FM Pretest - Preventative Medicine

Question 0

Hib vaccine

Answer 0

• 95-100% effective
• does not vv number of OM cases
• very few sfx
• dont give before 6 wks of age

Question 1

What should be done when a baby is born to a Hep B positive mom?

Answer 1

-tx infant w/ Hep B immunoglobulin w/ in 12 hrs of birth

Question 2

When a pregnant woman is found to not be immune to rubella what should be done?

Answer 2

• vaccinate ASAP POSTpartum!

- vaccination during the pregnancy can cause abortion of fetus

Question 3

What vaccine is given to adults in need of their tetanus shot?

Answer 3

• Tdap

- includes diphtheria and pertussis!

Question 4

Who is recommended to get the flu shot?

Answer 4

• ALL pts over 6mnths old!

- must be > 2yrs to get live attenuated

Question 5

Which pts is gaurdacil contraindicted in?

Answer 5

-pregnant!

Question 6

How and when should an adult receive their tetanus booster?

Answer 6

• every 10 years after age 12 (btwn ages 19 & 64)
• should be given Tdap –> for tetanus, diphtheria, & pertussis –> there has been increased cases of pertussis in adults in the US

Question 7

What is the minimum age for the live attenuated influenza vaccine?

Answer 7

-2 years

Question 8

What and how should a child less than 2 years old be given for a flu shot?

Answer 8

• the trivalent inactivated influenza vaccine

- given as 2 doses separated by at least 4 weeks in kids aged 6mnths-8 years

Question 9

What is the typical schedule for the 7-v pneumococcal vaccine?

Answer 9

• should be given at ages 2,4,6, & 12-15mnths
• if a child missed some of their doses, the immunization should still be given, but on a modified schedule with each given at least 8 wks appart

Question 10

Who is considered immune and therefore do not need an MMR vaccine?

Answer 10

-pts born before 1957

Question 11

Patients born when are considered to be immune to varicella?

Answer 11

-1980

Question 12

What are the recommendations for hyperlipidemia screening in males? Females?

Answer 12

• men should be screened at age 35, even in the absence of other risks –> should be screened earlier if the pt has DM, or a family hx of heart dz by age 50, or other risk factors
• women: age 45 “ “

Question 13

What are the recommendations for colorectal cancer screening?

Answer 13

• should begin at age 50 and continue every 10 yrs to age 75
• if there is a family hx of colon cancer, it is recommended to start screening 10 years before the youngest age of onset in the family, or start at 50 if that comes first

Question 14

What are the recommendations for mammograms?

Answer 14

-should begin at age 50 and be done every 2 years until age 74

Question 15

What are the recommendations for self breast exams?

Answer 15

-for patients with normal risk, BSE are recommended against at any age!

Question 16

What are the recommendations for prostate cancer screening?

Answer 16

• there is insufficient evidence for or against DREs and PSAs
• patients who request screening, you should discuss benefits and harms with them

Question 17

What are the recommendations for cervical cancer screening?

Answer 17

• pap smears should be done every 3 years starting at age 21 until age 65
• after age 65, screening can stop as long as prior screening was adequate and patient not at high risk

Question 18

What are the recommendations for genetic testing for breast cancer in non-ashkenazi jews

Answer 18

1. 2 first-degree relatives with bc, one dx before age 50
2. 3 or more first-degree relatives dx with bc, regardless of age
3. Combo of bc and ovarian cancer among first and second degree relatives
4. First-degree relative with bilateral breast cancer
5. Combo of 2 or more first or second degree relatives with both breast or ovarian ca at any age
6. Male relative with bc

Question 19

What are the recommendations for genetic testing for breast cancer for ashkenazi jews?

Answer 19

• ashkenazi jewish women should be offered testing if ANY first-degree relative has bc
• or if 2 second-degree relatives on the same side are diagnosed with bc or ovarian ca

Question 20

What is the most lethal complication of surgery in general?

Answer 20

-cardiac complications

Question 21

Who are pulmonary complications of surgery are most common in?

Answer 21

• obese pts

- kids

Question 22

What are 4 low risk surgeries? Why? Pre-op teting?

Answer 22

• have only 1-5% risk of cardiac death
  1. Breast surgery
  2. Cataract surgery
  3. Superficial dermatologic surgery
  4. Endoscopy
• generally do not require additional cardiac testing

Question 23

What are high risk surgeries? Why?

Answer 23

• aortic or peripheral vascular surgery

- risk of cardiac death > than 5%

Question 24

How long after an MI is it safe to do elective surgeries?

Answer 24

-after 6 mnths

Question 25

What are the 2 most common causes of death while traveling? Rank?

Answer 25

1. Heart disease

2. Accidents

Question 26

What is the only legally required vaccination for travel?

Answer 26

-yellow fever

Question 27

What should be done with a pt on OCP who has HTN becuase of it?

Answer 27

• discontinue the OCP
• both estrogen and progestin can cause high bp
• the bp should normalize after 3 mnths of discontinuing the OCP

Question 28

What should be done if a pt misses an OCP pill?

Answer 28

• if there has been no intercourse in 5 days, take two pills immediately and use backup for 7 days
• if there has been intercourse in last 5 days, take emergency contraception and restart pills the next day, use backup for 5 days

Question 29

Progestin-only OCPs

Answer 29

• no hormone-free period, should be taken every day
• do not have an increased risk of thromboembolism
• safer for women with risks of DVTs, PEs, DM, Obesity, or HTN

Question 30

Progestin-only OCPs and ectopic pregnancies

Answer 30

• in general they lower the chance of ectopic pregs by decreasing chance of conception
• but if a pt on them do get pregnant, the chances of ectopic preg does increase!