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1 USMLE Step 3 Main one > Preventive Medicine > Flashcards

Preventive Medicine Flashcards

1
Q

breast cancer screening test that lower mortality the MOST

A

mammogram

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2
Q

breast self-examination or by physician

A

-20-40 yo, q 3 yrs
->40 yo, annually
has NO proven benefit

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3
Q

breast cancer screening”mammogram”

A
  • -start age 40 or 50 (controversial)
  • stop at 74
  • annually
  • or every 1-2 years
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4
Q

cervical cancer screening: Pap smear guidelines

A
  • start at age 21
  • regardless of sexual activity
  • every 3 years
  • Pap: every year without HPV testing till age 30
  • if age greater than 30 then do a pap and HPV test q3yr

(-if 3 neg cytology tests)
(- if Pap+HPV then q yr if HPV and cytology neg)

  • until age 65
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5
Q

if Pap smear shows ASCUS

A

HPV testing

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6
Q

if ASCUS is HPV positive

A

COLPoscopy

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7
Q

colon cancer screening

A
  • start at age 50 to 75
  • colonoscopy q 10 yr
  • or Flex sig, double contrast barium enema, CT colonography q 5 yr
  • or fecal occult blood, fecal immunochemical test, annually
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8
Q

colon cancer screening if close family member had colon cancer

A
  • start at age 40, or 10 years earlier than when family member was diagnosed, whichever comes first
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9
Q

hereditary nonpolyposis colon cancer syndrome (HNPCC) definition

A
  • 3 family members
  • 2 generations
  • 1 premature (colon cancer before age 50)
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10
Q

hereditary nonpolyposis colon cancer syndrome (HNPCC) colon cancer screening

A
  • start at age 25

- every 1-2 years

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11
Q

prostate cancer screening

A

NO recommendation to do routine screening

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12
Q

influenza vaccine greatest benefit

A
  • everyone older than 50
  • pregnant women
  • health care workers
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13
Q

indications for influenza and pneumococcal vaccines

A
  • patient with chronic lung, heart, liver, kidney, and cancer conditions
  • HIV positive patients
  • patients on steroids
  • DM patients
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14
Q

influenza vaccine should be given

A

annually

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15
Q

pneumococcal vaccine should be given to

A

all patients greater than 65 yoa or 2-65 in certain circumstances

  • adults >65 yo, one time
  • ages 2-64 w chronic dz, asplenia, q 5 yr boosters
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16
Q

pneumococcal vaccine should be given

A

once (single injection)

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17
Q

meningococcal vaccination

A
  • age 11
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18
Q

children at high risk of meningitis

A
  • functional/anatomic asplenia

- terminal complement deficiency

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19
Q

HPV vaccination

A
  • ALL females between ages 13-26
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20
Q

varicella-zoster vaccination for shingles

A
  • everyone above 60 yoa
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21
Q

most effective method of achieving smoking cessation

A

oral medication = bupropion, or varenicline

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22
Q

osteoporosis screening

A
  • bone densitometry (DEXA)
  • all women >=65 yo: DEXA scan
  • > =60 yo + RF: DEXA
    osteopenia: T score -1.5 to -2.5
    osteoporosis: Tscore
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23
Q

abdominal aortic aneurysm (AAA) screening

A
  • age 65-75
  • EVER smokers
  • screen ONCE with US
    with one time abd US for an abd aortic aneurysm
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24
Q

diabetes screening

A
  • only if pt have risk of dz like HTN

- diag: 2 fasting glu >126, or random glu >200 with symp

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25
Q

HTN screening

A

ALL patients above age 18 at EVERY office visit

26
Q

hyperlipidemia screening

A
  • men greater than 35 yoa
  • women greater than 45 yoa
  • start men 35 yo, women 45 yo w/o RF
27
Q

vaccinations for HIV pt

A

influenza, hepatitis viruses, pneumococcal polysaccharide

  • no live virus vaccines except MMR, varicella, zoster (>60yo) if CD4>200 and no h/o AIDS illness
  • no BCG, anthrax, oral typhoid, intranasal influenza, oral polio, yellow fever
28
Q

