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50 Cards in this Set
- Front
- Back
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What are 4 stategies in prevention of AIDS
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1.Incorporate HIV testing as a routine part of care in traditional medical settings unless pt decides not to
2.Implement new models for diagnosing HIV infections outside medical settings. 3.Prevent new infections by working with people diagnosed with HIV and their partners 4.Further decrease mother-to-child HIV transmission |
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HIV virus can stay latent for how long?
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up to 10 years
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HIV disease increasing among heterosexual especially black women
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true
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Who has greater risk of cancer men or women black or white
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black and men
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Who should get screened for prostate CA
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The prostate-specific antigen (PSA) test and the digital rectal examination (DRE) should be offered annually beginning at age 50 to men who have a life expectancy of at least 10 years. Men at high risk should begin testing at age 45 (african descent or 1st degree relative diagnosed as young age
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Know surveliance CA screening
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find, artilce, textbook, chart on forum
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Know symptoms of CA
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find
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Know if do chest xray before CT with contrast
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find
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HIV when to screen & how to screen
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rapid testing confirm with western blot, if neg and have low index then have not been exposed, if index of suspision the rescreen in couple of months
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HIV Who to screen
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All pregnant women, who has sex with men, known needle sharers, sexual exposure,
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When do HIV antibodies show up?
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1-2 months after exposure
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Test Question: Know how to interpert viral load
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find
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Know how to interpurt TB test
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5mm red flag on TB test with HIV
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Know about karopski sarcoma and know when to start prophylactic antibiotics for infections
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find - do not need to know therapy meds
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Know about prevention of HIV
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find
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When should end of life decisions be made by a person - advance care planning
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at the first visit before anyone is sick - all adults
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What appetite stimulant can be used for anorexia of cancer
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megace
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What to use for depression if death is imminent within 1 mont
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psychostimulant - methyphenidate
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What an person dying from terminal illness may manifest
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anorexia, cachexia, deliruim, depression, anxiety & fear, dyspnea, dry mouth (xerostoma),nausea & vomiting, constipation. bowel obstruction, pain
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What should be involved in a cancer screening
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inspection of skin, oral cavity, breasts, external genitailia, cervix, palpate thyroid, breasts, oral cavity, thyroid rectum, prostate,testes, ovaries,uterus & lymph nodes.
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What teaching to include involving CA risks in yearly visits
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tobacco, sun exposure, diet & nutrition, risk factors, sexual practices, environmental and occupational exposures
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Breast CA screening
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#2 CA killer in women, mammography helps detect before metastasis, screen women > 40 1-2 years, women at risk, early menarche, fam hx breast ca, late menopause, nulliparity, 1st child after 30, obestiy, postmenopausal hormone replacement, excessive alcohol
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Colorectal CA Screening
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3rd most common CA, screen everyone age 50 and above
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What is the recommended screening for breast cancer?
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yearly mamograms starting age 40
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What is the recommended screening for colon & rectum
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beginnning age 50 - sigmoidoscopy q 5 years, colonsocpy q 10 years (best test for CA screening), fecal occult bld test every year
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What is the recommended screening for prostate
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PSA & digital rectal exam offered annually beginning age 50 to men with life expectancy over 10 yrs. High risk with fm hx start at 40 or 45 (controversal on this screening test - a lot of false positive tests which result in over testing and unneeded proceedures and anxiety) Can offer let pt decide
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What is the recommended screening for Uterus/cervix
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3 years after begin vaginal intercourse or age 21 yearly til age 30 then 2-3 years in women with have had 3 normal paps in a row, discontinue at age 70 if 10 years of neg paps
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What are risk factors for prostate CA
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fam hx, ethnicity (african american and jamacian), & age over 65
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What type of skin cancers are there?
