Usmle Step 2 Screening And Prevention And Random Things To Remember

Front 1

Colorectal CA

Back 1

>50 y/o
FOB qy
sigmoidoscopy q5y OR
colonoscopy q10y

Front 2

Prostate CA

Back 2

>40 y/o
DRE QY

Front 3

Colon CA

Back 3

>40 y/o
DRE QY

Front 4

Prostate CA

Back 4

>50
offer PSA QY

Front 5

Gyn CA

Back 5

Pelvic Exam
20-40 Q3y
>40 QY

Front 6

Endometrial CA

Back 6

Biopsy
Once at menopause

Front 7

Breast CA

Back 7

BSE QM >20
Physician Exam
20-40 Q3Y, >40 QY
Mammo >40 QY (earlier if high risk)

Front 8

Cancer Checkup

Back 8

20-39 Q3Y
>=40 QY
includes thyroid, testis, ovary, lymph nn, oral, skin.

Front 9

Hep B immuniz

Back 9

any adult at risk or who wants it

Front 10

Influenza vacc

Back 10

>50 y/o QY
high risk, women who will bepregnat during flu season

Front 11

Pneumococcus vacc

Back 11

>65 y/o, or high risk of infection

Front 12

Rubella vacc

Back 12

Any woman child-bearing age, lack of immunization. NOT PREGNANT WOMEN
Not to immunocompromised except HIV

Front 13

Td

Back 13

Q10Y. give for wound if uk hx or <3 doses. Unclean/major wounds give if >5y since last

Front 14

Classification and tx HTN

Back 14

<120/<80 normal no tx
120-139/80-89...pre none unless dz
140-159/99...stage 1 start thiazides
>160/>100..stage 2 thiazide and more

Front 15

General Cholesterol #s

Back 15

Total <200
Triglyc <150
HDL >60 (<40 is low)

Front 16

Screen for Cholesterol

Back 16

Q5Y >20
TC, LDL, HDL, TG
unless strong history, etc

Front 17

Diabetes screening

Back 17

universal screening not recommended. possible if risk factors

Front 18

diabetes Dx

Back 18

Fasting gluc >126 or random >200
If sx x1 or x3 if no sx

Front 19

LDL levels and interventiona

(CHD risks, etc)

Back 19

No risks >2 risks CAD* VHR tx
<160 <100 <100 <70 NONE
160-189 100-129 -o- 70-99 diet > - meds
>190 >130 >100 /100 MEDS

VHR: CAD + MI, DM, other severe/poorly controlled risk factors

Front 20

Risk factors CHD

Back 20

1. Age men>=45, women >=50 (or premature menopause w/o estrogen replacement

2. Fam Hx premature CHD (male MI <55 or female <65)
3. *****smoking*****
4. HTN (140/90 or on meds)
5. HDL <40

Front 21

Newborn Screen

Back 21

PKU, congen hypothyroid. Rest varies by state: biotinidase deficiency, maple syrup urine disease, congenital adrenal hyperplasia, cystic fibrosis, galactosemia, homocystinuria, hemoglobinopathies, toxoplasmosis, and tyrosinemia.

Front 22

Ped hearing

Back 22

initial before 1 month, tx by 6 m/o
follow-up ages 4-10 or risk factor

Front 23

Ped vision

Back 23

vision screen age 3 or 4

vision risk assess at all HM visits, esp <5 y/o esp w/ hx premie, met/genetic dz, others

screen 6, 8, 10, 12, 15, 18 y/o

Front 24

Ped Developmental and behavior screens

Back 24

developmental 9, 18, 30 mos

autism 18, 24 mos

Front 25

Ped Iron and Lead screen

Back 25

Iron defic anemia- 4 mos,
Hgb/HCt - 18, 24 mos, then QY

Lead (target <10 mcg/dL) - screen ages 12 and 24 mos

Front 26

Ped Oral Health screen

Back 26

6, 9 mos (18, 24, 30 mos or until dental home)

referral to dental home at 1 y/o

Front 27

Ped TB screen

Back 27

only if exposed or imunocompromised

Front 28

Ped Lipid profile screen

Back 28

Risk assessment Q2y

Lipid profile between 18 and 21 y/o

Front 29

Ped EtOH screen

Back 29

CRAFFT >2 points=high risk
Car - ridden w/ someone under infl
Relax - to relax/feel better/fit in
Alone - when alone
Forget - forget things did whn using
Friends - tell you to cut down?
Trouble - because of etoh/drugs

Front 30

Spirometry COPD/obstructive

Back 30

FEV1/FEV less than normal, FEV1 may be normal

Front 31

Spirometry Emphysema/restrictive

Back 31

FEV1/FEV normal. FEV1 may be low

Front 32

Gastric vs Duodenal ulcers in PUD

Back 32

Duod (most common) gastric
high acid low acid
h. pylori NSAIDs
age 40s 50s
food improvs -> worse no change

Front 33

Osmotic diarrhea

Back 33

nonabsorbable solute. lactose or other intolerance. stops with cessation of ingestion

Front 34

Secretory diarrhea

Back 34

toxins (cholera, ecoli), VIP tumors, bile acids p resection.

continues w/ NPO

Front 35

Malabsorption diarrhea

Back 35

celiac sprue, Crohns, gastroenteritis, exocrine pancreatic insuff

stops with NPO

Front 36

Infectious diarrhea

Back 36

fever, WBC in stool (if shigella, salmonella, yersinia, campy), travel hx
giardia: steatorrhea, protozoal cysts.

metronidazole.

Front 37

Exudative diarrhea

Back 37

IBD or cancer

due to inflammation and seepage of cluid from mucosa

Front 38

Altered intestinal trnsit diarrhea

Back 38

after resection and meds

Front 39

Hemochromatosis

Back 39

AR, liver/pancreas/heart/skin/joints/
impotence, amenorrhea, hair loss, koilonychia (spooning fingernails).

MOST COMMON INHERITED DISORDER IN CAUCASIANS

Men>women

elevated iron, transferrrin, ferritin, DNA test. Tx w/ phlebotomy

Front 40

Wilson's disease

Back 40

AR, low ceruloplasmin, high Urine copper, low serum copper, dx w/ liver biopsy. CNs and psych.

tx pencillamine

Front 41

alpha 1 antitrypsin

Back 41

AR, younger adult w/ cirrhosis, emphysema. low A1AT blood levels. Tx w/ replacement A1AT.