860 exam 1- prevention

what are we tryiing to prevent using asprin?

• cardiovascular disase

• colorectal cancer

is asprin innocuous?

nah

ACC/AHA guideline on primary prevention of CV disase

1. use infrequently

2. for primary prevention of ASCVD age 40-70 who are at HIGHER risk ASCVD risk but not inc bleeding risk

3. low dose aspirin (75-100mg oral daily) NOT for 70+ age

4. low dose aspirin NOT for those adults any age who are at inc risk of bleeding

USPSTF

• adults 40-59 with: 10+% + and 10 yr CHD risk, are NOT inc risk of bleeding, life expectancy of 10 yr, willing to tk aspirin for 10 yrs = low dose asprin

• adult 60-69 = no low dose

• under 40, over 70 = no

abdominal aortic aneurysm screening

• freq: once

• pop: MALE, 65-75, hx of smoking

alc/unhealthy drug

freq: yearly

pop: all adult

anxiety screening

freq: once, and for cause

pop: 8-64

breast cancer

freq:

• once every 2 years —> women 40-74

  • but if have abnormal result = every yr

ACCORDING TO ACS

• option for annual screening: 40-44

• annually: 45-54

• biennial (every other yr) or pt choice anually: 55+

cervical cancer

21- 29:

• cervical cytology (pap smear) once every 3 years

30-65

• pap smear once every 3 yr

• OR HPV testing every 5 yr

• OR pap smear + HPV every 5yr

colorectal cancer

pop: all adults 45- 75

one of the below:

1. colonoscoopy Q 10 YRS

2. CT colonography Q 5 YRS

3. flexible sigmoidoscopy Q 10 YRS PLUS annual fecal occult blood test

4. stool dna test Q 3 YRS

5. fecal blood test Q YEAR

• can do < 45 if: + fx hx or 10 years before youngest case = colonoscopy every 5 yr

depression

yearly, 12+

fall prevention

during exercise intervention; for 65+

folic acid

• for: pt planning to get preg

  • 400-800 mcg daily

hep b

for cause

• adults at high risk of infx

hep c

once- all adult 18-79

periodically - high risk of infx

HIV

• ONCE: ALL ADULT 15- 65

• PERIODICALLY: young/old adult at high risk

DOMESTICAL VIOLENCE

YEARLY ALL ADULT

Lung cancer

freq: annual

pop: 50-80

• who had 20 pack hx (1 ppd 20 yrs, or 2 ppd 10 yrs) AND current smoker or quit within 15 yrs

  • D/C: if quit for 15 yrs or not willing to do surgery due to health

osteoporosis

freq:

• if normal, not more frequenty than 5 yrs

• if dx: every 3-5 yrs

• pop: women 65+

  • or women under 65 w high FRAX

ORAL CANCER

freq: as needed

pop: adult w current tobacco use or former chew user

prediabetes/DM screening

freq: periodic

pop: adult 35- 70 who are OW or obese

STI counseling and screening syphillis

freq: periodic

pop: person at high risk

STI counseling/screening: gonorrhea, chlamydia

freq: periodic

pop: sexually active women age 24 and younger and women 24+ at inc risk of infx

TOBACCO CESSATION

FREQ: PERIODIC

POP: ALL PT

alc consumption

• moderate

  • moderate = inc risk of falls, car crash, violence, drowning, gi cancer

caffeine consumption

• 3-5 cups, 400 mg/d

exercise

WHO:

• minimum for 18-64 years : 1 of below

  • 150 mins of moderate exercise aerobic

  • 75 mins of vigorous aerobic activity

  • combo of both

CDC:

• 5-17 yrs: 60 mins daily

• 18-64:

  • do WHO + 2x/wk muscle training

  • pregnancy/post partum: 150 mins of moderate

  • 65+ no diff, just do fall assessment too

Yearly screenings

Depression , alc drug , violence … more