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74 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Describe the 3 levels of Prevention: Primary, Secondary, Tertiary
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Primary- preventing disease-Exercise, nutrition, immunization, water fluoridation, pollution control
Secondary-Aimed at detecting disease early or in pre-clinical states to minimize impact (screening)-BP screening, Mammography, cholesterol screening, DDST Tertiary-treatment-Decreasing negative disease outcomes- Cardiac or stoke rehab, avoiding further target organ damage, managing hypertension, diabetes |
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What is normal range for BMI?
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19-25
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What are some age specific consideration for life span assessment for pediatric, adult, geriatrics, and disabled individuals?
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Pediatric=Anticipatory guidance, safety, daycare & school
Adult=Work issues, family & child commitments and stress, “sandwich generation”, disease risk factors Women - pregnancy, childcare, menstrual cycle Elderly=Home environment, physical changes with aging, cognitive alterations, ability to drive Disabled=Access to care, health insurance, ability to manage and understand, and participate in own care |
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When teaching, how often and how long should one excercise? How many pounds a week should a person aim to lose?
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30 minutes most day of the week.
1/2-2 pounds per week. Losing 10 pounds can positively impact health. |
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When teaching about BP control and diet. What are the dash recommendations?
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Exercise
Diet- 1teaspoon of Na per day; High fiber diet; and increase K intake |
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What are some risk factors for melanoma?
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-Intermittent and intense sun exposure
-Blistering sunburns -Family history -Lighter skin -Presence of atypical moles -> 50 moles -Immunosuppression |
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What are some protective measures one can take to prevent melanoma?
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Avoid unnecessary sun exposure
Use sunscreen of at least SPF of 15 -Inspect the skin -Clinician screening at least every 3 years for 20 to 39 y.o. -40 y.o. and older – annual |
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What are some characteristics of a melanoma?
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A – asymmetry
B – irregular borders C - color variation D – diameter > 6mm E - elevation |
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What is the difference between basal cell and squamous cell CA?
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Basal cell CA - Ulcerated nodules with translucent or pearly surfaces
Squamous cell CA – roughened patches of skin with erythema |
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How often should a person test their vision?
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Every 2 years
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What test screens for glaucoma and what are some risk factors?
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Eye exam with tonometry >50 y.o.
Age over 65 y.o African American Diabetes Myopia Family history Ocular hypertension |
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What are the differences in the fundus and vision in glaucoma and cataracts?
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Glaucoma-History of decreased peripheral vision. Fundoscopic exam - change in size and color of the optic disc
Cataracts – History of dimming of vision, dulling of colors. Fundoscopic exam - clouding of lens |
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What are some findings from an eye exam from a person that has macular degeneration?
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History of change in central vision, blurring
Fundoscopic exam – mottling of macula, variations in retinal pigmentation, subretinal hemorrhage or exudate |
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What is presbycusis?
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Hearing loss.
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What are some risk factors for children in regards to hearing loss?
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Ear infections
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What test do you do when screening for hearing?
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The whisper test
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When should a child get his/her first dental exam?
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At age 3
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What are some oral cancer risks?
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Tobacco use
Excessive ETOH use |
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What is the leading cause of death in men and women?
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Hyperlipidemia
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When should kids and adults be screened and what are the normal values of a lipid profile?
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Kids
screen as early as 2 if Grandparent with premature CV disease and child with risk factors or concerns Adults Lipid profile in all adults aged 20 or older q 5 years Optimum levels LDL <100 Total Cholesterol < 200 HDL > 45 for women > 55 for men Triglyceride < 150 |
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What are breast cancer risk factors?
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Age > 50 y.o.
Family history first degree relative (mom, sister) Menstrual History and Pregnancy Early menarche <12 y.o. Delayed menopause > 55y.o. First live birth after 35 y.o. or no pregnancy Breast Conditions and Diseases Benign breast disease with biopsy of atypical hyperplasia or lobular CA in situ |
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What screening test are done for breast cancer and when should they be done?
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BSE at age 20
Clinical breast exam (CBE) 20 – 39 - q 3 years Annually after age 40 Mammography 40 y.o – q 2 years > 50 y.o – q 1 year High risk patients may screen at 30 |
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What screening is done for alcohol abuse?
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CAGE questionnaire for alcohol abuse
Cut down Angry Guilty Eye Opener |
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Describe Hepatitis A characteristics?
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Fecal-oral shedding
Vaccine for travelers to endemic areas, food handlers, military, caretakers for children, Native American and Alaskan American, selected healthe care, sanitation, lab workers Vaccine for homosexual contacts, IV drug users |
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Describe Hepatitis B characteristics?
