{"id":144,"date":"2020-08-12T21:13:46","date_gmt":"2020-08-12T21:13:46","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=144"},"modified":"2021-05-05T22:47:49","modified_gmt":"2021-05-05T22:47:49","slug":"7-preventive-care-and-health-maintenance","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/pa_obgyn\/overview\/7-preventive-care-and-health-maintenance\/","title":{"rendered":"7. Preventive Care and Health Maintenance"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/-UsuqWkfbQY\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" data-mce-fragment=\"1\"><\/iframe><\/p>\n<p>Duration = 9:49<\/p>\n<input type='hidden' bg_collapse_expand='69e9b568093a56062217185' value='69e9b568093a56062217185'><input type='hidden' id='bg-show-more-text-69e9b568093a56062217185' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9b568093a56062217185' value='Hide Transcript'><button id='bg-showmore-action-69e9b568093a56062217185' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9b568093a56062217185' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number seven<br \/>\n00:02<br \/>\npreventive care and health means<br \/>\n00:05<br \/>\nobstetrician\/gynecologist develop<br \/>\n00:06<br \/>\nsubstantial relationships with their<br \/>\n00:08<br \/>\npatients through the lifespan often<br \/>\n00:10<br \/>\ntaking care of women through their<br \/>\n00:11<br \/>\npregnancy or pregnancies and with<br \/>\n00:13<br \/>\ngynecologic issues throughout their<br \/>\n00:15<br \/>\nreproductive years and beyond the annual<br \/>\n00:18<br \/>\nhealth maintenance visit provides a<br \/>\n00:19<br \/>\ngreat opportunity to counsel patients<br \/>\n00:21<br \/>\nabout maintaining a healthy lifestyle<br \/>\n00:23<br \/>\nand minimizing health risks the<br \/>\n00:26<br \/>\nobjectives of this video are to be able<br \/>\n00:28<br \/>\nto counsel patients regarding the<br \/>\n00:29<br \/>\nfollowing and suggest appropriate<br \/>\n00:31<br \/>\nreferrals if necessary contraception<br \/>\n00:33<br \/>\nintimate partner violence prevention of<br \/>\n00:35<br \/>\nsexually transmitted infections<br \/>\n00:36<br \/>\nimmunizations diet and nutrition<br \/>\n00:39<br \/>\nexercise seatbelt use stress management<br \/>\n00:41<br \/>\nsun exposure depression tobacco use and<br \/>\n00:44<br \/>\nalcohol substance use to explain<br \/>\n00:46<br \/>\nprevention guidelines including<br \/>\n00:48<br \/>\nscreening procedures for diseases of the<br \/>\n00:50<br \/>\nfollowing organ systems breast cervix<br \/>\n00:53<br \/>\ncolon cardiovascular skin and bone and<br \/>\n00:56<br \/>\nto identify risk factors in a patient&#8217;s<br \/>\n00:59<br \/>\npersonal and family history for diseases<br \/>\n01:00<br \/>\nof the following organ systems breast<br \/>\n01:02<br \/>\ncervix colon cardiovascular skin and<br \/>\n01:06<br \/>\nbone there are many important aspects of<br \/>\n01:09<br \/>\nmaintaining a healthy lifestyle that are<br \/>\n01:10<br \/>\nimportant to emphasize at an annual<br \/>\n01:12<br \/>\nhealth maintenance visit diet and<br \/>\n01:15<br \/>\nnutrition exercise seatbelt use sun<br \/>\n01:21<br \/>\nexposure alcohol and substance use<br \/>\n01:24<br \/>\ntobacco and depression as women&#8217;s health<br \/>\n01:28<br \/>\nproviders we also need to think about<br \/>\n01:29<br \/>\ncontraception for any sexually active<br \/>\n01:31<br \/>\nwomen of reproductive