preventative health and screening in general practice: the 4 step guide to memorising
Post on 16-Jul-2015
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How to remember.
By Sam Ognenis (UWA medical student)
@SOgnenis
MyPreeeeeecious
Find it here from the RACGP website: http://www.racgp.org.au/your-practice/guidelines/redbook/
Downloadable link: http://www.racgp.org.au/download/Documents/Guidelines/Redbook8/redbook8.pdf
Prevention. Doing it wrong.
Source: Randy Glasbergen, “How to Eat Healthy”: https://www.flickr.com/photos/glasbergen/3563893971/
Immunisations
Risk factor screening
Cancer screening
Sexual health stuff
Investigations
How do we prevent?
“I’ll have an ounce of prevention”, by Dana Fradon in the New Yorker, 1987: http://www.condenaststore.com/-sp/I-ll-have-an-ounce-of-prevention-New-Yorker-Cartoon-Prints_i8474222_.htm
How to remember?
1. SNAP
2. Major Diseases – screening algorithms
3. Cancer screening programmes
4. Head to toe
How to remember?
1. SNAP: Smoking, Nutrition, Alcohol, Physical activity2. Major diseases – screening algorithms
Diabetes – AUSDRISK is first (every 3 years from 40, or ATSI 18) CV – BMI, waist circumference, BP, lipids, BGL – all CV risk factors; and the Absolute CV risk
assessment once 45 (35 ATSI) Renal disease: high risk patients; smoking >40, HT, obesity, FHx, diabetes, ATSI>30 (basically most
patients) – BP, ACR, eGFR every 1-2 years Osteoporosis – fracture risk >45 (F); >50 (M) Falls – falls risk assessment tool – there are many!
3. Cancer screening programmes: CRC: FOBT from 50years Breast: Mammography from 50years Skin: Skin cancer advice Cervical: Pap smear from 18years, 2 years post first intercourse
4. Then, head to toe: Oral health (lift the lip) Immunisation CV, Renal, Osteopororsis Genitalia – contraception, pap, STI screening5. At the end, or IF YOU GET STUCK! Do a quick head to toe Ask about family history – they probably need more/earlier screening for that disease!
How to remember?
Prostate cancer, ovarian cancer, depression, VA,
suicide, glaucoma, incontinence, vitD, wide genetic screening etc.
but be alert in all of these – may need to evaluate if high-risk
What don’t we do?
Cases
Mammography – Discuss the pros and cons (2012
exam), and then conduct appropriate screening for this 54yo woman (2011)
Case 1
Case 1
Health screening – 45 year old man with some
cardiovascular risk factors (2010, 2006)
Case 2
41yo female patient with 3 first-degree relatives with
breast cancer, and motivational interviewing smoking cessation (2009, 2008)
Case 3
38yo Aboriginal woman for ‘check up’
Case 4
62yo woman for routine pap smear and general
health check
Case 5
55yo man general health check
Case 6
16yo male for checkup
Case 7
75yo woman who lives alone
Case 8
4yo boy for routine immunisation – overweight
Case 9
4 yo boy with immunisation
Why bother?
Sourced from: http://advancedlifestylemedicine.com/?page_id=13
Fin.
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