Preventative Health and Screening in General Practice: the 4 Step guide to memorising

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Preventative Health and Screening in General Practice: a guide to remembering the different tests and diseases A presentation about how to easily incorporate preventative health into each medical consultation, through remembering four steps: 1. SNAP (smoking, nutrition, alcohol and physical activity) 2. Major diseases (CVD, diabetes etc.) 3. Cancer screening (breast, cervical, colorectal etc.) 4. Head to toe

Gesundheit & Medizin

How to remember.
By Sam Ognenis (UWA medical student)
@SOgnenis

My
Preeeeeecious
Find it here from the
RACGP website:
http://www.racgp.or
g.au/your-
practice/guidelines/r
edbook/
Downloadable link:
http://www.racgp.or
g.au/download/Doc
uments/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


1. SNAP
2. Major Diseases – screening algorithms
3. Cancer screening programmes
4. Head to toe
How to remember?

$1. SNAP: Smoking, Nutrition, Alcohol, Physical activity 2. Major diseases – screening algorithms  Diabetes – AUSDRISK is first (every 3 years from 40, or ATSI 18)  CV – BMI, waist circumference, BP, lipids, BGL – all CV risk factors; and the Absolute CV risk assessment once 45 (35 ATSI)  Renal disease: high risk patients; smoking >40, HT, obesity, FHx, diabetes, ATSI>30 (basically most patients) – BP, ACR, eGFR every 1-2 years  Osteoporosis – fracture risk >45 (F); >50 (M)  Falls – falls risk assessment tool – there are many! 3. Cancer screening programmes:  CRC: FOBT from 50years  Breast: Mammography from 50years  Skin: Skin cancer advice  Cervical: Pap smear from 18years, 2 years post first intercourse 4. Then, head to toe:  Oral health (lift the lip)  Immunisation  CV, Renal, Osteopororsis  Genitalia – contraception, pap, STI screening 5. At the end, or IF YOU GET STUCK!  Do a quick head to toe  Ask about family history – they probably need more/earlier screening for that disease! How to remember?$


 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?


 Mammography – Discuss the pros and cons (2012
exam), and then conduct appropriate screening for
this 54yo woman (2011)
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


 4yo boy for routine immunisation – overweight
Case 9


Why bother?
Sourced from: http://advancedlifestylemedicine.com/?page_id=13

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