Health care maintenance is the examination of asymptomatic individuals and screening Screening Preoperative Care for any occult disease. The process provides an opportunity for disease prevention and early diagnosis and the possibility of preventing progression and complications. During a health care maintenance examination, the primary physician conducts a thorough personal, social, and family history with a comprehensive systematic review to uncover any relevant risk factors. A physical examination is performed, and relevant screening Screening Preoperative Care exams are recommended. Screening Screening Preoperative Care tests cover malignancies (breast, prostate Prostate The prostate is a gland in the male reproductive system. The gland surrounds the bladder neck and a portion of the urethra. The prostate is an exocrine gland that produces a weakly acidic secretion, which accounts for roughly 20% of the seminal fluid. Prostate, Seminal, and Bulbourethral Glands: Anatomy – BROKEN, colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy, lung) and other conditions, including diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus, cardiovascular diseases, and infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease. Immunizations are administered if indicated. Different interventions are discussed to help reduce health risk factors, and health goals are set to determine future follow-up and monitoring.
Last updated: 25 Aug, 2021
Category | Systolic BP | Diastolic BP | |
---|---|---|---|
Elevated BP | 120–129 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg | AND | < 80 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg |
Hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension stage 1 Stage 1 Trypanosoma brucei/African trypanosomiasis | 130–139 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg | OR | 80–89 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg |
Hypertension Hypertension Hypertension, or high blood pressure, is a common disease that manifests as elevated systemic arterial pressures. Hypertension is most often asymptomatic and is found incidentally as part of a routine physical examination or during triage for an unrelated medical encounter. Hypertension stage 2 | ≥ 140 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg | OR | ≥ 90 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg |
Blood pressure check by a health care professional
Image: “A healthcare professional performing blood pressure monitoring on a patient” by rawpixel.com. License: CC0Dyslipidemia is defined as lipid values associated with an increased risk of and/or presence of disease for which the initiation of lipid-lowering therapy will be of benefit.
USPSTF recommendations:
Screening Screening Preoperative Care is not recommended in:
Papanicolaou (Pap) smear showing cervical cancer Cervical cancer Cervical cancer, or invasive cervical carcinoma (ICC), is the 3rd most common cancer in women in the world, with > 50% of the cases being fatal. In the United States, ICC is the 13th most common cancer and the cause of < 3% of all cancer deaths due to the slow progression of precursor lesions and, more importantly, effective cancer screening. Cervical Cancer: Pap staining in a patient with squamous carcinoma, exhibiting clusters of cohesive cells with marked nuclear enlargement, pleomorphisms, hyperchromatism, and keratinization (X40)
Image: “ Pap smear Pap smear Cytological preparation of cells collected from a mucosal surface and stained with Papanicolaou stain. Cervical Cancer Screening showing cervical cancer Cervical cancer Cervical cancer, or invasive cervical carcinoma (ICC), is the 3rd most common cancer in women in the world, with > 50% of the cases being fatal. In the United States, ICC is the 13th most common cancer and the cause of < 3% of all cancer deaths due to the slow progression of precursor lesions and, more importantly, effective cancer screening. Cervical Cancer” by Department of Pathology, Muhimbili University of Health and Allied Sciences (MUHAS), P,O, Box 65001, Dar es Salaam, Tanzania. License: CC BY 2.0USPSTF recommendations for average-risk individuals:
USPSTF recommendations for high-risk individuals:
Woman having a mammogram Mammogram Fibrocystic Change
Image: “Woman Receives Mammogram Mammogram Fibrocystic Change” by Rhoda Baer. License: Public DomainThe USPSTF recommends screening Screening Preoperative Care for colorectal cancer Colorectal cancer Colorectal cancer (CRC) is the 2nd leading cause of cancer-related deaths in the United States. Colorectal cancer is a heterogeneous disease that arises from genetic and epigenetic abnormalities, with influence from environmental factors. Colorectal Cancer (CRC) in adults to be initiated at age 45 years.
Screening Screening Preoperative Care methods include:
Individuals requiring more frequent screening Screening Preoperative Care and before 45 years of age (depending on the condition):
The USPSTF recommends daily low-dose aspirin Aspirin The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. Nonsteroidal Antiinflammatory Drugs (NSAIDs) for primary prevention of CRC (and cardiovascular disease) for individuals aged 50–59 years who have:
Colonoscopy Colonoscopy Endoscopic examination, therapy or surgery of the luminal surface of the colon. Colorectal Cancer Screening: This colon Colon The large intestines constitute the last portion of the digestive system. The large intestine consists of the cecum, appendix, colon (with ascending, transverse, descending, and sigmoid segments), rectum, and anal canal. The primary function of the colon is to remove water and compact the stool prior to expulsion from the body via the rectum and anal canal. Colon, Cecum, and Appendix: Anatomy cancer screening Screening Preoperative Care procedure is generally recommended to start at the age of 50 years (45 years based on American Cancer Society recommendations) for average-risk individuals.
