preventive-care
Preventive Schedule
Preventive Care Schedule — Ishamma T M
Patient: Ishamma T M | Age: 81 | Sex: Female
Active diagnoses: Acute Myeloid Leukemia (AML), on Azacitidine + Venetoclax
Patient is on active AML chemotherapy (Azacitidine + Venetoclax) causing immunosuppression. ALL vaccine decisions must be coordinated with the treating hematologist (Ashwin V Nair). Live vaccines are contraindicated.
Age-Appropriate Screenings
| Screening | Recommendation | Status | Notes |
|---|---|---|---|
| Mammography | Individualized (USPSTF: not routine past 75) | NOT DOCUMENTED | Discuss with oncologist given AML prognosis |
| Colonoscopy / CRC screening | Selective 76-85 (USPSTF) | NOT DOCUMENTED | Consider deferring during active chemo |
| DEXA (bone density) | Recommended for women ≥65 | NOT DOCUMENTED | Assess osteoporosis risk |
| Blood pressure | Annual | NOT DOCUMENTED | Monitor at clinic visits |
| Influenza vaccine | Annual | NOT DOCUMENTED | CAUTION: verify timing relative to chemo cycles with hematologist |
| COVID-19 vaccine | Per ACIP guidance | NOT DOCUMENTED | CAUTION: immunosuppressed — timing matters |
| Pneumococcal (PCV20) | One-time if not done | NOT DOCUMENTED | CAUTION: immunosuppressed |
| Zoster vaccine (Zostavax) | One-time ~2016 | GIVEN (~2016, patient report) | Efficacy likely waned (>8 yrs). Prior shingles history. See Herpes Zoster |
| Shingrix (shingles) | 2-dose series ≥50 | NOT GIVEN | Recommended even after Zostavax. DEFER during active immunosuppression. Discuss timing with oncologist. |
| Falls risk assessment | Annual | NOT DOCUMENTED | High priority given age + anemia |
| Vision/hearing | Annual | NOT DOCUMENTED | |
| Depression screening | Annual | NOT DOCUMENTED | |
| Diabetes monitoring (fructosamine) | Every 4–6 weeks (preferred over HbA1c in AML) | Last fructosamine: 2026-04-22 (310 µmol/L, HIGH). Last HbA1c: 2026-03-02 (5.7% — unreliable) | Next fructosamine ~May 2026. HbA1c invalid due to AML-related RBC turnover. See Fructosamine, Diabetes Mellitus |
| Renal function | Annual or per chemo protocol | Last: 2026-04-06 (Cr 0.6) | Current via chemo labs |