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Old 06-05-2011
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Question Secondary versus Tertiary Prevention

Is (Treatment of Hypertension) considered secondary prevention OR Tertiary prevention?
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Rx HT is tertiary prevention
secondary prevention is community blood pressure screening
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Correct Answer

Secondary prevention is screening and other tests to find the disease early and cure it.

Treatment in such a way as to prevent further complications from an already well established disease is tertiary prevention.

So treatment of HTN would be tertiary prevention.

An example of the 3 levels of prevention
http://www.cdc.gov/excite/skincancer/mod13.htm
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what about screening for hypertension? i guess its also Tertiary... agree?
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Screening is always secondary!
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alright

so this means that lumpectomy and radiation are considered tertiary prevention do you concur?
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Quote:
Originally Posted by docoftheworld View Post
alright

so this means that lumpectomy and radiation are considered tertiary prevention do you concur?
Good question. I think it would be secondary "early diagnosis and treatment".
Tertiary might be to control metastatic disease and prevent complications.
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""Treatment in such a way as to prevent further complications from an already well established disease is tertiary prevention.""

but this is more subjective and philosophical rather than objective:

you could argue that treating HTN is also early and is preventing retinopathy/nephropathy/etc
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Secondary prevention is usedó

after the disease has occurred, but
before the person notices that anything is wrong

From the page you've provided:

based on this concept lumpectomy+radiation = Tertiary (there is a mass that the patient notes)

no?
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what about screening for microalbuminuria?? thats screening, but i bet that its tertiary!
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In HTN you can't cure it. You control it with meds and in effect you control the damaging complications associated with HTN. So tertiary prevention.

Here in lumpectomy you are removing the localized disease before it has metastasized. So early diagnosis and treatment. Secondary prevention.

If the tumor has metastasized you give chemo, and that is tertiary prevention.
Thats what I think.
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in lumpectomy you are removing the localized disease before it has metastasized"

but we could never know if there have been metastases (even if sentinel node is negative, there is a chance that mets happened)

you didnt comment on my microalbumin. screening thing? if its indeed tertiary, and you accept that, why isnt screening for HTN is tertiary by the same token
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Quote:
Originally Posted by docoftheworld View Post
what about screening for microalbuminuria?? thats screening, but i bet that its tertiary!
Ok. When do we do screening for microalbuminuria. In diabetics, to prevent nephropathy. So that will be tertiary.

In HTN we are screening for the disease itself not for its complications (e.g retinopathy). So screening for htn would be secondary prevention and treatment would be tertiary prevention.

In DM : screening for complications of DM (nephropathy) by checking for microalbuminuria would be tertiary prevention and screening for DM itself would be secondary prevention.
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Every adult gets his or her BP checked at each office visit. If that person is a known case of HTN, then this would be tertiary prevention. If not, then it would be secondary prevention
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very convincing!!!!!!! amazing actually, i am convinced with the comparison between DM and HTN
-----------------

we still differ on Lumpectomy+radiation (or even lung resection in the case of siutated cancer)

what do you think? could you discuss this further? the website you gave said that secondary (the disease happened HOWEVER The patient is not aware of anything)

you agree? if you agree then Lump.+lung resec is NOT secondary cuz the patient perhaps notices (hemoptysis, lump in breast, etc)

what do you think?
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Quote:
Originally Posted by docoftheworld View Post
very convincing!!!!!!! amazing actually, i am convinced with the comparison between DM and HTN
-----------------

we still differ on Lumpectomy+radiation (or even lung resection in the case of siutated cancer)

what do you think? could you discuss this further? the website you gave said that secondary (the disease happened HOWEVER The patient is not aware of anything)

you agree? if you agree then Lump.+lung resec is NOT secondary cuz the patient perhaps notices (hemoptysis, lump in breast, etc)

what do you think?
http://www.cdc.gov/excite/skincancer/mod13.htm
That site referred to skin cancer. There was a suspicious lesion but the patient didn't know. Its about the disease not recognised yet and the doctor picks it up and treats early so that it can be cured.

Same goes for breast CA in early stages. We do lumpectomy and prevent it from progressing further. Secondary prevention.
If it has metastasized, then controlling it through chemo is tertiary.

I think we should get an opinion from some one else as well
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the patient perhaps notices (hemoptysis, lump in breast)

i am in total agreement IF the cancer was detected by mammo only and not self found by patient (as in mass)

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