Vaccines
Three vaccines to consider to patient older than 50yo
Consider Herpes Zoster (>50yo), Pneumococcal (>65yo) and Influenza (q 1 year, especially >65yo)
Breast cancer screening guidelines for average risk
Mammogram for 50-74yo q1-2y
Blood pressure screening
Recommended at all appropriate primary care visits
Asymptomatic bacteriuria screening
Screen all pregnant women once during the first trimester with urine culture for asymptomatic bacteriuria
Recommendation for vision screening over 65yo
No vision screening recommended in primary care settings for patient 65y and older
Tetanus shot frequency
every 10 years
Lung cancer screening guidelines
Low dose CT q1y x3 if 55-74yo and has 30 or more pack years and currently smoking OR quit less than 15y ago
Lipid Screening guidelines
50-75yo q5 years
Anxiety and Depression screening in children/adolescents
Cognitive Impairment
Do not screening asymptomatic adults (≥65 years of age)
List at least 3 high risk groups in which you should consider administering a pneumococcal vaccine in
DM, chronic kidney disease, HIV, smoker, homeless, IVDU, cirrhosis
Prostate cancer screening guidelines
Rectal Exam for men over 50 every year. PSA is not recommended as routine screening test. It should be interpreted in conjunction with the DRE. Patients are invited to talk about the harms and benefits of testing with their physicians.
Diabetes Screening guidelines
Hgb A1C q1-5y starting at 40yo
Screen q6-12m if "very high risk"
Folic Acid supplementation
The USPSTF recommends that all persons planning to or who could become pregnant take a daily supplement containing 0.4 to 0.8 mg (400 to 800 mcg) of folic acid.
List medications for secondary prevention of Cardiovascular events
Statin (greatest benefit), ACEI/ARB, BB, anti-platelet agent
Age group in which the meningococcal quadrivalent vaccine is recommended in
Recommended for teens in grade 9 or between 12-17 years of age
Colon cancer screening guidelines for average and high risk groups
Average risk: 50-74yo with FOBT/FIT q2y or sigmoidoscopy q10yrs
High risk: colonoscopy q5y starting at 40 or 10 younger than the age of diagnosis of youngest first degree relative with colon cancer
** if patient has personal hx of adenomas then colonoscopy q3-5 years
Latent Tuberculosis screening
Screening is recommended for populations at increased risk such as:
- Live or spend time with someone who has TB
- Were born in parts of the world where TB is common
- Live or have lived in crowded conditions where TB can easily spread, such as nursing homes, homeless shelters, or correctional facilities
- Work in a hospital or nursing home.
Screen with tuberculin skin test or interferon gamma release assay blood test
An optimal time to administer the acellular pertussis vaccine in pregnant population
27 – 32 weeks of gestation
Abdominal Aortic Aneurysm Screening guidelines
Screen every male aged 65-80yo with one time abdominal ultrasound.
(Screen females between 65-80yo only IF hx of smoking or CVD is present as per CCFP exam topics)
List all the vaccines that a 1-year-old child in Canada should have ideally received
Diphtheria, tetanus, pertussis, hepatitis B, polio, Haemophilus influenzae type b (DTaP-HB-IPV-Hib) vaccine. Pneumococcal conjugate vaccine. Meningococcal C conjugate vaccine. Rotavirus vaccine. Influenza. MMR. Varicella.
Current cervical cancer screening guidelines
Pap test for anyone with cervix aged 25 to 69 years every 3 years. Patients 70 years and older may stop screening after 3 successive normal paps in the previous 10 years
Cervix self-screening with a swab for anyone aged 25 to 69 years every 5 years.
STI screening guidelines
Chlamydia and Gonorrhea:
Per CTFPHSC, screen all sexually active individuals under 30 years of age who are not known to belong to a high-risk group, annually, for chlamydia and gonorrhea at primary care visits, using a self- or clinician-collected sample.
Per Public Health Agency of Canada, screen all sexually active women and men age 25y or younger, all pregnant women, anyone treated for chlamydia 6m after treatment, anyone over 25yo who is at higher risk (new partner or partners), anyone bisexual or transgender
Syphilis:
Screen all pregnant patients at first prenatal and anyone with high risk sexual behaviors ( men who are sexually active with other men, have HIV etc)
Screening tests to be done at the first pre-natal visit
Beta-hCG, ABO, RH, antibody screen, CBC, Rubella titres, Hep sAg, VDLR, HIV, G+C, urine culture.
Also consider doing TSH, DM, Hb electrophoresis, ferritin, B12, Varicella, Hep C, toxo, CMV, TB, drug screen, pap
Fragility fractures screening guidelines
Risk assessment-first screening is recommended for females 65 years and older with FRAX risk assessment tool. If afterwards pharmacotherapy is still considered then Bone Mass Density should be ordered using dual energy X-ray absorptiometry of the femoral neck and the FRAX re-calculated with BMD.
** Ensure calcium and Vitamin D intake as well