PERIODIC HEALTH EXAM AKA ANNUAL PHYSICAL GENERAL MEDICAL EXAM EOGHAN O’SHEA MD

CANADIAN FAMILY PHYSICIAN VOL 57 FEB 2011 DR MICHEAL HOWARD-TRIPP DR. CLEO MAVRIPLIS SHOULD WE ABANDON THE PERIODIC HEALTH EXAM ?

RATIONALE CASE FINDING SCREENING FOR UNDETECTED DISEASE RISKY BEHAVIOUR IDENTIFICATION HEALTH PROMOTION DISEASE PREVENTION IMMUNIZATION UP TO DATE ?

DECISION TO INCLUDE INTERVENTION BURDEN OF SUFFERING QUALITY OF SCREENING SENSITIVITY SPECIFICITY EFFECTIVENES OF INTERVENTION

QUESTIONNAIRE AND EXAMINATION ALLERGIES REVIEW PAST HISTORY FAMILY HISTORY SOCIAL HISTORY OBSTETRICAL HISTORY EDUCATION ALCOHOL,SMOKING,SUBSTANCE USE DIET EXERCISE HEIGHT, WEIGHT,BMI VITALS

MOVING TARGET AGE EXTREMES E.G. TODDLER V FRAIL SENIOR GENDER CLINICAL CHARECTERISTICS ANTICIPATED DURATION OF LIFE

KEY OBJECTIVES DETERMINE PATIENT’S RISKS FOR COMMON GENDER/AGE SPECIFIC CONDITIONS ELICIT INFORMATION ABOUT ETHNIC,FAMILY,SOCIO- ECONOMIC,OCCUPATIONAL,CHARACT ERISTICS THAT PUT AT HIGH RISK FOR PARTICULAR CONDITION

GROUPS/COHORTS INFANT/TODDLER <3 CHILD 3-12 YOUTH ADULT MIDDLE AGE SENIOR

INFANT AND TODDLER DELAYED GROWTH ROURKE CHART DEVELOPMENT NIPISSING APPROPRIATE MILESTONES ? ABUSE V NEGLECT ? IMMUNIZATIONS UP TO DATE ? PASSIVE SMOKING ? CAS ???

SENIORS ELDER ABUSE,FALLS,HEARING,VISION NUTRITION,CANCER,VIT D IMMUNIZATION: annual influenza/pneumococcal Decreased screening after 70-75

YOUTH “HEADS” MOTOR VEHICLE ACCIDENTS SUBSTANCE ABUSE STIs CHLAMYDIA,HIV,VDRL Sedentary lifestyle BP DENTAL FEMALE RUBELLA,FOLIC ACID,HPV TESTICLE EXAM??

ADULTS SUBSTANCE ABUSE EATING DISORDERS FAMILY VIOLENCE (PAP 30-70)

MIDDLE AGE LUNG CANCER COLON CANCER SKIN CANCER OBESITY BREAST CANCER CARDIOVASCULAR PROSTATE (controversial role of PSA)

ONTARIO BIG 5 F.O.B. EVERY SECOND YEAR MAMMOGRAM PAP CHILDHOOD IMMUNIZATIONS ANNUAL INFLUENZA IN ELDERLY

PERIODIC HEALTH,MELROSE Every 3-5 years Height and weight BP Preventive counselling Health risk assessment Immunizations ?

Specifics Height and weight 1-3 years BP at least every 2 years Vision q 2 years Lipids q 5 years after age 35 Glucose q2-3 years after age 45 F.O.B q 2 years Mammogram q 1-2 years Pap until 70

Preventive care,Ont PAP MAMMOGRAPHY Childhood immunizations <2 Colorectal Influenza >65