age as well as<br \/>\n01:33<br \/>\nscreening for sexually transmitted<br \/>\n01:35<br \/>\ninfections all healthcare providers need<br \/>\n01:37<br \/>\nto also be more cognizant and deliberate<br \/>\n01:39<br \/>\nand screening for intimate partner<br \/>\n01:40<br \/>\nviolence many of our reproductive age<br \/>\n01:43<br \/>\npatients primarily see their<br \/>\n01:45<br \/>\ngynecologist and develop substantive<br \/>\n01:46<br \/>\nbonds with their providers the<br \/>\n01:48<br \/>\nobstetrician gynecologist can help<br \/>\n01:50<br \/>\nprovide resources such as nutritionists<br \/>\n01:52<br \/>\nfor obesity and diet counseling and<br \/>\n01:54<br \/>\nsocial workers and support networks for<br \/>\n01:56<br \/>\nwomen at high risk environments we will<br \/>\n01:58<br \/>\ndiscuss risk factors and prevention<br \/>\n02:00<br \/>\nguidelines in this video for the<br \/>\n02:01<br \/>\nfollowing organ systems breast cervix<br \/>\n02:04<br \/>\ncolon<br \/>\n02:05<br \/>\ncardiovascular skin and bone breast<br \/>\n02:08<br \/>\ncancer is the second most common<br \/>\n02:10<br \/>\nmalignancy and women and the second most<br \/>\n02:12<br \/>\ncommon cause of<br \/>\n02:13<br \/>\ntwo related death and women age is the<br \/>\n02:16<br \/>\nmost significant risk factor at the age<br \/>\n02:18<br \/>\nof 20 a woman&#8217;s risk of breast cancer is<br \/>\n02:20<br \/>\none out of 17 60 at age 38 is one out of<br \/>\n02:24<br \/>\ntwo 29 at 40 it&#8217;s 169 at 50 it&#8217;s one out<br \/>\n02:28<br \/>\nof 42 at sixty it&#8217;s one out of 29 and at<br \/>\n02:31<br \/>\n70 it&#8217;s one out of 27 a woman&#8217;s lifetime<br \/>\n02:34<br \/>\nrisk of developing breast cancer is one<br \/>\n02:36<br \/>\nout of eight the second risk factor is<br \/>\n02:39<br \/>\nfamily history and genetics having a<br \/>\n02:41<br \/>\nfirst-degree relative with breast cancer<br \/>\n02:43<br \/>\nputs a woman at higher risk as well as<br \/>\n02:45<br \/>\nbeing a carrier for brca1 or 2<br \/>\n02:47<br \/>\ncomponents of the reproductive and<br \/>\n02:50<br \/>\nmenstrual history can also be risk<br \/>\n02:51<br \/>\nfactors including early menarchy before<br \/>\n02:53<br \/>\nage 12 late menopause after 55 delayed<br \/>\n02:57<br \/>\nchildbearing her first child after 30<br \/>\n02:59<br \/>\nand Nullah parity radiation exposure is<br \/>\n03:02<br \/>\nan additional risk factor women who<br \/>\n03:04<br \/>\nreceived significant radiation for<br \/>\n03:05<br \/>\nHodgkin&#8217;s disease or an enlarged thymus<br \/>\n03:07<br \/>\ngland are at increased risk of<br \/>\n03:09<br \/>\ndeveloping breast cancer and women with<br \/>\n03:11<br \/>\ndense breasts also are an increased risk<br \/>\n03:13<br \/>\nof developing breast cancer for breast<br \/>\n03:16<br \/>\ncancer prevention guidelines the<br \/>\n03:17<br \/>\nAmerican College of Obstetricians and<br \/>\n03:19<br \/>\nGynecologists recommend starting<br \/>\n03:21<br \/>\nmammograms at age 40 and continuing to<br \/>\n03:23<br \/>\nhave them annually the American Cancer<br \/>\n03:25<br \/>\nSociety has the same recommendations of<br \/>\n03:27<br \/>\nage 40 and annually the National Cancer<br \/>\n03:30<br \/>\nInstitute recommends starting at age 40<br \/>\n03:32<br \/>\nand having mammograms performed every<br \/>\n03:33<br \/>\none to two years the US Preventive<br \/>\n03:36<br \/>\nServices Task Force recommends biannual<br \/>\n03:39<br \/>\nmammograms starting at age 50 through<br \/>\n03:41<br \/>\nage 74 women should be informed of the<br \/>\n03:44<br \/>\nbenefits of mammography and the risks of<br \/>\n03:46<br \/>\nadditional imaging or biopsies that may<br \/>\n03:48<br \/>\nbe recommended based on screening<br \/>\n03:50<br \/>\nresults we will now discuss colorectal<br \/>\n03:52<br \/>\ncancer it is the third leading cause of<br \/>\n03:55<br \/>\ncancer death in women it is diagnosed<br \/>\n03:57<br \/>\nmore in women than any individual<br \/>\n03:59<br \/>\ngynecologic cancer screening tests are<br \/>\n04:02<br \/>\nunderused in many segments of the<br \/>\n04:04<br \/>\npopulation risk factors include<br \/>\n04:06<br \/>\ninflammatory bowel diseases such as<br \/>\n04:08<br \/>\nCrohn&#8217;s disease or ulcerative colitis<br \/>\n04:10<br \/>\nfamily history of colorectal cancer or<br \/>\n04:13<br \/>\ncolorectal polyps genetic syndromes such<br \/>\n04:15<br \/>\nas familial adenomatous polyposis or<br \/>\n04:17<br \/>\nhereditary nonpolyposis colorectal<br \/>\n04:19<br \/>\ncancer other risk factors include<br \/>\n04:22<br \/>\nlifestyle factors such as lack of<br \/>\n04:24<br \/>\nregular physical activity low fruit and<br \/>\n04:26<br \/>\nvege too<br \/>\n04:26<br \/>\nintake low-fiber high-fat diet<br \/>\n04:29<br \/>\noverweight and obesity alcohol<br \/>\n04:31<br \/>\nconsumption and tobacco use ACOG<br \/>\n04:34<br \/>\nrecommends colorectal cancer screening<br \/>\n04:36<br \/>\nfor average age risk women beginning at<br \/>\n04:38<br \/>\nage 50 and for African American women<br \/>\n04:40<br \/>\nbeginning at age 45 and recommends<br \/>\n04:43<br \/>\ncolonoscopy every 10 years as the most<br \/>\n04:45<br \/>\neffective screening modality moving now<br \/>\n04:48<br \/>\nin a cervical cancer the incidence of<br \/>\n04:50<br \/>\ncervical cancer has decreased more than<br \/>\n04:52<br \/>\n50 percent in the past 30 years because<br \/>\n04:54<br \/>\nof widespread screening it continues to<br \/>\n04:56<br \/>\nbe more common worldwide particularly in<br \/>\n04:58<br \/>\ncountries without screening programs<br \/>\n05:00<br \/>\nwe&#8217;ll begin by discussing cervical<br \/>\n05:02<br \/>\ncancer risk factors most cervical cancer<br \/>\n05:05<br \/>\noccurs in women who were either never<br \/>\n05:07<br \/>\nscreened or were inadequately screened<br \/>\n05:11<br \/>\n50% of women diagnosed with cervical<br \/>\n05:13<br \/>\ncancer have never had cervical cytology<br \/>\n05:15<br \/>\ntesting an additional 10% of women had<br \/>\n05:18<br \/>\nnot been screed within 10 years of<br \/>\n05:19<br \/>\ndiagnosis other risk factors for<br \/>\n05:21<br \/>\ncervical cancer include<br \/>\n05:23<br \/>\nimmunosuppression there is a higher<br \/>\n05:24<br \/>\nincidence of HPV infection and<br \/>\n05:26<br \/>\nprogression in HIV organ transplant and<br \/>\n05:29<br \/>\nother immunosuppressed women smoking and<br \/>\n05:32<br \/>\nearly cor turkey the screening<br \/>\n05:34<br \/>\nguidelines are that Pap test should<br \/>\n05:36<br \/>\nbegin at age 21 and from age 21 to 30<br \/>\n05:39<br \/>\ncytology alone should be performed every<br \/>\n05:41<br \/>\nthree years and from age 30 to 65<br \/>\n05:43<br \/>\ncytology plus HPV every five years is<br \/>\n05:46<br \/>\nthe preferred screening