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25 Cards in this Set
- Front
- Back
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Cancer screening |
Only recommended for colon, breast, & cervix Smokers --> low dose CT scan/yr |
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Colon cancer screening |
No sig family hx --> begin at age 50 Colonoscopy every 10 yrs Fecal occult blood testing every yr (if positive --> colonoscopy) Sigmoidoscopy with barium enema every 5 yrs |
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High risk colon cancer |
first degree relative dx at age <60 OR MULTIPLE first degree relatives dx at any age Screening should start at age 40 OR 10 yrs earlier than age at which youngest affected relative was dx Colonoscopy every 5 yrs |
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Breast Cancer |
50-75 years old --> Mammography every yr Self breast exam cannot be screening tool alone |
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High risk breast cancer |
Multiple first degree relatives consider prophylatic tamoxifen |
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Cervical cancer |
Starting age 21 --> Pap smear annually < 30 yrs old --> screen annually using conventional methods OR q2 yrs using liquid based methods > 30 yrs old --> screen q2 yrs if > 3 normal annual pap smears IF PAP SMEARS ARE ALWAYS NEG --> STOP AT AGE 65 |
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Hepatitis A |
Hep A is most common vaccine preventable disease for travelers Due to fecal contamination of food or drinking water > 2 weeks away from travel --> vaccine < 2 weeks of travel --> vaccine & immune globulin Acute Hep A infection --> vaccine & immune globulin Booster shot given 6 months after initial vaccination --> immune for 10 yrs |
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Hepatitis B |
Transmitted via sexual intercourse or receive medical or dental care If traveling for > 6 months --> should be vaccinated |
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Malaria prophylx |
Chloroquine for traveling to: Mexico Central America (except Panama) Caribbean Mefloquine for traveling to any other endemic areas --> given 1 week prior to leaving, while in travel location, & for 2 weeks after they return to US Mefloquine has psychiatric side effects including depression, very bad dreams, hallucinations Instead of mefloquine --> doxcycline (given q1 day) but photosensitivity maybe side effect For pregnant --> can use cholorquine, if not, atovaquone+proguanil |
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Rabies |
Vaccine recommended for travel to areas where rabies is common among domesticated animals (eg India, Asia, Mexico) Chloroquine can blunt response to intradermal rabies vaccine --> need to get vaccine prior to chloroquine |
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Yellow fever |
Vaccine is live-attenuated Vaccine is required to sub-saharan Africa and some South American countries Contraindicated in immunocompromised & pregnant woman |
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Typhoid |
Vaccine is capsular vaccine (live attenuated is also available but maybe difficult to give to pt) Recommended for travelers to countries in which they will have prolonged exposure to contaminated food and water |
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Polio |
Adults traveling to developing countries who have never been vaccinated Should receive 3 doses of inactivated polio vaccine Previously immunized should receive a 1 time booster Live attenuated polio vaccine is no longer recommended bc of risk of vaccine associated disease |
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Meningitis |
Polysaccharide vaccine Should get for travel to Nepal, sub-saharan Africa, northern India Saudi Arabia requires immunization for pilgrims to Mecca In US, ppl living in close quarters (eg army barracks, college dorms) should receive vaccine Pts with functional or actual asplenia and/or complement def should also receive vaccine Should receive meningococcal vaccine at age 11 Exposed to Neisseria Menigitis --> prophx with rifampin and/or cipro |
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Diarrhea |
Avoid salads and unwashed fruit and drinking tap or ice water Loperamide --> for non bloody diarrhea with no fever Fluoroquinolone or Azithro --> moderate to severe Sxs (eg fever, leukocytosis, bloody diarrhea) E. coli --> Most common IDENTIFIED cause of travelers diarrhea |
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Influenza Vaccine |
Annually for all adults regardless of age Regardless of age --> Hx of cardiopulmonary dz, DM, hemoglobinopathy, residents of chronic care Pregnant woman in 2nd or 3rd trimester should receive Most common side effect is local erythema DOES NOT CAUSE INFLUENZA LIKE SYNDROME |
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Pneumococcal vaccine |
Polysaccharide vaccine with 23 different types (PPSV23) 65+ years of age If PPSV23 given prior to age 65 --> booster shot if it was given more than 5 yrs earlier High risk so get at any age: Sickle cell dz or splenectomy Cardiopulmonary dz Etohics or cirrhosis Alaskan natives and certain Native American populations Immunocompromised Chronic renal failure or nephrotic syndrome High risk patients should get revaccinated 1x after 5 yrs of initial vaccination (particularily asplenic pt) |
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Varicella vaccine |
Live attenuated virus All adults who do not have hx of childhood infection CONTRAINDICATED IN IMMUNOCOMPROMISED OR PREG WOMAN |
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Shingles vaccine |
Lyophilized live attentuated VZV 60+ yrs of age is recommended Only 1 dose is given No need to get hx or serology for evidence of prior varicella infection, can still give vaccine Pts with hx of zoster AND chronic medical condition (kidney disease, DM, etc), can be vaccinated NOT INDICATED FOR ACUTE ZOSTER |
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HPV vaccine |
Vaccine against 4 types of HPV (6, 11, 16, 18) assoc with genital warts & cervical cancer Given in 3 doses & recommended in ages 11-12 but can be given at age 9 or later If not vaccinated btwn age 13-26, can also receive Males can also receive btwn age 9-26 to prevent genital warts Pap smear screening should continue after vaccination |
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Smoking cessation |
Smoking responsible 1/5 deaths in US 5 steps: 1) ASK about smoking at every visit 2) ADVICE all smokers to quit at every visit 3) ATTEMPT to identify those willing to quit 4) ASSIST --> set quit date and use nicotine patches/gum or bupropion (or Varenicline) supportive therapy 5) ARRANGE f/u Patches or medical supportive therapy should be continued 6-9 months after quitting |
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Smoking and AAA |
Male smokers >65 should be screened once with u/s for abdominal aortic aneurysm If aneurysm found --> need to follow, but if >5cm ---> requires surgery |
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Osteoporosis prevention |
DEXA scan is screening modality All woman >65 High risk --> low body weight or increased risk of fractures screen at age 60 |
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Preventing etoh abuse |
Most important screening tool is CAGE questionare Cut down? Annoyed by criticism of your drinking? Guilty about your drinking? Eye opener in morning? Yes to 1 question --> raise possibility of etoh abuse Yes to 2 questions --> positive screen |
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Injury and violence prevention |
Common cause of death <65 seat belts, bicycle helmets, not driving under the influence, firearm safety Only call protective services for child abuse or elderly individual who cannot take care of themselves |
