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Duke Family Medicine Center
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Preventative Health
Guidelines for Immunizations
Immunizations have very successfully decreased the incidence of once common diseases. But universal, population-wide immunization must be continued or we will lose the protection. The schedules of specific immunizations for children, adolescents, and adults can be found by clicking on the following titles:
 
 
Preventive Health Guidelines
SCHEDULE FOR HEALTH SCREENING AND PHYSICAL EXAMS*
Children:

  • Visits at 1, 2, 4, 6, 9, 12 & 15 months of age, then yearly thereafter.
  • Includes developmental screening, common parental concerns, anticipatory guidance and all immunizations required by North Carolina Academies of Family Physicians, and Pediatrics.
  • Lead and blood count at 12 and 24 months of age.
 
All Adults:
 
  • Blood pressure & weight: every one to two years.
  • Physical exam: based on risk factors.
  • Cholesterol: every 5 years, begin age 35.
  • Tetanus shot: every 10 years.
  • Counseling will be offered for smoking, exercise, diet and other health risks.
 
Adults 50 years & older:
 
  • Colon cancer screening: yearly fecal occult blood testing, sigmoidoscopy or colonoscopy every 5 - 10 years.
  • Flu shot: yearly.
  • Pneumoccocal vaccine: once at age 65 or older.
  • Abdominal ultrasound if male ages 65-75 and present or past smoker.
 
Women's health screening:
 
  • Pap smear: every 1-3 years based on risk. After hysterectomy - not required unless otherwise advised.
  • Mammograms: every 1-2 years between the ages of 40-50 and then yearly.
  • Osteoporosis counseling: periodically. DEXA scans begin age 65. If there is a high risk of osteoporosis, DEXA scans may begin at an earlier age.
 
Men's health:

  • Prostate health counseling: yearly after age 50.
 
*Guidelines subject to change
 
Click on the title below for more information:
Preventive Services for Healthy Living 
 
Chronic Disease Management
Diabetes Metrics
 
Tests to be done if you have diabetes:
 
1) Check blood pressure at every visit, with a goal of < 130/80
2) Check weight at every visit, with a goal body mass index < 25
3) Visual foot exam on every visit
4) Foot monofilament exam annually
5) HgbA1C every 3-6 months depending on severity
6) Urine Microalbumin/Creatinine ratio annually
7) Total Cholesterol annually, goal < 200 8) LDL Cholesterol annually, goal < 100
9) Eye exam annually
10) Flu vaccine annually (unless allergic to eggs)
11) Pneumococcus vaccine once, booster if 65 or older and if your last vaccine was given more than 5 years ago
12) Aspirin 81 mg daily if you are over 40 and are not allergic
13) Diabetes education once, repeat yearly if your HgbA1C is over 7%.
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