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menaloma, and nonmelanomas (basal, cell and squamous cell), sunburns cause of CA and effects are culmulative, 2nd degree burns before age 18 double incidence of NMSC & increase risk of MM
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Who is at risk for skin CA
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fair-skinned men & women over 65, patient with atypical moles, those with > 50 nevi
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What are warning signs of skin CA?
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open sore that does not heal for > 3 wks, spot or sore that burns, itches, stings, crusts, or bleeds, any mole that change sin size or texture, develops irregular borders, or apears pearly, translucent or multicolored
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Lung CA is leading cuase of cancer related deaths
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true, more in blacks
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What are risk factors for lung CA?
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smoking, environmental and occupational exposures, low socioeconomic status, decreased education, racial minorities, genetics, prior lung disease, dietary factors, and decreased activity, no screening test for lung CA
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Where do lymphomas originate?
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lymph nodes, spleen, or extranodial sites including liver, gut,
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What is Hodgkins disease?
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if had epstein barr virus (mono) more suspectible to get hodgkins disease - manifests as swollen lymph nodes, wt loss, fever, night sweats, stageing depends on how many lymph nodes or regions are involved
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What is non-hodgkins lymphoma?
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Same s/s as hodgkins,
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What is leukemia?
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CA that affects the bone marrow and lymphatic tissue - WBC production affected - exposure to radiation biggest risk factor, workers exposed to benzene (in gasoline), rubber cement, & cleaning solvents risk for leukemia, workers exposed to paints, dyes, distillereis and leater tanning
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What is danger of immuno0deficiency?
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susceptibility ot infection
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What is best way to prevent CA risk?
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control risky behavior, dietary habits, tobacco or alcohol, sun exposrue, lack of physical exercise & risk sex
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When might a practitioner assist with caring for CA patient?
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managing symptoms and monitoring neutropenia, anemia, thrombocytopenia, kidney fx, liver fx how treatment affect rest of body systems.
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What to look for in Hodgkins lymphona
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B symptoms (prognostic importance) = significant fever, night sweats, weight loss > 10%
fatigue, malaise, weakness, cyclical Pel-Ebstein fever, persistent dry cough, 2%-5% pain with alcohol ingestion secondary to eosinophil infiltration, pruritus, anemia |
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What to look for in non-hodgkins lymphoma?
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lymph nodes > 1.5 cm in maximum diameter considered abnormal, splenomegaly in 30-40%
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Where to look for petechiase with thromocytopenia?
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on the top of soft palae
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What to asses for with colorectal CA?
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lymphadenopathy, palpable abdominal mass
signs of intestinal obstruction assess for hepatomegaly and ascites, palpable rectal mass <10% within digital reach, can accompany breast, ovarian or endometrial CA |
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What to look for with melanoma?
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A asymmetry
B border irregularities C colors > 1 (mottled, shades of brown, black, gray and white) D diameter > 6 mm (pencil eraser), enlarging, asymmetric, irregularly bordered, variably colored, large (> 6 mm) pigmented patch; black color is suspicious; may bleed and ulcerate; flat than nodular, usually elevated & not flat |
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What to look for with testicular CA?
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scrotal mass - firm painless mass on or connected to testicle, r/o epididymitis - resolves with treatment
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What to look for in multiple mylenomas?
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34% asymptomatic at presentation(1,3)
common features include(3) bone pain (58%) which may involve back, long bones, skull, ribs, pelvis pathologic fracture (26%-34%) fatigue (32%) weight loss (24%) |
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What to look for with bladder CA
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gross total hematuria (usually painless), bladder irritability (frequency, urgency, dysuria; also seen with CIS) and infection
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What is current guildeline for prostate CA screening
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Shared decision with pt. The best studies have shown little or no mortality reduction as a result of screening. Only screen with men who will live longer than 10 years, none after 75
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Who should be tested for HIV
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Everyone - 13-64 yrs old it shoudl be part of the routine clniical care - pt can opt out - for sure all pregnant women, all pt initiating treatment for TB, All patients with STD's, injection drug useres, prostitutes
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