Image: “ Colonoscopy Colonoscopy Endoscopic examination, therapy or surgery of the luminal surface of the colon. Colorectal Cancer Screening procedure” by United States Navy. License: Public DomainLow-dose CT screening Screening Preoperative Care image (left) and follow-up diagnostic CT image (right) for a patient diagnosed with adenocarcinoma
Image: “Low-dose CT scan screening Screening Preoperative Care for lung cancer Lung cancer Lung cancer is the malignant transformation of lung tissue and the leading cause of cancer-related deaths. The majority of cases are associated with long-term smoking. The disease is generally classified histologically as either small cell lung cancer or non-small cell lung cancer. Symptoms include cough, dyspnea, weight loss, and chest discomfort. Lung Cancer: comparison of images and radiation Radiation Emission or propagation of acoustic waves (sound), electromagnetic energy waves (such as light; radio waves; gamma rays; or x-rays), or a stream of subatomic particles (such as electrons; neutrons; protons; or alpha particles). Osteosarcoma doses between low-dose CT and follow-up standard diagnostic CT” by Ono K, Hiraoka T, Ono A, Komatsu E, Shigenaga T, Takaki H, Maeda T, Ogusu H, Yoshida S, Fukushima K, Kai M. License: CC BY 2.0The USPSTF recommends screening Screening Preoperative Care for HIV HIV Anti-HIV Drugs in:
An HIV HIV Anti-HIV Drugs pre- exposure Exposure ABCDE Assessment prophylaxis Prophylaxis Cephalosporins (PrEP) with antiretrovirals is recommended for high-risk individuals.
Abdominal aortic aneurysm Aortic aneurysm An abnormal balloon- or sac-like dilatation in the wall of aorta. Thoracic Aortic Aneurysms screening Screening Preoperative Care: abdominal ultrasonography in the sagittal plane Sagittal plane Anterior Abdominal Wall: Anatomy showing an abdominal aortic aneurysm Aortic aneurysm An abnormal balloon- or sac-like dilatation in the wall of aorta. Thoracic Aortic Aneurysms with axial Axial Computed Tomography (CT) plane diameter (red dashed line), and maximal diameter in the sagittal plane Sagittal plane Anterior Abdominal Wall: Anatomy (dotted yellow line)
Image: “Ultrasonography of abdominal aortic aneurysm Aortic aneurysm An abnormal balloon- or sac-like dilatation in the wall of aorta. Thoracic Aortic Aneurysms” by Mikael Häggström, M.D. License: CC0Dual-energy
X-ray
X-ray
Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source.
Pulmonary Function Tests absorptiometry assessment of
bone
Bone
Bone is a compact type of hardened connective tissue composed of bone cells, membranes, an extracellular mineralized matrix, and central bone marrow. The 2 primary types of bone are compact and spongy.
Bones: Structure and Types mineral density of the femoral
neck
Neck
The part of a human or animal body connecting the head to the rest of the body.
Peritonsillar Abscess (A) and the lumbar
spine
Spine
The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum.
Vertebral Column: Anatomy (B):
T scores of –4.2 and –4.3 (consistent with
osteoporosis
Osteoporosis
Osteoporosis refers to a decrease in bone mass and density leading to an increased number of fractures. There are 2 forms of osteoporosis: primary, which is commonly postmenopausal or senile; and secondary, which is a manifestation of immobilization, underlying medical disorders, or long-term use of certain medications.
Osteoporosis) were found at the hip (A) and lumbar
spine
Spine
The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum.
Vertebral Column: Anatomy (B), respectively, in a 53-year-old man affected with
Fabry disease
Fabry disease
Fabry disease (FD), also known as Anderson-Fabry disease, is an X-linked recessive lysosomal storage disorder and the 2nd most common of the lysosomal storage disorders. Fabry disease is caused by a deficiency in the alpha-galactosidase enzyme (alpha-Gal A), resulting in the accumulation of the glycosphingolipid globotriaosylceramide (Gb3) in lysosomes.
Fabry Disease.
Vaccines:
Influenza Influenza Influenza viruses are members of the Orthomyxoviridae family and the causative organisms of influenza, a highly contagious febrile respiratory disease. There are 3 primary influenza viruses (A, B, and C) and various subtypes, which are classified based on their virulent surface antigens, hemagglutinin (HA) and neuraminidase (NA). Influenza typically presents with a fever, myalgia, headache, and symptoms of an upper respiratory infection. Influenza Viruses/Influenza vaccine Vaccine Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa), antigenic proteins, synthetic constructs, or other bio-molecular derivatives, administered for the prevention, amelioration, or treatment of infectious and other diseases. Vaccination is recommended to be given annually to all adults ≥ 18 years of age unless they have a history of allergic reactions Allergic Reactions Type I hypersensitivity reaction against plasma proteins in donor blood Transfusion Reactions to components.
Vaccines:
In the United States:
Older adults:
Special indications:
Vaccines:
General principles:
Recommendations:
Vaccines:
In adults aged 19–64 years with an increased risk of pneumococcal infection and complications, a dose of PPSV 23 is indicated for those with:
In adults aged 19–64 years of age, both PCV13 and PPSV23 are recommended for individuals:
In adults aged 19–64 years of age, PCV13 and 2 doses of PPSV23 are recommended in individuals with:
In all immunocompetent adults ≥ 65 years of age:
PCV13 in adults ≥ 65 years of age:
Varicella vaccine Vaccine Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa), antigenic proteins, synthetic constructs, or other bio-molecular derivatives, administered for the prevention, amelioration, or treatment of infectious and other diseases. Vaccination:
Herpes zoster Herpes Zoster Varicella-zoster virus (VZV) is a linear, double-stranded DNA virus in the Herpesviridae family. Shingles (also known as herpes zoster) is more common in adults and occurs due to the reactivation of VZV. Varicella-Zoster Virus/Chickenpox vaccine Vaccine Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa), antigenic proteins, synthetic constructs, or other bio-molecular derivatives, administered for the prevention, amelioration, or treatment of infectious and other diseases. Vaccination: