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.