Chapter 4 (Preventive Health) ✔✔
Sensitivity ✔✔(SNOUT) Negative results rules out the disease. Sensitivity test are good at
identifying the
... [Show More] positive markers of disease. So good that it is more prone to report false positives.
So a negative result is more definitive
Specificity ✔✔(SPIN) Positive results rules in the disease. Specificity tests are good at
identifying the negative marker of a disease. So good that is more prone to report false negatives.
So a positive result is more definitive.
Primary Prevention ✔✔Prevent the disease in its entirety. Examples include healthy diet,
exercise, safety (helmets/seatbelts), immunizations, and job safety
Secondary Prevention ✔✔Early detection of a disease. Examples include screening testsTertiary Prevention ✔✔Rehabilitation of a disease. Examples include support groups, education
for pts with pre-existing disease, drug side effect safety, medical equipment safety, any type of
rehab like PT or OT
Breast Cancer Screening Guidelines (USPSTF) ✔✔Onset = 50yo. Biannual. Stop at age 74yo.
No SBE.
Breast Cancer Screening Guidelines (ACA) ✔✔Onset = 40yo. Annual. No stop age.
Cervical cancer screening guidelines ✔✔Onset=21yo (immunocompromised individuals start at
onset of sexual activity). Every 3 years Pap w/ no HPV test until 30yo. Pap and HPV test after 30
yo and can begin screening every 5 years. Stop at age 65yo. Complete hysterectomy means no
Pap unless pt has history of cervical cancer or high grade lesion.
Colorectal cancer ✔✔Onset 50yo. 1) colonoscopy q 10 years if wnl, 2) sigmoidoscopy q 5 years
if wnl, 3) annual FOBT with 3 stool samples. Stop age 75 yo.
Prostate cancer ✔✔USPSTF does not recommend screening with PSA but it based on individual
pt.Lipid screening ✔✔Onset 18-35/45yo screen if at increased risk of heart disease. Males >35yo
and Females >45yo
Flu vaccine ✔✔LAIV - Live virus can only be given to healthy non-pregnant 2 -49 yo w/o recent
hx of asthma (Peds). Cautioned or C/I in pts with egg, gentamicin or gelatin allergy and kids
receiving aspirin therapy (Reye's syndrome). TIV (trivalent inactivated vaccine) is approved for
>6months.
Tetanus vaccine ✔✔Q 10 years. Booster for dirty wounds if last TDAP/Td is > 5 years old. >7yo
receive Td/TDAP. Avoid in egg allergy and Gullian Barre. 5 doses of DTAP aka Pediarix
(2,4,6,15 months and 5 yo) First TDAP is at age 11-12yo. Td is the booster every 10 years or if
someone has never had TDAP (came out in 2005) then they should have a one time dose of
TDAP and then continue with Td boosters.
Pneumococcal vaccine ✔✔PCV 23 given one time at age 65 yo in healthy adults and for persons
who are 2 years and older and at high risk for pneumococcal disease (e.g., those with sickle cell
disease, HIV infection, or other immunocompromising conditions). PPSV23 is also
recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have
asthma. One time booster given 5 years after first dose (So non-healthy pts will receive 2 doses
of PSV23 over their lifetime). PCV 13 is for <5 yo. When both PCV13 and PPSV23 areindicated, PCV13 should be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be administered to adults
whose pneumococcal vaccination history is incomplete or unknown.
Varicella Vaccine ✔✔60 yo. May be given to pts who have previously had shingles. May be
given earlier at age 50yo. Live virus so c/I include pregnancy and immunocompromised.
Chapter 5 (EENT) ✔✔
Herpes Keratitis ✔✔Inflammation of the cornea. C/O abrupt severe eye pain, photophobia and
blurred vision. Diagnose with fluorescein dye and black lamp. Look for fernlike lines (corneal
abrasions appear more linear). Infection permanently damages corneal epithelium which may
result in blindness.
Acute angle closure ✔✔Glaucoma (Increased ICP r/t blocked drainage duct). Elderly pt c/o
abrupt onset of severe eye pain, HA, N/V, halos around eyes, and decreased vision. Exam reveals
mid-dilated pupil that is oval shaped, cloudy cornea, and fundoscopic exam shows cupping of the
optic nerve. Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and topical steroids.
Sx may be requiredCholesteatoma ✔✔Cauliflower like growth in the middle ear. Pt c/o foul smelling discharge and
hearing loss. On exam, no TM or ossicles visible. PMhx of chronic OM. The mass is not
cancerous but it can erode in to the bones of the face and damage CN7. Tx = ENT referral for sx,
abx. Mass is usually made of epithelium and cholesterol. AKA pearl tumor.
Battle's sign ✔✔Bruise behind the ear over the mastoid process. Hx of trauma, and indicates a
fracture of the basilar skull. Golden serous discharge from ear or nose. Refer to ED for abx and
imaging (CSF will be + for glucose. Mucous will be - for glucose). [Show Less]