HPDP Exam 1 Questions with Correct Answers
What is prevention?
Routine health care that includes screenings, check-ups, and patient counseling to prevent
illnesses, disease, or other health problems
When do preventive guidelines stop applying?
Once a person develops one symptom of a disease
What is primordial prevention?
Patient has no disease, but attempt is to reduce the chance of developing any risk factors for that
disease (healthy person with no risk factors)
Ex.) Encouraging young children to eat healthy to prevent later disease
What is primary prevention?
Patient has no disease, but attempt to treat the established risk factors (healthy person with risk
factors- treats risk factors)
ex.) Smoking cessation efforts to avoid developing COPD
What is secondary prevention?
Patient has a disease & the goal is to reduce disease recurrence
Ex.) Using tamoxifen (estrogen regulator) in patients with history of breast cancer or smoking
cessation in all cancer patients
,What is tertiary prevention?
Patient has a disease, but prevention efforts work to soften the impact of that disease on the
patient
Ex.) Pulmonary rehabilitation in COPD or depression support groups
What are the principles of screening?
-The condition should be an important health problem
-There should be a treatment for the condition
-Facilities for diagnosis and treatment should be available
-There should be a latent stage of the disease
-There should be a test or examination for the condition
-The test should be acceptable to the population
-The natural history of the disease should be adequately understood
-There should be an agreed policy on whom to treat
-The cost of finding a case should be balanced in relation to overall medical expenditure
What is the difference between a screening and diagnostic tests?
What is net benefit?
Net benefit = Benefits of a screening- harms of a screening
What are the letter grades and corresponding recommendations for screenings from the
United States Preventative Services Task Force (USPSTF)?
,A- The USPSTF recommends the service. There is high certainty that the net benefit is
substantial. Offer this service.
B-The USPSTF recommends the service. There is high certainty that the net benefit is moderate
or there is moderate certainty that the net benefit is moderate to substantial. Offer this service.
C- The USPSTF recommends selectively offering or providing this service to individual patients
based on professional judgment and patient preferences. There is at least moderate certainty that
the net benefit is small. Offer to selected patients.
(lower benefit from offering this service)
D- The USPSTF recommends against the service. There is moderate or high certainty that the
service has no net benefit or that the harms outweigh the benefits. Do not offer.
I- The USPSTF concludes that the current evidence is insufficient to assess the balance of
benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the
balance of benefits and harms cannot be determined. Discuss benefits vs. harms with patient
What are examples of category D screenings?
-Screening for genital herpes with serology
-Screening for asymptomatic carotid artery disease
-Screening for bacteria in urine in absence of symptoms
-Screening for BRCA in person without family history of breast cancer
-Screening for pancreatic or thyroid cancer
, -Screening for testicular cancer
If pt has Sxs, then these will be diagnostics- not screenings
What are reasons why category D screenings are not offered?
-Possible harm to patient that outweighs risks
-Lack of statistical evidence to show that intervention prevents disease or reduces mortality
-False positive or false negative testing
-Low number of affected individuals in target area
Aside from the USPSTF, what other organizations have screening recommendations?
1. American College of Obstetrics and Gynecology (ACOG)
2.American Medical Association (AMA)
3.American Urological Association (AUA)
4. American Association of Family practice (AAFP)
What is lead-time bias?
Occurs when a disease is diagnosed earlier through screening efforts, which makes it LOOK like
the patient lives longer with the disease than a patient who does not have screening
Ex:
- Female in rural area does not have mammography screening, she develops breast cancer which
What is prevention?
Routine health care that includes screenings, check-ups, and patient counseling to prevent
illnesses, disease, or other health problems
When do preventive guidelines stop applying?
Once a person develops one symptom of a disease
What is primordial prevention?
Patient has no disease, but attempt is to reduce the chance of developing any risk factors for that
disease (healthy person with no risk factors)
Ex.) Encouraging young children to eat healthy to prevent later disease
What is primary prevention?
Patient has no disease, but attempt to treat the established risk factors (healthy person with risk
factors- treats risk factors)
ex.) Smoking cessation efforts to avoid developing COPD
What is secondary prevention?
Patient has a disease & the goal is to reduce disease recurrence
Ex.) Using tamoxifen (estrogen regulator) in patients with history of breast cancer or smoking
cessation in all cancer patients
,What is tertiary prevention?
Patient has a disease, but prevention efforts work to soften the impact of that disease on the
patient
Ex.) Pulmonary rehabilitation in COPD or depression support groups
What are the principles of screening?
-The condition should be an important health problem
-There should be a treatment for the condition
-Facilities for diagnosis and treatment should be available
-There should be a latent stage of the disease
-There should be a test or examination for the condition
-The test should be acceptable to the population
-The natural history of the disease should be adequately understood
-There should be an agreed policy on whom to treat
-The cost of finding a case should be balanced in relation to overall medical expenditure
What is the difference between a screening and diagnostic tests?
What is net benefit?
Net benefit = Benefits of a screening- harms of a screening
What are the letter grades and corresponding recommendations for screenings from the
United States Preventative Services Task Force (USPSTF)?
,A- The USPSTF recommends the service. There is high certainty that the net benefit is
substantial. Offer this service.
B-The USPSTF recommends the service. There is high certainty that the net benefit is moderate
or there is moderate certainty that the net benefit is moderate to substantial. Offer this service.
C- The USPSTF recommends selectively offering or providing this service to individual patients
based on professional judgment and patient preferences. There is at least moderate certainty that
the net benefit is small. Offer to selected patients.
(lower benefit from offering this service)
D- The USPSTF recommends against the service. There is moderate or high certainty that the
service has no net benefit or that the harms outweigh the benefits. Do not offer.
I- The USPSTF concludes that the current evidence is insufficient to assess the balance of
benefits and harms of the service. Evidence is lacking, of poor quality, or conflicting, and the
balance of benefits and harms cannot be determined. Discuss benefits vs. harms with patient
What are examples of category D screenings?
-Screening for genital herpes with serology
-Screening for asymptomatic carotid artery disease
-Screening for bacteria in urine in absence of symptoms
-Screening for BRCA in person without family history of breast cancer
-Screening for pancreatic or thyroid cancer
, -Screening for testicular cancer
If pt has Sxs, then these will be diagnostics- not screenings
What are reasons why category D screenings are not offered?
-Possible harm to patient that outweighs risks
-Lack of statistical evidence to show that intervention prevents disease or reduces mortality
-False positive or false negative testing
-Low number of affected individuals in target area
Aside from the USPSTF, what other organizations have screening recommendations?
1. American College of Obstetrics and Gynecology (ACOG)
2.American Medical Association (AMA)
3.American Urological Association (AUA)
4. American Association of Family practice (AAFP)
What is lead-time bias?
Occurs when a disease is diagnosed earlier through screening efforts, which makes it LOOK like
the patient lives longer with the disease than a patient who does not have screening
Ex:
- Female in rural area does not have mammography screening, she develops breast cancer which
