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Terms in this set (16)
men: 45 to 79years benefit/risk
women 55 to 79 years
Men: < 45 recomment against
Men and Women over the age of 80 with avg risk: rec. against
Prehypertension is not a disease category but rather designates an individual at risk for developing hypertension.
The first step in ANY patient with prehypertension is aggressive counseling on lifestyle modifications.
In a patient with coexisting diabetes or kidney disease, lifestyle modifications are still the initial step in management.
With a normal blood pressure of 120/80 mm Hg, a person's risk of death from coronary artery disease and stroke doubles for every 20 mm Hg systolic or 10 mm Hg diastolic rise in blood pressure above normal.
Stage 1 hypertension: Stage 2 hypertension
systolic: 140 to 159 mm Hg at least 160 mm Hg
diastolic 90 to 99 mm Hg at least 100 mm Hg
Prehypertension: Stage 1 hypertension:
systolic: 120 to 139 mm Hg 140 to 159 mm Hg
diastolic 80 to 89 mm Hg 90 to 99 mm Hg
Currently, the US Preventive Services Task Force recommends screening for T2DM in asymptomatic adults with sustained blood pressure (either treated or untreated) higher than 135/80 mm Hg.
The current blood pressure targets fo diabetes are a systolic < 140 mm Hg
diastolic < 90 mm Hg
The primary benefit of the early detection of diabetes is the opportunity to more aggressively address hypertension and hyperlipidemia in these patients, thus reducing the incidence of cardiovascular events and cardiovascular mortality.
Screen all patients in the prehypertensive range (135/80) for T2DM
In patients with both diabetes and hyperlipidemia, treatment with lipid-lowering agents results in a similar reduction in the incidence of CHD events as patients without diabetes.
Aggressive blood pressure control and lipid treatment therapy in patients with T2DM have been shown to reduce the incidence of coronary heart disease (CHD) events.
Patients with diabetes are at risk for both microvascular and macrovascular disease. Macrovascular disease leads to a 2- to 4-fold increased risk of heart disease and stroke.
Tight glycemic protects against microvascular disease in type 2 diabetes but it's role in reducing cardiovascular risk has not been established as clearly for type 2 diabetes.
Tight glycemic protects against microvascular AND macrovascular (CVD) in type 1 diabetes
Screening should be considered at an earlier age in patients who have a BMI ≥25.0 kg/m2 and additional risk factors, including physical inactivity, a first degree relative with diabetes mellitus, a history of gestational diabetes or of delivering an infant weighing more than 9 lb,
Screening is recommended in asymptomatic adults beginning at age 45 in the absence of risk factors, and should be repeated at least once every 3 years
High sensitivity is the most important property.
This means that people in the population with the disease will not be missed.
Unfortunately, to get a high sensitivity we must often accept a higher false positive test rate.
What property of a test is most important for a screening test?
Low prevalence of the disease in the population being tested
High negative predictive value
Specificity is the proportion of patients without disease who test negative
1. cytology only (no routine HPV testing) in women aged 21 to 29,
cytology every 2 years,
whereas the other 2 guidelines recommend cytology every 3 years.
Who gets a pap test?
Women over 65 years old should routinely be vaccinated for:
HPV type 16
Of these, 8 types (16, 18, 31, 33, 35, 45, 52, and 58) are oncogenic. Of those 8 types, type 16 causes the highest number of cancers
The next most oncogenic type, HPV type 18, causes approximately 10-15% of cancers.
A 36-year-old woman has had cervical cancer screening with liquid-based cytology and human papillomavirus (HPV) co-testing. She receives a negative cytology result but her HPV test is positive. Of the 30-40 types of HPV, which of the following causes the plurality of cases of cervical cancer?
HPV type 16
HPV type 18
HPV type 14
HPV type 33
HPV type 52
top cervical cancer screening
All 3 guidelines recommend against screening for cervical cancer in women who have undergone hysterectomy with removal of the cervix for benign disease.
In women who have undergone hysterectomy, it is important to ensure that the cervix was, in fact, removed and that the procedure was not performed for cervical intraepithelial neoplasia 2 or greater cervical pathology.
vaginal hysterectomy including removal of the cervix
human papillomavirus (HPV)/cytology co-testing every 5 years
What is the least frequent screening and type of screening endorsed by current screening guidelines in healthy women in their 20's and 30's?
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