Internal Medicine
Curricular Elements:
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Objectives
Case I
Case II
Case III
Adult Vaccination
Cancer Screening
Diabetes Screening
PREVENTION & SCREENING
CASE #3
O.M. is a healthy 69-year-old male with a past history of controlled HTN and Parkinson disease. He has recently moved into a retirement community nearby and is visiting you after Halloween to establish a new primary care physician. He has a mild tremor and slow gait from his Parkinson’s, but otherwise denies any active complaints. He is interested in prostate cancer screening.
Medical History
Adult: 1) HTN for 20 years, easily controlled 2) Parkinsons Disease for 3 years
Meds: Dyazide, Sinemet
Allergies; None
Surgeries: Appendectomy 22 years ago
Habits: Smoking 1 ppd for 40 years, drug use, social drinker of 2 beverages a week
Social: Retired, former banker, lives with wife
Family: No family history of cancer or heart disease
Repro: Sexually active with wife only
Vaccines: Childhood series, Td after a laceration 17 years ago
Diet: 2 meals a day, low salt
Exercise: None regularly
QUESTIONS FOR DISCUSSION
1. List all
of the vaccines which he is eligible for. When is the best
time to vaccinate for
influenza?
2. What will you do with his request for prostate cancer screening?
3. Should
you screen for any other conditions? In geriatric patients
which senses require
special attention?
4. How would you council him regarding:
a) Diet
b) Exercise
c) Injury and fall prevention
d) Aspirin use for primary prevention of M