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50 Cards in this Set

  • Front
  • Back
What are 4 stategies in prevention of AIDS
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
HIV virus can stay latent for how long?
up to 10 years
HIV disease increasing among heterosexual especially black women
Who has greater risk of cancer men or women black or white
black and men
Who should get screened for prostate CA
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
Know surveliance CA screening
find, artilce, textbook, chart on forum
Know symptoms of CA
Know if do chest xray before CT with contrast
HIV when to screen & how to screen
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
HIV Who to screen
All pregnant women, who has sex with men, known needle sharers, sexual exposure,
When do HIV antibodies show up?
1-2 months after exposure
Test Question: Know how to interpert viral load
Know how to interpurt TB test
5mm red flag on TB test with HIV
Know about karopski sarcoma and know when to start prophylactic antibiotics for infections
find - do not need to know therapy meds
Know about prevention of HIV
When should end of life decisions be made by a person - advance care planning
at the first visit before anyone is sick - all adults
What appetite stimulant can be used for anorexia of cancer
What to use for depression if death is imminent within 1 mont
psychostimulant - methyphenidate
What an person dying from terminal illness may manifest
anorexia, cachexia, deliruim, depression, anxiety & fear, dyspnea, dry mouth (xerostoma),nausea & vomiting, constipation. bowel obstruction, pain
What should be involved in a cancer screening
inspection of skin, oral cavity, breasts, external genitailia, cervix, palpate thyroid, breasts, oral cavity, thyroid rectum, prostate,testes, ovaries,uterus & lymph nodes.
What teaching to include involving CA risks in yearly visits
tobacco, sun exposure, diet & nutrition, risk factors, sexual practices, environmental and occupational exposures
Breast CA screening
#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
Colorectal CA Screening
3rd most common CA, screen everyone age 50 and above
What is the recommended screening for breast cancer?
yearly mamograms starting age 40
What is the recommended screening for colon & rectum
beginnning age 50 - sigmoidoscopy q 5 years, colonsocpy q 10 years (best test for CA screening), fecal occult bld test every year
What is the recommended screening for prostate
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
What is the recommended screening for Uterus/cervix
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
What are risk factors for prostate CA
fam hx, ethnicity (african american and jamacian), & age over 65
What type of skin cancers are there?
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
Who is at risk for skin CA
fair-skinned men & women over 65, patient with atypical moles, those with > 50 nevi
What are warning signs of skin CA?
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
Lung CA is leading cuase of cancer related deaths
true, more in blacks
What are risk factors for lung CA?
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
Where do lymphomas originate?
lymph nodes, spleen, or extranodial sites including liver, gut,
What is Hodgkins disease?
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
What is non-hodgkins lymphoma?
Same s/s as hodgkins,
What is leukemia?
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
What is danger of immuno0deficiency?
susceptibility ot infection
What is best way to prevent CA risk?
control risky behavior, dietary habits, tobacco or alcohol, sun exposrue, lack of physical exercise & risk sex
When might a practitioner assist with caring for CA patient?
managing symptoms and monitoring neutropenia, anemia, thrombocytopenia, kidney fx, liver fx how treatment affect rest of body systems.
What to look for in Hodgkins lymphona
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
What to look for in non-hodgkins lymphoma?
lymph nodes > 1.5 cm in maximum diameter considered abnormal, splenomegaly in 30-40%
Where to look for petechiase with thromocytopenia?
on the top of soft palae
What to asses for with colorectal CA?
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
What to look for with melanoma?
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
What to look for with testicular CA?
scrotal mass - firm painless mass on or connected to testicle, r/o epididymitis - resolves with treatment
What to look for in multiple mylenomas?
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%)
What to look for with bladder CA
gross total hematuria (usually painless), bladder irritability (frequency, urgency, dysuria; also seen with CIS) and infection
What is current guildeline for prostate CA screening
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
Who should be tested for HIV
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