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

	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

Toronto Notes 2005

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