Exam (elaborations)
USMLE STEP 2 CK PREVENTION AND SCREENING
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USMLE STEP 2 CK PREVENTION AND SCREENING
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USMLE STEP 2 CK: PREVENTION AND SCREENINGosteoporosis in women - Answers-women >65 years old should get DEXA scan.
screening starts at 60 y.o. if there is low body weight or increased risk of fractures
abdominal aortic aneurysm - Answers-U/S one time in men >65 who have ever smoked.
There is no screening recommendations for male non-smokers and women smokers or
women non-smokers.
the role of physicans to prevent injuries - Answers-seat belts, wearing helmets and not
driving under the influence of alcohol; women - especially domestic violence - ask if
they've been hit, kicked can increase identification by more than 10%
high cholesterol - Answers-screening starts in men age 35 with no risk factors. Repeat
every 5 years in low-risk individuals.
in both men and women with risk factors for coronary artery disease, screening should
be done routinely after age 20.
diabetes mellitus - Answers-screening for DM should be considered only for patients
with hypertension.
diagnosis of diabetes is two fasting glucose measurements are ≥126 mg/dL OR HA1c >
6.5% or symptomatic random glucose is >200mg/dL .
carotid artery stenosis - Answers-there is no recommendation for screening carotid
artery stenosis.
future travel plans - Answers-set appointment 4-6 weeks prior to departure, discuss the
following:
HepA - get vaccine
<2 weeks of departure => vaccine + Ig
booster shot 6 months after initial vaccine confers 10 yrs of immunity
HepB -
Malaria - mefloquine for prophylaxis (doxycycline as alternative although has
photosensitivity adverse effect)
for pregnant patients, use chloroquine instead.
Rabies - recommended for travel to India Asia and Mexico
people with concurrent malaria prophylaxis, use IM administration of Rabies
vaccine(instead of intradermal) to avoid chloroquine interactions with vaccine.
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