screening can<br \/>\n05:49<br \/>\nstop after the age of 65 if she has not<br \/>\n05:51<br \/>\nhad any high-grade dysplasia for 20<br \/>\n05:53<br \/>\nyears and the HPV vaccine should be<br \/>\n05:55<br \/>\ngiven if females from age 9 to 26 moving<br \/>\n05:58<br \/>\nnow to bone health<br \/>\n06:00<br \/>\nosteoporosis has a 5 times greater<br \/>\n06:02<br \/>\nprevalence in women than in men and<br \/>\n06:04<br \/>\nwomen&#8217;s sustained 80% of hip fractures<br \/>\n06:07<br \/>\nin the United States hip fractures are a<br \/>\n06:10<br \/>\nsignificant source of morbidity and<br \/>\n06:11<br \/>\nmortality of women older than 80 years<br \/>\n06:14<br \/>\nold with a hip fracture only 56% could<br \/>\n06:16<br \/>\nwalk independently after one year and<br \/>\n06:18<br \/>\napproximately 3 to 6 \/ 7 a woman died of<br \/>\n06:21<br \/>\ncomplications while hospitalized for a<br \/>\n06:23<br \/>\nhip fracture 4 risk factors for<br \/>\n06:26<br \/>\nosteoporosis Caucasian women have the<br \/>\n06:28<br \/>\nhighest rates of hip fracture and<br \/>\n06:30<br \/>\nafrican-american women have the lowest<br \/>\n06:32<br \/>\nrates increasing age and low body weight<br \/>\n06:35<br \/>\npersonal history of fracture family<br \/>\n06:37<br \/>\nhistory of osteoporosis<br \/>\n06:39<br \/>\nalcohol and tobacco use for prevention<br \/>\n06:43<br \/>\nit is important to address bone health<br \/>\n06:44<br \/>\nin all age groups including puberty and<br \/>\n06:47<br \/>\nadolescence poor nutrition including<br \/>\n06:49<br \/>\nanorexia nervosa inactive lifestyle and<br \/>\n06:52<br \/>\nsmoking may prevent girls from reaching<br \/>\n06:54<br \/>\ntheir peak bone mass screening for<br \/>\n06:56<br \/>\nosteoporosis is with a DEXA scan of the<br \/>\n06:58<br \/>\nlumbar spine and hip it should begin at<br \/>\n07:00<br \/>\nage 65 DEXA scans can be selectively<br \/>\n07:04<br \/>\nused for women less than 65 if they have<br \/>\n07:06<br \/>\na medical history of aphrodite fracture<br \/>\n07:08<br \/>\nif they weigh less than 127 pounds<br \/>\n07:10<br \/>\nthey&#8217;ve a medical cause of bone loss of<br \/>\n07:13<br \/>\nparental history of a hip fracture if<br \/>\n07:15<br \/>\nthey are a current smoker if there is<br \/>\n07:17<br \/>\nalcoholism or if they have rheumatoid<br \/>\n07:18<br \/>\narthritis osteoporosis is diagnosed by<br \/>\n07:21<br \/>\nthe t-score which is the number of<br \/>\n07:23<br \/>\nstandard deviations above or below the<br \/>\n07:25<br \/>\nmean average bone density of young adult<br \/>\n07:27<br \/>\nwomen a normal T score is greater than<br \/>\n07:30<br \/>\nor equal to minus one low bone mass or<br \/>\n07:33<br \/>\nosteopenia is between minus 1 and minus<br \/>\n07:35<br \/>\n2.5 and osteoporosis is when it&#8217;s less<br \/>\n07:38<br \/>\nthan minus 2.5 let&#8217;s switch gears now<br \/>\n07:41<br \/>\nand discuss skin cancer the incidence of<br \/>\n07:44<br \/>\nmelanoma is increasing faster than any<br \/>\n07:46<br \/>\nother potentially preventable cancer in<br \/>\n07:48<br \/>\nthe United States risk factors are<br \/>\n07:50<br \/>\nfamilial having a typical Niva having a<br \/>\n07:52<br \/>\nhigh nevis count sun or UV exposure and<br \/>\n07:55<br \/>\nphenotypic traits of light skin<br \/>\n07:57<br \/>\npigmentation having a red or blond hair<br \/>\n07:59<br \/>\ncolor high density freckling