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Part 2 Exam > Healthcare Maintenance > Flashcards

Healthcare Maintenance Flashcards

1
Q

Primary Preventive Medicine

A

remove or reduce disease risk factors

ex) immunizations, smoking cessation, “sitting is the new smoking”

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2
Q

Secondary Preventive Medicine

A

promote early detection or precursor of disease

ex) routine PAP, self-breast and self-testicular exams

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3
Q

Tertiary Preventive Medicine

A

limit the impact of established disease

ex) partical mastectomy

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4
Q

Osteoporosis Prevention

A

calcium and vitamin D supplements, weight-bearing exercise program, bisphosphonates

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5
Q

Physical Inactivity

HHA an CDC Recommend

A
  • adults and older adults engage in 150 minutes of moderate intensity activity per week
  • Clinicians should incorporate motivational interviewing - the “5 A’s”
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6
Q

the “5 A’s”

A
  • Ask (identify who can benefit)
  • Assess (current activity level)
  • Advise (individualize plan)
  • Assist (provide written exercise prescription and support)
  • Arrange (appropriate referral and follow up)
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7
Q

Overweight and Obesity

A
  • we have to initiate the conversation
  • we have to recognize our biases
  • decrease stress
  • metabolic syndrome
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8
Q

Metabolic Syndrome Prevalence

A

1/4 of US population

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9
Q

Metabolic Syndrome

A

3 out of 5 criteria must be met

  • waist measurement >40 men and >35 women
  • Triglyceride >150
  • HDL <40 men and <50 women
  • BP >130/85
  • FBS>100
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10
Q

Clinical Preventive Services

A
  • mammography
  • colorectal cancer
  • Pap
  • HPV
  • Serial CT
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11
Q

Mammography

A

women 50 - 74 years old

every 2 years

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12
Q

Colorectal cancer

A

50 to 74 years old
gFOBT, FIT, FIT-DNA - annually
Flexible sigmoidoscopy - every 5 years
Colonoscopy - every 10 years

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13
Q

PAP

A

21 to 65 years old

every 3 years

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14
Q

HPV

A

30 to 65 years old

every 5 years

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15
Q

Serial CT

A

smoking 30 YPH

55-80 years old annually

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16
Q

Blood Pressure

A
  • systolic hypertension with a widened pulse pressure (difference between systolic and diastolic)
  • diastolic pressure stops rising in 6th decade
  • older population more at risk for developing orthostatic hypotension
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17
Q

Fever

A

starts at 100.4 degrees

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18
Q

Skin/Nails

A

turgor and actinic purpura

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19
Q

Turgor

A

dehydration status

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20
Q

Actinic Purpura

A

purple patches or macule that occur due to blood leaking out through poorly supported capillaries

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21
Q

Olfactory

A

significant deficits cause food to lose taste and people eat less which increases risk of orthostatic hypotension

  • 50% of patients 65-80 years old
  • 75% of patients older than 80 years old
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22
Q

Ocular

A
  • corneal arcus
  • presbyopia
  • vitreous degeneration
  • retinal detachment
  • muscular degeneration
  • cataracts
  • glaucoma
23
Q

Corneal Arcus

A

caused by lipid deposits at the limbus

Forms a white ring around eye

24
Q

Presbyopia

A

begins around 40 years old due to inability to accommodate and focus on near, distant vision remains fairly constant
-vitreous fluid helps you see but as you age the angle changes which reduces the amount of fluid

25
Q

Vitreous Degeneration

A

opacities “floaters” develop in vitreous fluid

26
Q

Retinal Detachment

A

Photopsia (bright flashers) and floaters

27
Q

Macular Degeneration

A

centralized loss of vision

28
Q

Cataracts

A

become thicker and may yellow which causes color discrepancy

29
Q

Glaucoma

A

can occur due to the growth of the lens

  • pushing iris forward causing narrow-angle glaucoma
  • increased intra-ocular pressure
30
Q

Hearing

A

sensory or conductive loss

31
Q

Sensory loss

A

presbycusis - age related hearing loss occurs around 50 years old
-most common cause of sensorineural hearing loss

32
Q

Early stages of prebycusis

A

high frequency hearing loss

33
Q

Presbycusis - gradually

A

sounds in the middle and lower rangs

34
Q

Prebycusis - progressions

A

loss of all frequencies

35
Q

Conductive loss

A

cerumen impaction

36
Q

thoracic

A

lung mass declines with predisposes risk of atelectasis and pneumonia

37
Q

Systolic bruits

A

middle upper portion of carotid arteries indicate possible partial arterial obstructions from atherosclerosis

38
Q

Cardiac output

A

HR decreases = stroke volume increases = maintain CO

39
Q

extra heart sounds

A

S3 and S4

40
Q

S3

A

physiologically a 3rd heart sound is common in children and young adults
-If S3 heard in adult >40 years old indicative of heart failure

41
Q

S4

A

possibly due to decreased ventricular compliance

42
Q

Aortic sclerosis

A

thickening at base of cups with fibrous tissue and calcification
-causes a BRISK carotid upstroke

43
Q

Aortic stenosis

A

valve leaflets are calcified and immobile resulting in obstruction
-causes a DELAYED carotid upstroke

44
Q

Aortic sclerosis and stenosis

A

both carry increased rick of CV morbidity and mortality

45
Q

Mitral regurgitation (MR)

A

systolic murmur that occur about 10 years later than aortic sclerosis

46
Q

Musculoskeletal

A

loss of height is significant with age, mostly due to thinning of intervertebral discs and vertebral bodies shortening or collapsing from osteoporosis
-this causes kyphosis and increased anteroposterior diameter of chest (barrel chested) which then caused shortness of breath

47
Q

Brain atrophy

A

usually begins to occur after 60 years old

-often accompanied by an inflammatory response

48
Q

Mental changes

A

benign forgetfulness and functional impairment

49
Q

Benign forgetfulness

A

names of people or objects, details of specific events

-usually due to stress, assure patients this is not Alzheimer’s

50
Q

Functional impairment

A

retrieve and process data slower

-more susceptible to delirium due to infection or mediations

51
Q

Benign tremor

A
  • faster
  • disappears
  • no muscle rigidity
52
Q

Parkinson’s disease

A
  • slower
  • present at rest
  • muscle rigidity
53
Q

Approaching the older patients

A

geriatric conditions/syndromes

  • cognitive impairment
  • falls/dizziness
  • depression
  • urinary incontinence
  • functional impairment

Part 2 Exam (7 decks)

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