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Contact with infected body fluids
High risk – injection drug users and sex workers Vaccine for all in US Kids at birth School students required Catch-up for all adults |
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What are risks factors for colon CA?
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Second highest cancer in prevalence and mortality
Risk Personal history of ulcerative colitis, adenomatous polyps Prior history of endometrial, ovarian, breast CA FH of colonic polyps, colorectal CA, adenoma in first degree relative |
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Name screening test and frequency for screening colon CA?
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Yearly after age 50 or
Yearly after age 40 if (+) FH of colon CA in first degree relative, IBS, familial polyposis FOBT – annually - many false positives Colonoscopy q 10 years - q 3-5 years if polyps found or Sigmoidoscopy – benefits linked to depth of sigmoidoscope insertion – uncomfortable, test q 3 to 5 years or Air contrast barium – q 3 – 5 years |
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When should a male get testicular exams done?
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Monthly for ages 15 to 35
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Name screening test and frequency for screening prostate CA?
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DRE – reaches posterior and lateral surfaces of prostate
Annual exam between ages 40 to 50 until 75 PSA testing - Controversy about screening All men > 50 y.o. African Americans and men with (+) FH at 40 y.o. Symptomatic with incomplete emptying, frequency, urgency, weak or intermittent stream of straining, hematuria, nocturia, pains in pelvis |
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new (as in "what are the lastest NEWS")
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خبر
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اخبار
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What are some risk factors for Papanicolau (PAP) screening?
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Risk Factors
early onset of sexual activity, multiple partners, infection with HPV or HIV, limited access to regular care |
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What are some risk factors for PVD?
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Risk Factors
Tobacco, diabetes, HTN, hyperlipidemia, CV or cerebrovascular dx History C/o claudication, aching, cramping, numbness, fatigue in legs Skin color changes |
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When should a person get a DEXA scan? Dual energy X-ray absorptiometry (DXA, previously DEXA) is a means of measuring bone mineral density (BMD).
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DEXA scan after age 50 for high risk
White & Asian, slender, bilateral oopherectomy before menopause, FH, fracture After 65 yo all others |
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Talk about screening for suicide.
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Screen for suicide
Ask about plan or note Risk Men > 65 y.o., increasing in teens and young adults History of psychiatric illness, substance abuse, personality disorder, prior attempt, abusive relationships, FH Ask about firearms, screen for ETOH & substance dependence DON’T FORGET YOUNG CHILDREN AND ELDERLY |
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How many adults get Alzheimer’s disease?
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Alzheimer’s disease (50 – 85%)
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What preventive measure can a person take to decrease chance of CVA?
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Control HTN
Stop smoking Moderate ETOH intake Weight control Exercise Stop drug abuse |
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What are sign of a TIA?
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TIA – get to ER
Visual loss (transient monocular blindness) Aphasia, dysarthria, change in facial movement or sensaton Clumsiness, weakness, paralysis, tingling or paresthesias of arm, leg, hemibody |
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What does the acronym SOAP(IE) stand for?
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Identify normal findings (to rule out)
Identify abnormal findings (to rule in) (Subjective findings) - From history (Objective findings) - From physical exam (Objective findings) - From tests obtained (A)ssessment naming the Problem(s) - Diagnosis (P)lan - Manage the problem (I) Implement your management (E) Evaluate how your diagnosis and plan worked |
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What is the difference reliability and validity?
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Reliability – indicates how well repeated measurements of the same relatively stable phenomenon will give the same result, also known as precision
Validity – indicates how closely a given observation agrees with the ‘true state of affairs” or the best possible measure of reality |
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Explain sensitivity.
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Identifies the proportion of people who test positive in a group of people known to have the disease or condition
False negative – when the observation or test is negative in persons who have the disease Good observations or tests have a sensitivity of more than 90% Help rule out disease because there are few false negatives |
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Explain specificity.
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Identifies the proportion of people who test negative in a group of people known to be without a given disease or condition
False positive – positive in persons without the disease Good observations or tests have a specificity of more than 90% help “rule in” disease because the test is rarely positive when disease is absent |
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What side of the patient should an examiner staff?
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Correct examining position-patient’s right side
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Overweight and obesity are risks factors for
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Diabetes, heart disease, stroke, HTN, osteoarthritis, sleep apnea.
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What are the functions of the skin?
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1st line of protection from infection
conservation of fluids temperature regulation excretion secretion sensation identity appearance |
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What are primary lesions? Name some examples.