and a light<br \/>\n08:02<br \/>\neye color<br \/>\n08:02<br \/>\nwhen performing a skin examination of a<br \/>\n08:05<br \/>\nlesion look at the a for asymmetry B for<br \/>\n08:08<br \/>\nborder irregularities C for color<br \/>\n08:10<br \/>\nvariation D for a diameter greater than<br \/>\n08:13<br \/>\nsix millimeters and E for enlargement or<br \/>\n08:15<br \/>\nevolution of color change shape or<br \/>\n08:17<br \/>\nsymptoms our final topic is coronary<br \/>\n08:20<br \/>\nheart disease one out of five Americans<br \/>\n08:22<br \/>\nhave a high total cholesterol level<br \/>\n08:24<br \/>\nabnormal cholesterol levels have been<br \/>\n08:27<br \/>\nfound to be associated with<br \/>\n08:28<br \/>\natherosclerosis and cardiovascular<br \/>\n08:30<br \/>\ndisease cholesterol levels that are<br \/>\n08:32<br \/>\nchecked are low-density lipoproteins or<br \/>\n08:34<br \/>\nLDL high density lipoproteins or HDL<br \/>\n08:37<br \/>\ntriglycerides and total cholesterol<br \/>\n08:39<br \/>\nlevels dis lipedema is diagnosed if<br \/>\n08:41<br \/>\nthere is a high LDL triglyceride or<br \/>\n08:44<br \/>\ntotal cholesterol level or a low HDL<br \/>\n08:46<br \/>\nlevel initial screening for women should<br \/>\n08:49<br \/>\nbegin at age 45 and occur every five<br \/>\n08:51<br \/>\nyears unless she has risk factors for<br \/>\n08:53<br \/>\ncardio<br \/>\n08:53<br \/>\nvascular disease and these risk factors<br \/>\n08:55<br \/>\ninclude family history of familial<br \/>\n08:58<br \/>\nhyperlipidemia family history of<br \/>\n09:00<br \/>\npremature cardiovascular disease less<br \/>\n09:02<br \/>\nthan 54 men and less than 64 women<br \/>\n09:04<br \/>\npersonal or family history of peripheral<br \/>\n09:06<br \/>\nvascular disease obesity diabetes<br \/>\n09:08<br \/>\nmellitus or multiple cardiovascular risk<br \/>\n09:11<br \/>\nfactors for example tobacco use and<br \/>\n09:12<br \/>\nhypertension the US Preventive Services<br \/>\n09:15<br \/>\nTask Force recommends starting<br \/>\n09:17<br \/>\ncholesterol screening at age 45 for<br \/>\n09:19<br \/>\nwomen who are at increased risk for<br \/>\n09:20<br \/>\ncoronary heart disease this concludes<br \/>\n09:22<br \/>\nthe aapko video on preventive care and<br \/>\n09:25<br \/>\nhealth maintenance we have discussed the<br \/>\n09:26<br \/>\nimportance of the health maintenance<br \/>\n09:28<br \/>\nvisit as well as talked about prevention<br \/>\n09:30<br \/>\nguidelines and identified risk factors<br \/>\n09:32<br \/>\nfor breast cervix colon cardiovascular<br \/>\n09:35<br \/>\nskin and bone disorders<\/p>\n<p><\/div>\n<hr>\n","protected":false},"excerpt":{"rendered":"<p>Duration = 9:49<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":46,"menu_order":7,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-144","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/144","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/comments?post=144"}],"version-history":[{"count":1,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/144\/revisions"}],"predecessor-version":[{"id":2763,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/144\/revisions\/2763"}],"up":[{"embeddable":true,"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/pages\/46"}],"wp:attachment":[{"href":"https:\/\/brooksidepress.org\/pa_obgyn\/wp-json\/wp\/v2\/media?parent=144"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}