treatment of bladder cancer?
Transurethral resection
Clues to screen for BRCA
history in fam of:
- before age 50
- bilateral
- breast + ovarian
- male
- fam w/ 2+ BRCA cancers
- Ashenkazi
How to intervene in BRCA+ patients?
- more frequent screening
- meds (tam/raloxifene)
- surgery (mastectomy, salpingo-oophorectomy)
Tamoxifen/Raloxifen:
Which to use in postmenopausal
raloxifene- postmenopausal
How gets mammograms?
50-74 q2 years
**Stop at 75
Mammo-Screen ages 40-49?
individualized decision
Benefits of breast feeding for momma
decreased breast/ovarian cancer rates
Benefits of breast feeding for infant
-less ear infections, LRTI, GI infections
Benefits of breast feeding in young children
less asthma, DMII, obesity
In what circumstances is breast feeding not reccomended?
galactosemia
HIV
When to screen for carotid artery stenosis?
Dont– screen for HTN, HLP, smoking etc.
What populations do not get pap smears
younger than 21, older than 65 (if prior were normal)
At what age can HPV co-testing be done with paps?
30+
How often should paps be done in ages 21-65
q3 years
q5 if co-testing negative
Who gets screened for chlamydia when asx?
patients 24 and younger that are sexually active
When to screen asx pts age 25+ for chlamydia
if at increased risk
sex workers, history STDs, other STD, etc
When to screen pregnant women for chlamydia?
1st trimester if younger/equal to 24 or at increased risk.
3rd trimester if at continuing risk
How to screen for CKD?
Should we?
GFR/microalbumin/creatinine
No reccomendation for or against
Risks for COPD
smoking, pollutant exposure, older than 40
Diagnostic test for COPD
spirometry, but dont screen if asx
How to prevent pulm illness?
3
smoking cessation
annual flu shot 50+
one time pnuemo at 65+
Drug treatments for memory
acetylcholinesterase inhibitors
memantine
What age group gets screened for colorectal cancer?
50-75
Methods of colorectal screening
- q1 FOBT
- q5 sigmoidoscopy w/ q3 FOBT
- q10 colonoscopy
Screening for CAD?
no… no stress, EKG, etc.
Just calculate risk to decide upon preventative treatment
When to screen for depression in adults
always if care supports are in place
When to screen for DM
asx adults with BP greater than 135/80
Reccomended DM screening
FPG, positive if greater than 126x2
Falls prevention
exercise
vitamin D
Folic acid dose for preggos
0.4-0.8 ug daily
start 1 month before pregnancy, continue through first trimester
**Dose may be higher with history of NTD, antiepileptics etc.
Dose of folic acid if momma has prior pregnancy with NTD
4mg/d
When to screen for HSV in pregnancy?
Dont.
When to screen preggos for GDM
24+ weeks
GTT 24-28 weeks
Glaucoma screening in primary care:
dont
When to screen for gonorrhea
sexually active under 25; pregnant women (at risk) at first visit-- again in 3rd trimester if still at risk
Treatment for gonorrhea
ceftriaxone (or other 3rd gen cephalosporin)
When to screen for hearing
Not really reccomended but can easily ask/do finger rub test/do watch tick test
Treatment for hemachromatosis
therapeutic phlebotomy
When/how to screen for HBV in pregnancy?
first trimester– HBsAg
How to handle infant exposed to HBV
give HBV IVIG and vaccine immediately, breast feeding is ok
Who gets screened for HCV?
- risky behaviors/prison
- transfusion before 1992
- birth between 1945-1965
- hemodialysis
- HCV infected mother
Treatment of HCV
interferon and ribavirin
Adults with HTN should also be screened for ___, ___.
HLP, DM
Who gets screened for HIV?
15-65, older or younger with risk. Anyone pregnant
White race is risk for ____ eye condition. Black race is risk for ______ eye condition.
white- ARMD
black- cataracts
Screen all adult women for ____
Intimate Partner Violence
Lipid Screening- who gets it?
men 35+
women 45+ 4
if have risks
Reasonable interval for lipid screening?
q5 years
Screening for lung cancer
55-80 smokers (unless quit more than 15 years ago). Annually until 80 or have stopped smoking for more than 15 years.
UPSTSF recs for HRT
dont do it.
When to refer obesity to multicomponent behavioral interventions
BMI 30 or more
Who gets DEXAs
65 and up or younger with risk equal to 65 year old
How to test for ovarian cancer?
TVUS + CA125 (but not if asx)
How to test for PAD?
ABIs but not if asx
USPSTF rec on PSA
Dont
When to screen pregnant women for Syphilis
first visit with VDRL/RPR
confirm with FTA-ABS
When to screen blood lead levels in kids
only if symptomatic
When to screen for congenital hypothyroidism
All 50 states; between days 2-4 of life.
If earlier, will be falsely elevated
Pavlik harness forces hip in what position?
abduction
How to prevent ocular gonococcus
all newborn infants erythromycin in eyes w/in 24 hours of birth
When to get hearing screen for babies?
