LMCC/Periodic Health Examination

Purpose of the PHE

  • primary prevention
    • identifying risk factors for common diseases
    • promotion of healthy behaviour
  • secondary prevention
    • early disease detection to allow early treatment and prevent progression
  • update patient's clinical data
  • fostering the patient-physician relationship

The College of Family Practitioners of Canada provides up to date evidence based PHE checklist forms

Periodic Health Exam

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General Population Special Populations
Discussion
  • dental hygiene
  • noise control and hearing protection
  • smoking cessation, nicotine replacement therapy
  • dietary advice on leafy green vegetables and fruits
  • seat belt use
  • injury prevention
  • moderate physical activity
  • sun exposure
  • problem drinking screening/counselling
  • STD counselling
  • nutritional counselling
Pediatrics:
  • home visits for high risk families
  • developmental milestones

Adolescents:

  • sexual activity and contraception
  • smoking prevention

Perimenopausal women:

  • osteoporosis/risks and benefits of HRT

Adults > 65

  • cognitive impairment
  • fall assessments
Physical
  • breast exam
  • blood pressure
  • BMI measurements
Pediatrics
  • exam of hips, eyes and hearing
  • serial heights, weights and head circumference
  • visual acuity testing

Adults > 65

  • visual acuity testing
  • audio testing

First degree relative with melanoma

  • full body skin exam
Tests
  • Hemoccult test
  • Sigmoidoscopy
  • mammogram (50-69) and pap smear (18-69)
Pediatrics
  • routine hemoglobin
  • blood lead screening

Diabetetics

  • urine dipstick
  • fundoscopy

TB high risk groups

  • Mantoux skin testing

STD High risk groups

  • HIV antibody screening
  • gonorrhea screen
  • chlamydia screen

Familial Adenomatous Polyposis

  • sigmoidoscopy and genetic testing

HNPCC

  • colonoscopy
Therapy
  • folic acid supplementation in women of child bearing age
  • varicella vaccine children 1-12 and immunocompromised
  • rubella vaccine for non-pregnant women
  • pharmacologic treatment of hypertension with DBP > 90 mmHG
Pediatrics
  • routine immunizations
  • hepatitis B immunization

Influenza high risk groups

  • outreach stragetgies for vaccination
  • amantadine prophylaxis for those exposed to index case
  • annual immunization

TB high risk groups:

  • INH prophylaxis for household contacts
  • INH prophylaxis for high risk sub-groups

Immunocompetent institutionalized > 55

  • pneumococcal vaccination

References

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Toronto Notes 2005