Young Adult Flashcards
Erikson stage for young adult
Intimacy vs Isolation
Gain independence, form intimate relationships. If not achieved will feel more isolated and not function as well in society.
3 Leading causes of death ages 20-34 per CDC
- Accidents
- Suicide
- Assault (homicide)
3 Leading causes of death ages 35-44 per CDC
- Accidents
- Malignant Neoplasms
- Heart Disease
2 screenings you should definitely do with young adults
- Alcohol Misuse (CAGE)
- ask specifics - Tobacco Use
- ask all pts.
Who should you test for gonorrhea and chlamydia?
All young women 24 and younger who are sexually active
Also, test if > 24 and at high risk
Who do you screen for Heb B and C
only high-risk individuals (not a routine screening)
Who do you test for HIV?
Get a baseline on all patients then screen at intervals based on their amt of high-risk behaviors
How often do those at high risk for HIV need to be screened?
yearly
Is it recommended to screen for syphilis on a yearly basis?
No. identify those at high risk and just screen those patients
What kind of behavior counseling do practitioners need to give to young adults?
proper diet and exercise for heart-healthy behaviors
Are there intervals to screen/ draw lipids?
Not at this time. (screen as needed and educate) identify those at high risk for cardiovascular disease
How often should you check blood pressure? BMI?
every visit
what should you do with your BP once you turn 40?
Check BP every day
What is recommended for women of childbearing age?
why?
take some sort of vitamin that has folic acid, at least 400 micrograms.
to prevent spinal cord defects
what to use to check for depression in young adults?
PHQ-2 to identify if there is a problem then they can use PHQ-9 or Beck’s Depression Inventory for more detail
What is needed to ask about intimate partner violence?
Do you feel safe at home?
Know local resources and referrals
Causes of anal cancer in males (avg age is 50)
HPV,
Immunodeficiency,
Smoking
what is natal sex?
sex assigned at birth
gender assigned according to genitals
birth-assigned sex
USPSTF rating for anal cancer screening
I
At-risk groups for anal cancer
HIB
MSM w/out HIV
pts with hx of receptive anal intercourse
Female screening NOT diagnostic test
Pap Smear
the goal is to detect high grade squamous intraepithelial lesions (HSIL)
Pap Smear
Usually benign lesion with high regression rate, particularly in adolescents and young adults
Low-Grade SIL (LSIL) found on pap smear
ectocervical sample collected with a spatula and endocervical sample collected with a brush
both applied to one slide with immediate fixation
- not done much anymore
Conventional Slide Pap
SurePath or ThinPrep
Increased detection of cervical disease, reflex HPV testing, STD testing,
+ more expensive and not equally available
liquid based cytology pap
may use spatula and brush OR broom; then vigorously move sampling device in liquid; may place broom into the liquid of SurePath
liquid-based cytology pap
for HPV testing if over 30 and both are negative screening can be extended to every_____
can be added as reflex testing in women < 30 years
5 years
USPSTF level of recommendation for women 21-65 pap smear and women 30-65 in combo with HPV testing
A
How often does the USPSTF recommend women aged 21-65 get screened for cervical cancer with cytology (pap)
every 3 years
USPSTF recommendation for HPV testing women < 30 yrs.
D
USPSTF recommendation for cervical cancer testing women < 21 yrs.
D
USPSTF recommendation for cervical cancer screening in comen > 65 who have ad adequate prior screenings
D
USPSTF recommendation for cervical cancer screening in women who have had a hysterectomy
D
According to USPSTF would you continue doing pap smears on women who had a hysterectomy and still has a cervix
yes
At what age should you start cervical cancer screening?
21
What populations might need more frequent screenings
HIV infection
immunocompromised
exposure to diethylstilbestrol in utero
previous cancer tx for CIN 2, CIN 3, or cancer
do women < 21 years of age need an internal pelvic exam?
No
magnified illumination used to assess colposcopic features that determine the presence of normal or abnormal findings; biopsies can be taken and HPV tests done
Colposcopy
used for further testing after an abnormal pap smear. requires specific training/ tools
Colposcopy
What is recommended for women with + ASC-US pap smear result
reflex HPV testing (add on if test comes back abnormal)
What is recommended for women with HPV positive ASC-US * (atypical squamous cells of abnormal significance)
colposcopy
What is recommended for women LSIL (low grade squamous intra-epithelial lesion) (w/ either no HPV result or + HPV)
colposcopy
What is recommended for women with CIN 2, CIN 3, CIn 2/3
excision, ablation may be used unless young or pregnant
what to do if pap comes back w/ unsatisfactory results
what if this keeps happening?
repeat cytology in 2-4 months
if keeps happening recommend a colposcopy
What to do if a pt aged 21-29 pap test comes back normal but there wasn’t any endocervical transformation zone noted?
This is normal for that age because hpV is normally found in the transformation zone … coontine routine screening in 3 years
What to do if the female pt is > 30 years and HPV was negative?
continue with regular screening
What to do if the HPV status is unknown from the pap smear in pt > 30 yrs?
Repeat cytology in 3 years instead of the 5
In what pts is it most likely that on a pap there is no lesion or malignancy but the endocervical transformation zone is absent?
Why?
post-menopausal
the endocervical component gets pulled up into the Os