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Lesion that is the first change occurring n the skin because of disease.
Macule Patch Papule Nodule Tumor Plaque Wheal Vesicle Pustule Bulla |
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What is a macule?
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Circumscribed, flat, non-palpable change in skin color
Hypopigmented hyperpigmented Small flat spot up to 1.0 cm- freckle or petechia |
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What is a patch?
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Flat spot 1.0 cm or larger
Port wine stain |
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What is a papule?
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Palpable elevated solid masses- dermis or epidermis
Up to 1.0 cm- elevated nevus Comment on shape Multiple papules- discrete or coalesce? |
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What is plaque?
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Elevated superficial lesion 1.0 cm or larger
Surface area is greater than elevation Often coalescence of papules Smooth or scaly? Combination of scaly papules and plaques= papulosquamous (psoriasis, pityriasis, fungus) |
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What is a nodule?
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Circumscribed elevated lesion-depth as well as elevation
Marble-like lesion larger than 0.5 cm Often deeper and firmer than papule |
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What is a wheal?
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Somewhat irregular, relatively transient, superficial area of localized edema
Secondary to histamine- extravasation of fluid from cutaneous blood vessels and vasodilation Mosquito bite, hives (urticaria) |
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What is a vesicle?
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Circumscribed superficial elevations of skin formed by free fluid in skin layers
Up to 1.0 cm Serous fluid- herpes simplex |
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What is a bulla?
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1.0 cm or larger
Filled with serous fluid Partial thickness burn |
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What is a pustule?
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Filled with pus
Impetigo acne |
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What is a secondary lesion?
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Arise from primary lesions
Arise from secondary factors- scratching |
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Types of secondary lesions?
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Scales
Crust Fissure Erosion Ulcer Scar Keloid Atrophy Lichenification Excoriation |
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What is an erosion?
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Circumscribed loss of the superficial epidermal layer
Moist, does not bleed After chicken pox vesicle erupts |
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What is crust?
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Results from accumulation of dried exudates or transudates on the skin
Seen on any oozing eruption- impetigo Serum, pus, blood |
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What is an ulcer?
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Deeper area of loss of tissue that extends into the dermis, to subcutaneous tissue or deeper- syphilis chancre, decubitus ulcer
Describe shape, size, depth, edges |
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What is a scale?
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Results from accumulation of desquamating skin; thin flake of epidermis
Hyperproliferation of the epidermis Describe type of scaling- coarse, fine, whie, yellow, silvery, greasy, adherent |
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What is a fissure?
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Linear crack in the skin
Hands and feet |
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What is basal cell carinoma?
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Comprises 80% of skin cancers
Shiny and translucent, they grow slowly and rarely metastasize |
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What is squamous cell carinoma?
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Comprises 16% of skin cancers
Crusted, scaly, and ulcerated, they can metastasize |
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What is a melanoma?
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Comprises 4% of skin cancers
Rapidly increasing in frequency, they spread rapidly |
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Know medical and lay term for skin disorders.
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Macule Dot
Papule Little bump Nodule Big bump Plaque Rasied or thickened Vesicle Little blister Bulla Big blister Pustule Pus pocket, pimple Desquamation Scaling, flaking Crust Scabs Excoriation Scratch marks Comedomes Blackheads |
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What is the function of the external ear?
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External functions
Protective Helps gather/channel sound |
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What is the function of the middle ear?
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Middle ear functions
Ossicles transmit sound from tympanic membrane to inner ear Tympanic membrane separates middle from external ear |
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What is the function of the inner ear?
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Inner ear functions
Cochlea transmits sound to eighth CN Semicircular canals involved in vestibular function |
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When do permanent teeth appear?
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6-15 years old
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What happens in older adults ears?
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Hair cells degenerate, stapes ossify
Hearing deteriorates Striae vascularis atrophy Sensorineural hearing loss TM becomes sclerotic Conductive hearing loss Cerumen becomes dry Obstructs ear canal |
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What is the Weber's test?
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Lateralization test. Sound should be equal in both ears.
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What are some causes of an abnormal Weber's test?
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Weber Test Lateralizes to affected side
Otitis Media Perforation of ear drum Cerumen impaction Weber Test Lateralizes to unaffected side Unilateral sensorineural hearing loss |
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What is the Rhine's test?
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Test for Air vs. Bone Conduction
Normal is AC > BC Place vibrating tuning fork on mastoid bone, behind ear & level with canal |
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What is an abnormal Rhine's test?
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In conductive hearing loss sound is heard through bone as long, or longer, than through air so…..
BC = AC or BC > AC |
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