Preventive Self-Care - PHL (Hennes)

Leading causes of death in the US

1. Heart disease

2. cancer

3. chronic lower respiratory disease: COPD, emphysema smoking predisposes— multiple illnesses, cancer

HP 2030 barriers

Cost, not having a PCP, living too far from providers, lack of awareness about what’s recommended

Well child visits

• 0-10yrs

• ophthalmic exam: vision test, parents begin after alphabet is learned, check ups, 1-2 years

• Hearing test initial newborn, 95%, follow up each visit

• monitor weight & temperature

Well-child: Check ups and schedule

Newborn 1, 2, 4, and 6 months

• 9 months: assessment, developmental, delays autism spectrum disorder (ASD)

• 1 yr or first tooth: first dental visit AAPD; tooth cleaning, fluoride rinse, oral health education for parents

Well-child: check-up & screening

2 ½, 3, 4, 5, 6, 8 & 10 years

• scoliosis: idiopathic most common among girls acanthosis nigricians

• Screening BP and BMI, if positive

DDST-2

Identify at risk children screening to assess developmental level.

• Identify concerns birth to six years for areas personal social, fine motor language, Grosse motor.

Testicular cancer

Only accounts for 1% of all men (15-35yr/o)

• Risk factors, crypto, courtesan, white family, history

• testicular assessment screen at birth curable with early detection

• solid tumor, common painless, heaviness

testicular exam

promote TSE education/awareness, ID changes for early detection

teens common issues (11-19)

Sexuality, substance abuse, gang and criminal activity, bullying, eating disorders, self injury, self-mutilation, oral hygiene

women priorities

• One physical exam, at least every two years consider specialists frequency of visits

• Breast exam, pelvic exam, and Pap smear

• STDs

• pregnancy and family planning

Heart disease

Women more likely to die from after age 75; hispanics and black groups affected

Gender and symptoms

Men: crushing chest pain, fatigue, SOB

Women, fatigue, sleep problems, SOB, indigestion, anxiety

• Signs and symptoms tend to occur/worsen one month before MI; post menopause increases risk

Heart healthy regimen

Low-dose aspirin 81mg/daily

• men: 45-79

• women: 55-79

Omega-3 supplement: OTC / Lovaza

• stress testing / calcium scoring

Diabetes mellitus

Screening every three years

• hypertension, hyperlipidemia risk factors, family history, BM over 25, Asian Americans screen if BMI greater than 23

Skin screening

High risk if have had skin cancer, family, history of skin cancer risk factors, consider environment, past history of sun exposure, weakened immune system

Dental hygiene

Twice a year — dental exam and cleaning screening for oral diseases, periodontal/gum, disease

• diabetes, heart, disease, and stroke

Mucosal changes: increasing incidence of oral and esophageal cancer

vision

40-54: eye exam q 2-4 yrs

55-64: eye exam q 1-3 yrs

vision probs: cataracts, eyesight changes

RF: glaucoma, diabetes, family hx

colorectal screening

under 45 yrs

• colon cancer, colon polyps, bowel dz (ulcerative colitis, inflammatory bowel)

45 yrs

• stool based fecal occult blood test

• colonoscopy q 5-10 yrs

• CT colonography q 5yrs

  • virtual: q5yrs

pulmonary ds

COPD: more men smoking than females

emphysema: 2x as high for men

PF: interstitial lung dz; scarring and inflammation of lungs

prevention: education in schools, avoid 2nd hand smoke, chemicals

lung screening

low dose computed tomography (LDCT) — (used to be 55) 50 - 80yrs

• 30 → 20 (new #) pack - year smoking hx and currently smoke'

• have quit in the last 15 yrs

osteoporosis

silent dz, bone density screening (DXA)

• women: osteopenia

  • >50yrs with fractures

  • < 65 yrs with RF

• mammo scheduled

breast exam

SBE & CBE, mammo q 1-2yrs

• women

  • 40-49 yr

  • 50-75 yr

• RF mother or sis with breast cancer

  • begin earlier than age when youngest fam member dx

  • breast US or MRI scan

cervical screening

begin at age 21 (HPV predominant)

• pap testing q 3 yrs

  • 30-65 yr/o — HPV test performed if abn pap result

  • 65-70 yr/o — do no require pap if they’ve had a norm test within the last 10 yrs

  • cervical dysplasia: 20 years after tx until age 65

  • hysterectomy with no cervical cancer hx → no longer required

ovarian screening

BRCA 1&2 lab tests

• detect breast and ovarian

CA 125

• cancer antigen & detects protein present

Transvaginal US

BPH tx

alpha beta adrenergics (SE & sexuality)

surgical intervention

herbal therapy: saw palmetto proven effective

COMBINATION TX *most effective

prostate exam

men at 50yrs

• discuss at 45 if they have RF: AA or fam hx (father or brother dx before age 65)

• annual digital rectal exam

• PSA testing - blood level

men screenings

Abdominal aortic aneurysm, vaccines, colorectal, screening glaucoma