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Step III
Step III - FP/Prevention 1
Question | Answer |
---|---|
Who needs vaccination against Influenza | COPD, CHF, healthcare workers, dialysis pts, steroid use, everyone >= 50 yo |
What screening test lowers breast cancer mortality the most | Mammogram |
When should women start screening for breast cancer and how often | 50-74 q2yrs |
When should women start getting pap smears | At 21 yo or within 3 yrs of sexual activity whichever comes first |
How often should pap smears be performed | At least q3yrs until age 65 when it can be stopped |
Pt is 65 yo and not had prior screening with pap smear. What do you do next | Tell her to get her pap on! |
In healthy normal pts, at what age should colonoscopies be done to screen for colon cancer | 50 yo until 75yo |
How often are colonoscopies repeated if they are normal | Q 10 yrs |
If pt has FmHx of colon CA then at what age should colonoscopies be performed | 40yo or 10yrs earlier than date of family member’s dx (pick earlier one) |
What type of FmHx gives a pt the dx of HNPCC/Lynch syndrome | 3 family members with colon CA over 2 generations with 1 member having it prematurely (before age of 50) |
If pt has h/o HNPCC then when should colonoscopies be initiated and how often | @25 yo q1-2 yrs thereafter |
What is the recommendation for prostate cancer screening | There are none and actually don’t do it for men >75yo b/c side effects of tx outweigh benefits |
What types of pts require vaccx with BOTH pneumo and influenza | Chr kidney, heart, liver, lung, cancer dzs, pts w/ HIV, pts on steroids, pts w/ DM |
Influenza is different from pneumo vaccx in these pts/situations | Pts > 50yo, healthcare workers, pregnant women: q1yr |
Pneumo vaccx is different from influenza vaccx in this type of pt | single injection in all pts >65yo |
What are the recommendations for meningococcal vaccx | All kids at 11yo |
What is the exception to meningococcal vaccx at 11 yo | Earlier in kids that are high risk eg functional/anatomical asplenia or terminal complement defx |
When should HPV vaccx be given to females | 13 – 26yo |
What is the most effective method of smoking cessation for pts | Buproprion/varenicline |
When should screening for osteoporosis begin using what | Bone densitometry @ 65yo |
Who and when should be screened for AAA using what | Men who were ever smokers @ 65yo using U/S |
Who and when should be screened for HYPERlipidemia | Men @35yo; women @45yo |
flex sig colonoscopies should be done how often? | q5 yrs |
what should be done annually for colon cancer screening | FOBT/DRE |
what age group is ROUTINE colon CA screening recommended against? | 76-85yo |
should women >75 yo be screened for breast ca? | NO |
should women <50yo be screened for breast ca? | depends on pt context / benefit / harm |
what are recs for self breast exams? | rules against dr teaching pt to do BSE |
what are the recs for clinical breast exam beyonf mammo for pts >40yo? | insufficient data to say good or bad either way - pts need to be told of this information |
what is the rec for AAA screening in pts who have ever smoked? | one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in MEN aged 65 to 75 who have ever smoked (rec B) |
what is the rec for AAA screening in pts who have never smoked? | no recommendation for or against screening for AAA in MEN aged 65 to 75 who have never smoked (rec C) |
what is the rec for AAA screening in women | recommends against routine screening for AAA in women |
recs for screening prostate cancer in men > 75yo? | against screening for men >75yo |
recs for prostate screening in men <75yo? | unclear balance of risks/benefits at this time |