Preventive Medicine

Preventive Medicine

Review points

Hepatitis A vaccine
needed in

*Travelers in endemic areas
*Homosexuals
*Chronic liver Disease (HBV,HBC)
*Day care Centre employees

Varicella
Live attenuated
Not to be given in immunocompromised/AIDS/pregnant patient

MMR
Live attenuated
Indications:
Healthy adults born after 1956 shud be vaccinated with one dose.
C/I
pregnant patient
immunocompromised(BUT Asymptomatic HIV may receive the vaccine)

Smoking Cessation

Ask about smoking
Advice quitting
Attempt to identify willing to quit
Assist: set a quit-date (usually 2 weeks)
Nicotine Patch or Gum OR oral antidepressant Bupropion ; both are equally effective.
Arrange Follow up

Cholesterol Screening Age

Men 35and plus
Women 45and plus

managemenet shudnt be based on single reading as cholestero may nomally vary upto 14% within two consecutive readings.

Diabetes Mellitus

Routine screening :- Only when patients is at high risk eg

*Obesity
*High Risk ethnicity
*Impaired fasting glucose
*Positive family History

Diagnosis
>126 fasting on two separate occassions
>200 Random on any occassion

Blood Pressure

screening recommended at every visit ; and atleast every two years

Alcohol Abuse

CAGE questionnaire
one 'yes' to cage= possibility of alcohol abuse

Prevention of Violence and Injury

Advice them about saftey practices.
In cases of violence simply asking them if they were hit or physically abused can increase identification by 10%