How to Human

Overview

  • Demographics

Human-ing is hard.

Social history

  • Family

  • Housing / Safety

Consider isolation + supports

Family

  • Mother

  • Father

  • Maternal Grandparents

  • Paternal Grandparents

  • Other

Consider individual risk

Family planning + risk of inherited conditions to children

Medical

  • Previous illnesses

  • Hospitalisations

  • Allergies

All the medical things

Medications

  • Medications

  • Herbal

  • Supplements

Check adherence

Any side effects

Medication interactions

Home Medication Review

Drugs

  • Smoking

  • Alcohol

  • Caffeine

  • Recreational

Consider drugs of addiction

Environmental

  • Work exposures

  • Travel

  • Toxic exposures

  • Animal exposures

  • Food exposures

Travel = Infections

Work = Dust diseases, Silicosis, Asbestos

Home + Food = Heavy metals, Lead, Mercury

Animals = Infections

Mental

  • Screening

  • Self-harm + Suicie=dality

  • Intimate partner violence screening

Consider Anxiety, Depression, Autism, ADHD, Bipolar, Schizophrenia, OCD, BPD

Suicide risk screening

Prevention Advice

Cardiovascular

  • Blood pressure

  • Lipids

  • Height, weight, waist

  • Assessment of cardiovascular disease risk

  • Uric acid

  • Apolipoprotein (a)

Screen all softer causes: Age, Hyperuricaemia + Gout, Metabolic syndrome, Psoriasis

Prevention advice

Facts: Kills 25% of all humans

Cancer

  • Breast cancer 2 yearly

  • Cervical cancer 5 yearly

  • Bowel cancer 2 yearly

  • Skin cancer 2 yearly:

Lung prevention advice

Neurodegenerative

  • Dementia screening

  • MMSE

Preventative advice: 150 min moderate exercise weekly, Omega-3

Metabolism

  • Diabetes risk assessment

  • Insulin resistance

Facts kills 3% of all humans but contributes to 1) cancer 2) AS-CVD 3) Neurodegenrative health

Preventative advice: Less processed food, low sugar

Sex

  • STI

  • Contraception and family planning:

  • Menstrual health

Chlamydia screening annually < 25 yo

Screen: Endometriosis, Menopause, ED, Libido

Lungs

  • Smoking

  • Occupational exposures

  • Lung cancer screening

  • Immunisations

Screen: Silicosis, uncontrolled asthma, COPD

Liver

  • Alcohol history

  • Recreational drugs

  • Metabolic liver disease

Advice: Alcohol cessation advice, reducing risks of fatty liver

Prevention:

Gut

  • Diet

Kidney

  • CKD

  • BP, Urine A/CR, and eGFR measurement

  • Prostate cancer screening

  • Incontinence screening

Kidney prevention advice

Infections

  • Influenza

  • DTP

  • Pneumococcus

  • Shingles

  • COVID-19

Consider travel vaccinations

Vision

  • Eye Health

Advise: Retinal detachment signs + urgent review

Screen: Glaucoma

Advise: Eye hygiene, lid health, UV exposure, eyelid skin cancers, Omega-3

Hearing

  • Hearing test

Advise: Presbyscusis

Dental

  • Dental health

Advise: Risks of systemic disease + links

  • Fluoridation of public water

  • Brushing 2 to 3 times daily with a fluoridated toothpaste (1000ppm)

  • Dietary reduction of sugar-rich foods and beverages

  • Oral antimicrobial rinses for high-risk patients

  • Reduce risk factors such as smoking

  • Regular dentist visits

Musculoskeletal

  • Osteoporosis

  • Strength

  • Aerobic and anaerobic

  • Balance and stability

  • Falls prevention

Advise: 150mg moderate exercise weekly, 2-3 strength sessions, risks of sarcopenia + osteoporosis

Prevention

  • Healthy eating

  • Physical activity

  • Weight

Longevity advice