USPSTF II Flashcards
What is the B rating for primary care interventions for breastfeeding?
Providing intervention during pregnancy an after birth to support breast feeding in all pregnant women, new mothers and their children
What are the benefits of breastfeeding?
Reduction in breast and ovarian cancer and DM2 for mother
*fewer ear infections, atopic dermatitis, lower respiratory tract infections
*Less likely to have chronic conditions
What are the different type of primary care interventions for breastfeeding?
*promoting benefits
*providing practical advice
*direct support on how to breast feed
*providing psychological support
What is professional support for breast feeding?
1 on 1 counseling provided by health professional
What is peer support for breastfeeding?
Provides 1 on 1 counseling from a layperson
What is formal education for breastfeeding?
*formalized program to convey general breast feeding knowledge
* group sessions
What is the D rating for screening with electrocardiography for CVD?
No screening for patients with resting or exercise electrocardiography for the prevention of CVD events in asymptomatic adults at low risk
What is the first line for screening for CVD?
Framingham risk score
What is the Framingham risk Model for CHD?
Person with a 10-year risk >20% are considered high risk
10 year risk < 10% considered to be low risk
10-20% are considered intermediate risk
What are the lifestyle modification and medication for asymptomatic adults who are at an increased risk for CVD??
*lipid-lowering medications
*ASA
*HTN management
*Tobacco cessation
What is an ankle brachial index?
Ratio of systolic blood pressure at the ankle to the systolic at the brachial artery
*value less than 0.9 indicated PAD
What is high sensitivity C-reactive protein?
Serum protein involved in inflammatory and immune responses
*greater than 2-3mg/L signifies increased CVD risk
What is coronary artery calcium (CAC) score?
Obtained by electron beam or CT and measures the calcium content in coronary arteries
What is the D rating for screening carotid artery stenosis?
Do Not Screen asymptomatic general adults
What wold be used to screen for carotid artery stenosis?
An ultra sound
*angiography is confirmatory test
What happens to a person with celiac disease when they eat gluten?
*there will be an immune-mediated inflammatory damage to the small intestine
*multi system autoimmune disorder
What is the screening test for celiac disease?
Tissue transglutaminase (tTG) test
*followed by endoscopic exam and biopsy of duodenum for histologies confirmation
What is the A recommendation for screening for cervical cancer?
Screen with cytology (pap smear) alone EVERY 3 YEARS for women 21-29
Women 30-65
*or every 5 with high risk human papillomavirus testing (hrHPV) alone
*or Cotesting with hrHPV and cytology
When should you not screen a woman for cervical cancer?
*younger than 21
*older than 65
*hysterectomy with removal of cervix
What are the risk factors for cervical cancer?
HPV infection
HIV infection
Immunocompromised
What is the purpose of cervical cancer screening?
To identify high grade precancerous cervical lesions prevent development of cervical cancer
*high-grade lesions treated with ablation or excision
Is it beneficial if primary care intervenes with child maltreatment?
No
What is the definition of maltreatment?
Any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child
What is the definition of child abuse?
Acts of commission, includes physical,s equal, and psychological abuse
What is the definition of child neglect
acts of omission, include the failure to provide for a child’s basic physical, emotional, health care, or educational needs or to protect a child from harm or potential harm
What age group is most vulnerable to child maltreatments?
Younger than 4 years old, having special health care needs, female sex, and past history of maltreatment
What are the factors of underreporting child maltreatment?
Missed diagnosis of intentional child injury
Fear of alienating caregivers
Stigma related to cops involvement
What is a B rating for screening for Chalmydia and Gonrrhea?
Screen for both if sexually active age 24 years and younger or in older women who are at increased risk for infection
*men insufficient evidence
What are the commonly reported STI in US
Gonorrhea and Chlamydia
*chlamydia is more prevalent
*most infections are symptomatic
What is the strongest risk assessment for screening for chlamydia and gonorrhea?
AGE
If someone has GC what are the next steps in contacting their sexual partners?