All should get within first month of life (usually in hospital)
Treatment of childhood hypertension
lifestyle if stage 1, meds not recommended
In what group is IDA screening recommended
pregnant women
Who should get iron supplements
babies 6-12 mos at risk of IDA
When to screen lipids in kiddos
dont
When kids to screen for depression
12-18 when there are supports in place; may consider SSRI if can follow
Which peds age groups get screened for obesity
6+
When and how to screen for PKU
all newborns; Guth Bacterial Inhibition Assay
When and how to screen for SCA
Thin layer isoelectric focusing (IEF); high performance liquid chromatography (HPLC)
All newborns
Newborn conditions that must be screened in all 50 states
PKU; SCA; Hypothyroid
How to handle infant with SCA
penicillin by age 2 months
pneumococcal immunizations as scheduled
When to start screening kids’ vision
ages 3-5
Vaccine given at birth
Hep B
Vaccines given at 2 months
DR HIP + Hep B
DTaP, Rota, Hib, IPV, PCV13
Vaccines given at 4 months
DR HIP
Vaccines given at 6 months
DIP + flu PRN, 2 doses first season
12-15 month vaccines
MMRV DTaP Hep A (x2) PCV13 Hib
4-5 year vaccines
DIM
DTaP
IPV
MMRV
11-12 year vaccines
meningococcal
TDaP
start HPV series
16 year old vaccines
meningococcal
Age to give zostavax
60, 1 dose
Adult age to give PPSV23
65 x 1 dose
Which vaccine is given q10
Td
Appropriate screening for thyroid
starting at 35, then q5
Suspect SAH but get no CT findings next step
LP
Workup for breast lump age 35 and under? over?
under- ultrasound
over- mammogram
Pinworms name
enterobious
How to confirm myasthenia diagnosis
trial of edrophonium IV
Cocktail for COPDE
corticosteroids
antibiotics
bronchodilators
IDA in male must rule out
colon cancer
What are the microcytic anemias?
TAILS thal anemia chronic disease iron def lead sideroblastic
Which lipid marker is most important to patient outcome
LDL
What is goal LDL?
no risks- 160
many risks- 130
known CAD- 100
What meds effect HDL? triglycerides?
HDL- niacin
TRIG- fibrates
Whats the target a1c for DMII
7.0
Specific ab for scleroderma
anti-centromere
Hallmark lab for polymyalgia rheumatic?
Treatment?
high ESR
steroids
Granulocytopenia (low neutros), splenomegaly, RA =
Feltys
Pt with increasing hat size, going deaf, tibial bowing. Dx? Lab?
Pagets– mosaic bone, high alk phos
Which patients cant use IUDs
young ones not also using barrier protection because risk STDs
OCPs and ovarian cancer?
decreased risk
VWD labs
normal PT/PTT but increased bleeding time
can sometimes get increased PTT
Treatment physiological cyst
6cm or less observe
Appearance dermoid/teratomas on ovarian imaging
calcifications
Define short stature
2SD below avg –> do bone age
Contrast familial and constitutional short stature
familial- bone age is actual age
constitutional bone lags behind actual
How to choose gout prophylaxis
urinary uric acid
if low– probenecid.
if high– allopurinol
Treatment ITP
high dose steroids
Rhabdo first intervention
IVF
Causes of cough more than 3 weeks.
post-nasal drip (allergic)
asthma
GERD
Heparin affects what lab?
ptt
Patient gets PE while anticoagulated what is next step?
IVC filter
Nitroprusside caveat
NEED inpatient admission
Treatment of cocaine induced HTN
labetolol blocks a and b
CHFE most important dx step
echo
don’t need BUN if its obvious theyre in failure
New onset enuresis labs
urinalysis
AIDS px starts at what CDC count
200
AIDs px at 200
Bactrim for PCP
AIDs px at 100
Bactrim for toxo
AIDs px at 50
Azithro for MAC
What is a +PPD in AIDs
5MM
Congenital toxo triad
hydrocephalus
intracranial calcifications
retinitis
congenital rubella triad
cataracts
blueberry muffin rash
deafness
Isolated elevated opening pressure on LP =
cryptococcal meiningitis
Anatomical cause of RPL
incompetent cervix
Palpable cordlike structure under skin + fever=
thrombophlebitis
Thrombophlebitis treatment
NSAIDs rest ice
Antimitochondrial antibodies=
PBC (bitches, maternal, mitochondira)
Sudden vertigo + peripheral nystagmus prevented by fixating… follows viral illness. DX?
labrynthitis
Mild comedonal acne treatment
creams…
retinoid or salicylic/glycolid acid or benzoyl peroxide
Non gap acidosis causes
GI bicarb loss
RTA
Anion gap equation and normal value
Na- (Cl+HCO3) =8-16
How to dx menopause
FSH
How to determine if asthma exacerbation is worsening
CO2 ^ and less wheeze
VCUG management
px until gone
Injectible PDEi for patients with ED on nitro
alprostadil
Normal pressure hydrocephalus MRI findings
large ventricles normal brain
Mastitis management
cover staph, keep breast feeding
MCC nephrotic syndrome in peds
minimal change disease
Minimal change symptoms and labs
proteinuria
edema
hypoalbuminemia
hyperlipidemia
Minimal change histopath
fusion of foot processes
Congo red /apple green birefringence= buzz words for?
amyloidsosis
MC correct maintenance fluids
5-10 dextrose + 1/4 normal saline + KCL usuallt 20
Diverticulitis abx
Cipro + metro
also good for diabetic foot wounds
Prostatitis empiric tx
Bactrim