USPSTF III Flashcards
Should you screen adults without vision symptoms for primary open-angle glaucoma who are seen in primary care?
NO (insufficient evidence)
What are the risk factors for open-angle glaucoma?
Increased intraocular pressure
Older age
FH of glaucoma
AA race
What is the leading cause of impaired vision and blindness?
Glaucoma
What is the definition of a pelvic exam?
Assessment of external genitalia, internal speculum exam, biannual Palpation, and rectovaginal exam
What is the definition of a Pap smear?
Screening test performed during the pelvic exam for specifically evaluating for cervical cancer
What is the B rating when offering behavioral counseling for adults with CV risk factors?
Offer or refer adults who are overweight or obese AND have CV risk factors to behavioral counseling to promote healthy diet and physical activity
Is it necessary to screen asymptomatic adults aged 50 years or older for hearing loss?
NO
What is the definition of presbycusis?
A gradual, progressive decline in the ability to perceive high-frequency tones
*due to degeneration of hair cells in the ear
What is the best intervention to improve hearing?
Hearing aids
What are hearing loss screening tests?
Whispered voice test
Finger rub test
Watch tick test
single-item screening
Handheld audiometer
What is the A rating for screening for hepatitis B?
Screen for Hep B virus in all pregnant women at first prenatal visit
*screen each pregnancy
What is the Hep B screening test?
Hepatitis B surface antigen (HBsAG)
What are the proper ways to administer a Hep B vaccine/Immune globin to pregnant women and infants
*Give Hep B vaccine AND hep B immune globin to HBV-exposed infants within 12 hours
What happens if you don’t know the mothers Hep b status?
*Infants should receive Hep B vaccine within 12 hours of birth
*followed by hepatitis B immune globulin if mom is positive
*within 7 days of birth
Should you screen asymptomatic, non-pregnant adolescents and adults at high risk for infection?
Yes (B)
What are some risk factors of Hep B virus?
*Person born in countries and regions with high % of HBV infection
*HIV-Positive person
*injection drug users
How many doses of Hep B are there?
3 doses
What is the B rating for screening Hepatitis C?
Screen for HCV infection in all asymptomatic adults 18-79 without known liver disease
What age group has seen the most rapid increase of Hep C?
Young adults 20-39 who inject drugs
Are pregnant women screened for Hep C?
YES, all pregnant women should be screened for HCV during each pregnancy
*screening is voluntary
What are some risk factors of hepatitis C?
Past or current drug use (Most important)
Blood transfusion before 1992
Long term hemodialysis
Being born to CV infected mother
What is the screening test for hep C?
Anti-HCV antibody
*if + get quantitative viral load (polymerase chain reaction testing for HCS RNA)
What is the treatment for Hep C?
Oral direct-acting antiviral regimens without interferon have been accepted as standard treatment for chronic HCV
*Therapy is not considered during pregnancy
What are the screening protocols for high blood pressure in adults older than 40?
Adults aged> 40 and persons at increased risk for high blood pressure should be screened annually
What are the screening protocols for high blood pressure in adults 18-39?
If they have normal blood pressure and NO other risk factors should be rescreened every 3 to 5 years
If you have an adults with HTN what shod they be screened for next?
Diabetes
What happens if the lifestyle modification do not work when trying to lower HTN
Medications is the next step
Should we be prescribing postmenopausal women with hormone therapy as the PRimary Prevention to prevent chronic conditions?
NO
What is menopause? And the criteria to define it?
-Permanent cessation of a woman’s menstrual cycle
*12 months after a woman’s final menstrual period
*Expected to live another 30 years
What are some harms of estrogen and progesterone/
-increased risk of invasive breast cancer and venous thromboembolism
- small to moderate harm of increased risk of coronary heart disease
What are some harms of estrogen?
Moderate harms of i creed risk of stroke, dementia, gallbladder disease, urinary incontinence, and venous thromboembolism
What are some A rating for screening for HIV?
Screen adolescents and adults aged 15-65
Screen Younger adolescents and older adults at increased risk for infection
Screen pregnant women
How often should you screen men who have sex with men for HIV?
Every 3-6 months
What is the screening test for HIV?
Antigen/antibody immunoassay
Rapid antigen tests
* if + then western Blot test
Should we screen asymptomatic adults age 65 and older for visual acuity?
No (I rating )
What is the screening test for visual acuity?
Snellen chart
What are the two most common types of visual impairment
Cataracts and macular degeneration
what is the common sign of a cataract?
White globe over the eye
What is the B rating for screening women for IPV?
Screen women for IPV and provide or refer women who screen positive to intervention services
What is the definition of IPV
The physical, sexual, psychological aggression, or stalking by a romantic or sexual partner
What are some health consequences of IPV?
-Injury or death
-Mental health conditions
-STD
-Chronic pain
-Unintended pregnancy
What are risk factors of IPV in elders?
Isolation
Lack of social support
Lack of functional impairment
Poor physical health
Lower income
What are some screening tools for IPV?
)Hurt, insult, threaten, scream (HITS)
Extended-hurt, insult, threaten, scream (E-HITS)
Humiliation, afraid, rape, kick (HARK)
* try to separate partners during screening
What is the I rating for screening for iron deficiency anemia in pregnant women?
Insufficient evidence to support screening asymptomatic pregnant women and adolescents for iron deficiency anemia to prevent adverse maternal health
What is the screening test for iron deficiency?
Serum hemoglobin and hematocrit
What are some factors associated with an increase risk of IDA in young children?
-prematurity
-low birth weight
-use of non-iron fortified formula
-introduction of cows milk in the first year of life
What is the B rating for screening for later tuberculosis infection?
