Preventive Care and Health Promotion
What candidates must know
Preventive care is organised into primary (prevent disease), secondary (early detection) and tertiary (limit disability) prevention. Understand the evidence-based screening recommendations by age and sex (cervical, breast, colorectal, cardiovascular risk, diabetes), immunisation across the lifespan, and behavioural counselling (smoking cessation, alcohol, diet, physical activity). Know the 5As of behaviour change (Ask, Advise, Assess, Assist, Arrange) and the principles of motivational interviewing. Understand chemoprophylaxis where indicated (e.g. statins, aspirin in selected patients) and the importance of shared decision-making about screening harms and benefits.
Traps in questions
- Over-screening: not every test is recommended for every patient; know the age bands and intervals.
- Primary vs secondary prevention: a statin in a patient with established disease is secondary prevention.
- Brief intervention works: the correct answer to a smoker is structured advice, not a lecture.
- Vaccination in immunocompromised or pregnant patients: live vaccines are generally contraindicated.
- Shared decision-making: the answer often reflects discussing benefits and harms, not simply ordering the test.
Rule of thumb
Match the intervention to the prevention level and the patient's risk. Ask: is this preventing disease, detecting it early, or limiting its consequences - and is this patient in the target group?
Worked example
A 50-year-old smoker asks about "checking everything". The evidence-based response is to offer colorectal screening, cardiovascular risk assessment and structured smoking-cessation support, while explaining that some tests are not recommended without symptoms - shared decision-making, not a blanket panel.