ACR 1 (Screening/Vaccination/Wellness visits)

Question 1

Screening test are performed to ID (symptomatic/asymptomatic) dz

Answer 1

asymptomatic

Question 2

Criteria for screening include characteristic of the ___, ___, and ____

Answer 2

Disease Test Population screened

Question 3

What characteristic of disease are criteria for screening? (5)

Answer 3

• Impacts quality/length of life - Prevalence vs Cost - There are acceptable methods of tx - There is an asymptomatic period - Can treat in the asymptomatic period

Question 4

Characteristics of testing that are important for screening

Answer 4

The tests are specific and sensitive

Question 5

Characteristic of the population that count as criteria for screening

Answer 5

• High dz prevalence - Accessibility - Compliance

Question 6

_____ occurs when a dz that would have gone undiagnosed during a pt’s lifetime is dx because of a screening test

Answer 6

Over-diagnosis

Question 7

5-A’s of Behavioral counseling?

Answer 7

• Ask - Advise - Assess willingness - Assist - Arrange f/u

Question 8

What does CAGE stand for and what is it used for?

Answer 8

• Cut down? - Annoyed by criticizing - Guilt - Eye opener Questionnaire to assess alcohol abuse

Question 9

What systems should be included in the ROS and PE for wellness exams

Answer 9

ALL of them

Question 10

What are the 5 immunization categories

Answer 10

• Routine vaccinations of childhood/adolescence - Routine vaccinations of adults - Post exposure prophylactic - Travel related - Work-related/special circumstances

Question 11

What are the 2 immunization types?

Answer 11

Active Passive

Question 12

The following describes what type of immunization? - Contains live attenuated microorganisms, killed organisms, purified proteins or polysaccharides, or deactivated toxins - Provides long-term protection - Immunity is not achieved until 2-4 wks post injxn

Answer 12

Active

Question 13

The following describes what type of immunization? - Performed antibody (immunoglobulin) - Immediate protection, but is shorter term of protection

Answer 13

Passive

Question 14

What are the 7 vaccines that we should be familiar with?

Answer 14

influenza pneumococcal herpes zoster meningococcal tetanus HPV varicella

Question 15

Then is the Influenza vaccine indicated?

Answer 15

all adults, every year

Question 16

Then is the Pneumococcal vaccine indicated?

Answer 16

>65 y.o. Or ↑risk

Question 17

Then is the Herpes zoster vaccine indicated?

Answer 17

adults >60 y.o. (contraindicated: preg, immunocomp)

Question 18

Then is the Meningococcal vaccine indicated?

Answer 18

college, military, immunocompromised

Question 19

Then is the Tetanus vaccine indicated?

Answer 19

10yrs, pregnant (27-36wks) one Tdap

Question 20

Then is the HPV vaccine indicated?

Answer 20

Females to 26y.o. & males to 21

Question 21

Then is the Varicella vaccine indicated?

Answer 21

Immunity

Question 22

Adults can receive up to __ vaccines in 1 day in the ___

Answer 22

Adults can receive up to 4() vaccines in 1 day in the (deltoid)

Question 23

If >1 live attenuated viral vaccine is indicated, administer them on the same day or at least __(time) apart

Answer 23

4 weeks

Question 24

Immunoglobulin preparations + live viral vaccines (should/should not) be administered together as the Ig carries antibodies against such viruses

Answer 24

Immunoglobulin preparations + live viral vaccines (should NOT) be administered together as the Ig carries antibodies against such viruses

Question 25

Live viral vaccine should be administered at least __ (time) prior to Ig prep.

Answer 25

2 wks

Question 26

If Ig prep is given 1st, __ (time) should elapse before live viral vaccine can be given

Answer 26

3-11 months

Question 27

Ig + non-living vaccines (can/cannot) be given together

Answer 27

Ig + non-living vaccines (CAN) be given together

Question 28

Generally live-attenuated viral vaccines (should/should not) be administered to pregnant women & immunocompromised

Answer 28

Generally live-attenuated viral vaccines (SHOULD NOT) be administered to pregnant women & immunocompromised

Question 29

What population should be screened for lung cancer? What are the recommendations for the screen? When should lung CA screening be discontinued?

Answer 29

55-80 y/o w/ a History of Smoking Annual Screening if; ≥ 30 pack-year smoking hx, currently smoking or have quit w/in the past 15 yrs, and who are in relatively good health. - Have not smoked for 15 yrs - Develops a health problem that substantially limits life expectancy or ability/willingness to have curative lung surgery.

Question 30

What population should be screened for COPD For who is COPD screening not recommended?

Answer 30

Asymptomatic adults THE FUCK? asymptomatic adults.

Question 31

What population should be screened for Osteoporosis What are other recommendations for Osteoporosis screening

Answer 31

Women, 65 y/o + Recommended in Younger women whose fx risk is =/\> a 65-year-old w/ no additional risk factors.

Question 32

What population should be screened for Prostate CA?

Answer 32

Age 50 : average risk of prostate cancer and expected to live at least \>10 years. Age 45: high risk, includes; AAs, 1st-degree relative dx w/ prostate cancer at an early age (\<65y/o). Age 40 : higher risk (\>1 first-degree relative who had prostate cancer at an early age).

Question 33

What population should be screened for Breast CA? What population can discontinue Breast CA screening

Answer 33

40-44 : should have the choice to start annual breast cancer screening if they wish to do so. 45-54 : should get mammograms every year. 55+ : mammograms every 2 years, or can continue yearly screening. Screening should continue as long as a woman is in good health and expected to live \>10 yrs \>75 y.o. and women w/ dense breasts can d/c screening

Question 34

What population should be screened for Cervical CA? When can Cervical CA screening be d/c

Answer 34

Age 21-65 y/o: every 3 years Women \>65 w/ adequate prior screening Women who have had a hysterectomy

Question 35

What population should be screened for Colon CA? How often should Colon CA screenings be performed? When are colon CA not recommended?

Answer 35

50-75 y.o. African Americans begin screening at 40-45 y/o - Repeat e. 10 yrs in average-risk pts - PMHx of colon polyps, e. 5 yrs - Pt w/ 1st-degree family member who has had CRC, screening should start at 50 y/o, or 10 yrs before age of dx, whichever is younger and repeated e. 5 yrs Not recommended: \>85 y/o

Question 36

What population is eligible for ASA therapy

Answer 36

50-59 y.o. - highest benefit from tx with low dose (81mg) is ASCVD is \>10% 60-69 y.o. - likely to benefit if ASCVD is \>10%

Question 37

What populations are eligible to take Statins?

Answer 37

Question 38

What population should be screened for DM?

Answer 38

45 y/o, ↑BP over-wt

Question 39

Who gets screening for; HTN, obesity, smoking, alcohol, depression

Answer 39

Everyone gets screened e. visit

Question 40

an infant should be Crawling around __ months

Answer 40

9 months

Question 41

A child hsould be Walking by __ months

Answer 41

16 months

Question 42

A child should be Talking by age __ and have a vocabulary of __ words

Answer 42

2 years 20 words