Screen for latent tuberculosis infection in asymptomatic adults at increased risk for infection
What is the bacteria that causes tuberculosis?
Mycobacterium tuberculosis
Who are at risk populations for TB?
-person born in, or are former residents of countries with increased TB prevalence
-person who live in, or lived, in a high risk congregate settings
What are the screening tests for TB?
Mantoux tuberculin skin test (TST) (PPD)
*Positive test confirmed by chest x-ray
Quantiferon Gold (IGRA)
What screening test is used for lipid disorders?
Fasting or non-fasting total cholesterol
What does the AAP recommend for screening lipids disorders in children?
Screen all children 2-18
*total cholesterol <170 is normal
*170-199 is borderline
*>200 is elevated
When does the AAP and National Health Institute recommend screening for lipid disorders?
Universal screening at ages 9-11 and 17-21
At what ages should at risk population for cholesterol be screened/
2,4,6,8,10
*screen negative retested in 3-5 years
When does low-dose aspirin be used to prevent preeclampsia?
Used after 12 weeks of gestation in women who are at high risk (B)
How many risk factors do you need to be categorized as high risk of preeclampsia/
Have one or more
*Chronic hypertension
*type 1 or 2 diabetes
* renal disease
*autoimmune disease
What are the b rating for screening for lung cancer?
*Annual screening with low-dose computed tomography (LDCT) in asymptomatic adults aged 50-80 years who have a 30 pack-year smoking history AND currently smoke
*Annual screening with (LDCT) in asymptomatic adults age 50-80 who have quit within the past 15 years
What are pack years?
(Packs smoked per day) X (years as smoker)
EX (.5) X (6)=3 pack hx
What is the treatment for lung cancer when caught early?
Treated with surgical resection and chemo
What is the B rating for screening for obesity in children?
Screen children aged 6 and older for obesity and offer intensive behavioral interevention
What are the screening tests for obesity?
BMI
What percentiles are overweight and obesity?
Overweight: >85th-94th
Obesity: >95th
What are the risk factors of sleep apnea?
-Male
-older age
-postemenopausal
-higher BMI
-Craniofacial and upper airway abnormatilites
What are most oral cancers classified as?
-90% squamous cell carcinoma
What are the screening tests for oral cancer?
-Inspection and Palpation
*tissue biopsy to confirm diagnosis
What is the B rating to screen for osteoporosis to prevent fractureS?
Screen for osteoporosis in women 65 years or older with bone measurement testing to prevent osteroporotic fractures
Screen for osteoporosis in postmenopausal women younger than 65 who are at increased risk for osteoporosis determine by HCP
Is there any evidence to screen men for osteoporosis?
Nope
What are the screening tools for osteoporosis?
Simple calculated osteoporosis risk estimation (SCORE)
Osteoporosis index of risk (OSIRIS)
Fracture risk assessment (FRAX)
If a person uses FRAX and there score comes back as 9.3% or higher what should happen next?
They should be scanned for osteoporosis
*FRAX estimate the 10 year probability of hip fracture
Should we screen women for ovarian cancer if they do not have a genetic mutation?
No
What are the common screening tests for ovarian cancer?
Transvaginal ultrasound and serum tumor marker cancer antigen (CA-1250
Is there any accuracy of imaging based screening test for pancreatic cancer?
No evidence
*CT scans, MRI, etc
What are the recommendations for pancreatic cancer prevention?
Stopping tobacco, moderate alcohol intake, and eat balanced diet to help in prevention
What is perinatal depression?
Occurrence of a depressive disorder during pregnancy or following childbirth
*increase risk of suicide, suicidal ideation, harming infants, disengagement
What are the baby blues?
Transient mood disturbance
*crying, irritability, fatigue, and anxiety
What groups should counseling be offered to with perinatal depression?
History of depression
Current depressive symptoms
Low income
Adolescent parenthood
What is cognitive behavioral counseling?
Concept that positive changes in mood and behavior can be achieved by addressing and managing negative thought belief and attitudes
What is interpersonal therapy?
Focuses on treating interpersonal issues thought to contribute to the developmental or maintenance of psychological disorders
What is peripheral artery disease?
PAD is a manifest ion of atherosclerosis that involves the lower limbs
What are some symptoms of PAD?
Intermittent claudication
*resulting in calf pain over time becoming more severe
* shiny and hairless lower legs, blotchy foot skin that may get sores
What are the screening tests for PAD?
Magnetic resonance angiography (MRA) or CTA
What are the screening tests for preeclampsia?
BP measurement at every visit
*confirmed with repeat measurement (>140/90)
*Treatment is baby aspirin 81mg ASA after 12 weeks
When should Preexposure prophylaxis PrEP be given out?
To person not infected with HIV and at high risk
Who should be considered for PrEP?
Men who have sex with men
Heterosexually active women and men
Persons who inject drugs
What reduces the risk of HIV-1 infection from sex?
HIV-1 pre-exposure prophylaxis (PrEP)
What lab work needs to be completed before PrEP can be taken?
HIV testing
Kidney function
Serologic testing for hep B and C
Testing for other STI
Pregnancy
Are there any medication for tobacco cessation in children and adolescents?
No
*No FDA approved medication
Is a digital rectal exam recommended to screen for prostate cancer?
NO
What can cause elevated Prostate-specific antigens?
An enlarged prostate or inflammation in addition to prostate cancer
What is the A rating when screening for Rh(D) incompatibility
Rh(D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care
What is the B rating for Rh (D) incompatibility?
If initial is negative, repeat screen at 28 weeks, unless the biological father is known to be Rh (D) negative
