FAMILY MED AQUIFER/673
QUESTIONS AND ANSWERS (A+)
Breast self-exam (BSE) recommendations -
√Answer :The USPSTF and the American Cancer
Society (ACS) both do NOT recommend physicians to
teach pts to do BSEs
Quiz :Breast CA screening USPSTF - √Answer :biennial
screening mammography for women aged 50-74 yrs
Quiz :Cervical cancer screening guidelines -
√Answer :age 21: screening begins
21-29: q3 yrs
30-65: q5 hrs if co-tested for HPV or q3yrs with cytology
alone
Quiz :Risk groups who need to have more frequent
cervical CA screening - √Answer :immunocompromised
HIV positive
hx of CIN 2, 3 or CA
exposure to DES in utero
Quiz :When to stop cervical CA screening -
√Answer :women >65 yrs who have had adequate
screening within the last 10 yrs
3 consecutive nml pap tests with cytology alone or 2 nml
paps if co-tested
Quiz :Characteristics of a good screening test - √Answer
:1. Accuracy (high sensitivity and specificity)
2. Able to detect disease in an asymptomatic phase
3. Minimal associated risk
,4. Reasonable cost
5. Acceptable to patient
6. Have an available treatment for the disease
Quiz :Lung CA screening USPSTF - √Answer :- low-
dose CT scan to screen for lung CA in pts ages 55-80
who have smoked for 30 + years
-should also be currently smoking or have quit within the
prior 15 years
Quiz :Diagnostic tests for breast lesions - √Answer :- if
cystic, aspiration --> fluid sent for cytology; FNA if
available
- if solid, mammography is the next step
- US can be helpful in distinguishing a solid vs cystic
lesion
Quiz :Risk factors for developing breast CA - √Answer :-
FHx of breast CA in 1st degree relative
- prolonged exposure to estrogen
- genetic factors
- age
- post-menopausal obesity
- excessive alcohol intake
Quiz :Tdap immunization - √Answer :Tetanus, diptheria,
and acellular pertussis (Tdap) should replace a single
dose of Td for adults 19-64 who have not received a
dose of Tdap previously
Quiz :Osteoporosis screening - √Answer :Women >65
yo : dual energy x-ray absorptiometry (DEXA)
recommended)
,Women <65 yo : for high risk pts
Quiz :Physical activity guidelines - √Answer :150 min of
mod intensity exercise, 75 min of vigorous intensity or a
combo of both per week
+ strengthening exercises 2 days/wk
Quiz :Atherosclerotic cardiovascular disease (ASCVD)
risk calculator - √Answer :fasting lipids q4-6 yrs in adults
20-79 yrs of age who are free from ASCVD if at
increased risk for CAD (ie, diabetics, hypertensive,
premature personal hx of atherosclerosis for FHx in
males <50 and F <60)
to estimate 10-year ASCVD risk q4-6 yrs in adults 40-79
yrs of age without ASCVD
Quiz :Diabetes initial therapy - √Answer :metformin 500
mg once daily with evening meal, if tolerated, add a
second 500 mg dose with breakfast
-can reach a total dose of 2000 mg per day
+lifestyle modifications!
Quiz :Effects of alcohol - √Answer :+: small increase in
HDL, prevent platelet aggregation but not recommended
still
-: pts with HF, cardiomyopathy, diabetes, HTN,
arrhythmia, obesity, hypertriglyceridemia, or who are
taking meds may have AEs
red wine: some antioxidants and falvonoids may reduce
heart disease risks but no hard evidence to show direct
effect
, Quiz :Gathering a complete nutrition history -
√Answer :1. 24-hour dietary recalls
- ask about each meal; "WAVE - Weight, Activity,
Variety, and Excess"
2. daily dietary intake record (or food diaries)
-everything in the last 3-4 days
3. food frequency questionnaire
- food intake over the period of a month
4. usual diet history
- describes a typical day's diet
Quiz :ABCDE of suspiscous skin lesions -
√Answer :Asymmetry
Border irregularity
Colon non-uniform
Diameter > 6 mm
Evolution or change over time
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