*all sex partners of infected patient preceding 60 days be evaluated, tested, and treated
*infected patient must abstain from sexual intercourse, until they and sex partners COMPLETED TREATMENT and no longer have SYMPTOMS
What happens if the partner of the infected patient does not have a PCP?
Can be given a prescription
What should a PA do if the there is a high chance of reinfection of GC?
Retest all patients and diagnosed with GC 3 months after treatment
What is the diagnostic test for COPD?
Spirometry
*all current smokers should be offered counseling and pharmacological therapy
What is the definition of dementia or majorneurocognitive disorder?
Significant decline in 1 or more domains that interferes with a persons independence in ADLs
What is the definition of mild cognitive impairment
Impairment is not severe enough to interfere with instrumental ADLs
What are the screening tests for cognitive impairment
mini-mental state examination
*patient performs tasks assessing cognitive domains
memory, attention, language, Visio spatial, or executive functioning
What is the A rating for colorectal cancer?
45-75
What are the screening test for colorectal cancer? Part one
High-sensitivity guanaco fecal occult blood test (FOBT) OR
Fecal immunochemical test (FIT)
*test for occult blood in the stool
Stool DNA-FIT every 1 to 3 years
CT Scan computed tomography colonography every 5 years
What are the screening test for colorectal cancer part two?
Flexible sigmoidoscopy every 5 years
flexible sigmoidoscopy every 10 years +annual FIT
Colonoscopy screening every 10 years
What happens if someone has a FH of colorectal cancer?
They need to be screened earlier
*there is a high lifetime risk of CRC
*10 years before the youngest age of first diagnosis
What is lynch syndrome?
Inherited disorder that increases the risk of many types of cancer
What is FIT-DNA testing?
Fecal immunochemical test combined with altered DNA biomarkers in cells shed in the stool to identify CRC
What is the most important risk factor for colorectal cancer?
Old age
Male sex
AA race
What are the most common chronic disease in children in the US
Dental caries
When should a child began oral fluoride/varnish supplementation?
At age 6 months (B rating)
Age of primary tooth eruption (B rating)
What are the commonly used screening instruments for depression in adults?
-Patient health questionnaire
-Hospital anxiety and depression scales in adults
-geriatric depression scale in older adults
-Edinburgh postanatal depression scale in pregnant and post parturition multiple screening tests
What happens if there is a positive while screening for depression?
Needs to be a full diagnostic interview
What are treatments for adults with depression?
Antidepressant medications and psychotherapy
What are the two most common screening instruments for children and adolescents with depression?
Patient health questionnaire for adolescents
Beck Depression inventory
What are the screening test for elevated blood lead levels in children and pregnant women?
Capillary blood testing
*confirmatory test in venous blood testing
What does the CDC define as elevated blood levels?
5 micrograms/dL or greater
*lead gasoline, lead paint, contaminated water from lead plumbing (sources of lead exposure)
What are the risk factor assessment for elevated blood lead levels?
Living in older homes with cracked or peeling lead based paint
-use of pottery with lead paint glazed
-industrial exposure
Does vitamin D supplementation have any benefit in preventing falls?
No
What is the preventive medication to prevent neural tube defects?
Folic acid
*women planning or capable of pregnancy should take 0.4-0.8mg
*A major defect of the brain and spine can occur
What is anencephaly
Underdeveloped brain and an incomplete skull and spina bifida
When should a woman start taking folic acid?
At least one month before conception
*continue through first 2-3 months of pregnancy
What are the screening tests for genital herpes?
PCR
Antibody based tests
Viral culture
*western blot is god standard
What is the b rating for screening gestational diabetes?
Screen in asymptomatic pregnant women after 24 weeks
What is the screening test for gestational diabetes?
50g glucose challenge test
*between 24-28 weeks in NON-fasting state
*level checked within one hour (130-140 need oral glucose tolerance test)
What is the fasting screening test for gestational diabetes?
Oral glucose tolerance test
*levels checked at 1,2, and 3 hours
*diagnosis is made when 2 or more glucose levels meet or exceed the specified glucose thresholds
What are the 1,2,3 hours marks of the OGTT
Fasting: 105mg/dl
1: 190
2: 165
3: 145
