Internal Medicine
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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 Parkinsonís, 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