Levels for therapy for hyperlipidemia

A 
risk LDL goal lifestyle change drug tx
CHD or risk equiv <100 all 130
>2 RF. <130 all 130
2 RF <130 130 160
0-1 RF. <160 160 190
risk equiv: DM, PVD, CAD, AAA
RF: men>45, women>55, HTN, smoke, HDL< 40, fam h/o premature CHD
29
Q

Vision exam in children

A
  • screen for strabismus, amblyopia, refractive errors

- child age 0-5 yo

30
Q

Rota virus vaccine

A

-given to infant between 2-8 months old

31
Q

Meningococcal vaccine

A
  • given to child 11-12 yo

- aplenic child may be given vaccine at 2 yo

32
Q

Pelvic exam

A
  • if 21-64 yo: annual or q3yr if 3 normal exams

- >65 yo, annual

33
Q

Hep B vaccine

A
  • adolescent - 18 yo

- adults at high risk

34
Q

Rubella vaccine

A
  • women child bearing age, ppl around preg women

- no preg 4 weeks after vaccine

35
Q

still birth definitionDi

A

prenatal or natal (during delivery) death after 20 wks of gestation

36
Q

MCC neonatal mortality, rate in US?

A
  • prematurity

- 6/1000 (high in blacks)

37
Q

maternal mortality causes

A

causes

  • maternal related deaths (while preg or in first 42 days after delivery/100,000 live births
  • PE, preeclampsia/eclampsia, hemorrhage
38
Q

BP screening men and women

A

at least once every two years

39
Q

colon, prostate screening

A
  • initiate 40 yo

- digital rectal exam annually

40
Q

PSA

A
  • start at 50 yo

- controversial benefit, offer annually

41
Q

Gyn pelvic exam

A
  • 21 -64 yo: annually

- –after 3 normal exams, q2-3 yr

42
Q

Endometrial cancer screening

A
  • at menopause, do endometrial biopsy

- no routine screening

43
Q

diabetes screening

A

-check blood glucose or HBA1c screening starting at 45 yo, q 3 yrs

44
Q

Top 3 causes of death in men

A

Heart disease 26.3%
Cancer 24.1 %
Unintentional injury 6.6%

45
Q

Top 3 causes of death in women

A

heart disease 25.8%
cancer 22%
stroke 6.7%

46
Q

Top cancers in men

A

Prostate, lung, colorectal

47
Q

Top cancer in women

A

Breast, lung, colorectal

48
Q

Meningicoccal vaccine

A

-recommended if some other risk factor present: military recruits, microbiologists, complement pathway deficiencies, asplenia, at risk individuals vaccinated in that past 3-5 yrs, travelers to endemic area for meningococcal disease, adolescents between 11-18 yo

49
Q

Top cancer in both sexes

A

Lung cancer

50
Q

Who gets the tetanus booster shot?

A

-recommended in second trimester of pregnancy to all women who have not received booster in the 10 yrs before the pregnancy
or
pt who have not completed the course of immunization in childhood

51
Q

breast self-examination

A

Monthly

52
Q

HTN screening

A

every 1 to 2 years

53
Q

HPV vaccine

A

11-26 one series of 3 vaccines

54
Q

Influenza vaccine

A

everyone

55
Q

Diphtheria/tetanus/pertussis vaccine

A

19-64 years one time in place of diptheria/tetanus booster

56
Q

Diphtheria/tetanus vaccine boster

A

every 10 years and after 65 once

57
Q

VZV vaccine shingles

A

once after 60

58
Q

Counselling for adults

A

FuNEy SASS. Fire arm safety, nutrition, exersise alcohol, abuse, drugs, safe sex, and seat belt,

59
Q

Counsel for kids

A

Heads assessment, no drugs

60
Q

Menopausal

A

Hormone replacement counseling, osteoporosis

1 USMLE Step 3 Main one (37 decks)

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