What are the recommendations for influenza vaccine?
Yearly starting at 6 months
What are the recommendations for DTap/Td/Tdap?
DTap at 2, 4, 6, 15-18 months and 4-6 years Tdap 11-12 years Tdap in place of Td once between 19-65 years Td booster every 10 years
What are the recommendations for the shingles vaccine?
Once at age 60+ Live attenuated vaccine so contraindicated in HIV, immunosuppressed
What are the recommendations for the pneumococcal vaccines?
At age 65, one dose of PCV13 followed by one dose of PPSV23 one year later If younger than 65 and chronic cardiac, pulmonary, liver disease, alcoholism, diabetes, smoking, PPSV23 only; one-time revaccination with PPSV23 when older than 65 if first dose given more than 5 years previously If younger than 65 and asplenic, sickle cell, immunocompromised, PCV13 and first dose of PPSV23, second dose of PPSV23 5 years later
What are USPSTF recommendations for colon cancer screening?
Screen between age 50-75 FOBT q1y Sigmoidoscopy q3y Colonoscopy q10y
What are USPSTF recommendations for breast cancer screening?
40-49: consider mammography q2y after discussing with patient 50-74: mammography q2y Sooner and more frequent screening if high risk (genetics, family history, etc.)
What are USPSTF recommendations for cervical cancer screening?
Start at age 21 or within 3 years of the onset of sexual activity (whichever comes first)
21-29: Pap q3y
30-64: Pap q3y or Pap + HPV q5y
Recommend 3 normal pap smears annually before spacing the interval
If partial hysterectomy (cervix still in place), paps q3y if five normal paps in a row
Don't need to continue paps if the women had a total hysterectomy for a non-cancerous indication
Hysterectomy for dysplasia --> q1y paps
Can stop paps at age 65 if hysterectomy, no hx of CIN2 or worse and 3 consecutive negative paps or 2 consecutive negative co-tests
What are USPSTF recommendations for lung cancer screening?
Annual low-dose CT scan if 30 pack-year smoking history and smoked within the past 15 years at age 55-79
What are USPSTF recommendations for abdominal aortic aneurysm screening?
If ever smoked, one-time abdominal ultrasound at age 65-75 (MALES ONLY)
What are USPSTF recommendations for high blood pressure screening?
Screen all adults q2y if 120/80
What are USPSTF recommendations for high blood cholesterol screening?
All males > 35 All females > 45 All adults at increased risk TC, HDL, LDL q5y
What are USPSTF recommendations for diabetes screening?
Adults with BP > 135/80 ADA recommends screening all adults > 45 and adults
What are USPSTF recommendations for depression screening?
All adults if mechanisms in place for ensuring accurate diagnosis, treatment, and follow-up
What are USPSTF recommendations for alcohol abuse screening?
What are USPSTF recommendations for tobacco use screening?
What are the recommendations for the Hepatitis B vaccine?
Birth 2 months 6 months Recommended for health-care workers, those exposed to blood products, dialysis patients, IVDU, persons with multiple sexual partners or recent STI, MSM
What are the recommendations for the Hepatitis A vaccine?
12 months, second dose given 6-18 months later Recommended for persons with chornic liver disease, who use clotting factors, who have occupational exposure, IVDU, MSM, travel to areas where hepatitis A is endemic
What are the recommendations for the meningococcal vaccine?
11-12 16 Recommended for college dormitory residents, military recruits, complement deficiencies, asplenia, travel to countries where it is endemic
Excess uric acid leading to deposition of monosodium urate crystals in joints a/w alcohol and meat consumption, thiazide diuretics Dx: joint aspiration --> needle-like with negative birefringence Tx:
Joint pain and inflammation due to calcium pyrophosphate dehydrate crystals Dx: joint aspiration --> rhomboid crystals, weakly positive birefringence
Septic arthritis vs. gout joint aspiration
Septic arthritis: 25,000-150,000 WBCs, > 90% neutrophils Gout: 2,000-60,000 WBCs,
What are USPSTF recommendations for osteoporosis screening?
DEXA in women after 65 or after 60 if at higher risk of osteoporosis-related fractures
Recommendations for HPV vaccine
All girls and women: 11-26
Boys and men: 9-21 (9-26 for MSM and HIV)
FDA-approved first line treatments for smoking cessation
Nicotine replacement therapy
Varenicline (avoid if mood disorder, CVD)
Bupropion (contraindicaated with bulimia, seizures)