Screening and Preventive Medicine [Video]

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Screening and Preventive Medicine Basics for the USMLE Step 1:

1. Screening: This refers to the application of tests, examinations or other procedures to detect a disease in people who have no symptoms of that disease.

2. Preventive medicine: It intensifies efforts to prevent diseases and injuries from happening, instead of treating them or their symptoms. This can come in a few different forms like Primary prevention (preventing disease before it starts), Secondary prevention (detecting and addressing disease in early stages) and Tertiary prevention (managing established disease).

Importance of Screening and Preventive Medicine:

1. Early Detection: It allows for early detection of diseases which can often lead to better prognosis as the disease could be treated in the initial stages.

2. Disease Prevention: Preventive medicine helps in preventing the occurrence of certain diseases, either through lifestyle changes or through vaccination etc.

Screening Steps:

1. Risk Assessment: Considering the age, gender, genetic factors, lifestyle and personal or family histories to identify individuals more likely to develop diseases.

2. Screening Test: Apply appropriate tests or exams. Example of such tests include mammography for breast cancer, colonoscopy for colorectal cancer and blood pressure measurement for hypertension.

3. Follow-up: Further testing, examination or treatment based on the results of the screening test.

Preventive Medicine and Vaccination:

1. Immunizations: Vaccines to prevent infectious diseases like influenza, Pneumococcal pneumonia, Hepatitis B, Measles, Mumps and Rubella.

2. Preventive medication: Chemoprophylaxis can be used in certain people at high risk, e.g., daily aspirin use to prevent heart disease or stroke in those at increased risk.

Key High-Yield Facts:

1. USPSTF: The U.S. Preventive Services Task Force provides evidence-based recommendations about clinical preventive services such as screenings, counseling services, preventive medications.

2. Newborn screening: It’s most comprehensive and successful public health screening which tests newborns for endocrine, hemoglobin, metabolic, and other inherited conditions.

3. Sensitivity and Specificity: Sensitivity measures the proportion of positives accurately identified, while specificity measures the proportion of negatives accurately identified. A good screening test is one which has high sensitivity and specificity.

4. Prostate Cancer Screening: PSA (prostate-specific antigen) screening is a contentious issue with various guidelines recommending different approaches.

5. Breast Cancer Screening: Mammography is recommended for women above certain age groups, but also depends on individual risk factors.

Screening and preventive medicine is a core part of USMLE Step 1 examination and forms an essential part of primary care. Understanding the concepts can help in ensuring better patient outcomes and in making cost-effective healthcare decisions.