general health assessment

Question 1

adolescent age 11-10
first exam
how often
what to look for

Answer 1

first exam 11-14 years
three visits 11-14, 15-17, 18-21

height, weight, skin, oral cavity (gingivitis and dental caries) abuse, neglect, depression , look for eating disorders, BP normal is less than 120/80

Question 2

adolescent age 11-10

vaccine for HPV

Answer 2

gardisil 9
age 9-14
15-26
series of tow six months apart
series of 3 at 0,2 and 6 months

Question 3

adolescent age 11-10 syphilis screening for both

Answer 3

when sexually active, PRN or with pap smear

Question 4

reccomend breast and testicular exam

Answer 4

self exam monthly

Question 5

adolescents 11-19 and hiv

Answer 5

depends on level of sex or drugs, talk abouut prevention

Question 6

adolescents 11-19 meningococal (menactra/menveo

Answer 6

all adolescents ages 11-18- controversial- revac 1x for high risk, college freshman living in dorms 5 years from last vax

Question 7

adolescents 11-19 pneumococcal vax

Answer 7

age 19-64 if smoking, asthma, COPD or ETOH

Question 8

adolescents and PPD

Answer 8

once during adolescence, and every two years or with exposure

Question 9

age 20-39 physical females

Answer 9

pap smear (with with GC and chlamydia screens)
cytology - conventional or liquid based
HPV co test (Cytology +HPV test administerd together
self breast exam
clinical breast exam
and HPV vax

Question 10

tetanus and diptheria boster timing

Answer 10

every 10 years

Question 11

mammography timing

Answer 11

annually for age 45-54 and q 2 theirafter

USPSTF q2 50-74

ACOG annually 50-74

Question 12

all males over 50years of age should have a digital rectal exam and a PSA test.

Answer 12

annually

Question 13

colorectal cancer screening

Answer 13

annual FOBT
flex sig q5 years
colonoscopy q 10 starting at age 45

Question 14

major mortality cause age 12-19

Answer 14

MVC
suicide
accidents
homicide
malignancy
CV or congenital disease

Question 15

major mortality cause age 20-39

Answer 15

MVC's 
Homicide
suicide
injuries
heart disease 
AIDS

Question 16

major mortality cause age 40-59

Answer 16

heart disease
accidents
lung cancer
CVA
breast and colorectal CA
COPD

Question 17

Elderly adult over 60 years

Answer 17

Heart disease
CVA
COPD
pneumonia or influenza
lung and colorectal CA

Question 18

my plate

Answer 18

half your plate is fruits and veggies
switch to skim milk or 1%
half your grains are whole grains
vary protein in food choices

Question 19

diet recs for carbs

Answer 19

55-60%

Question 20

diet recs for fats

Answer 20

less than 30% of total calories with less than 10 percent being saturated fats

Question 21

diet recs for proteins

Answer 21

0.8-1.0g/kg/day

Question 22

protien needs with illness

Answer 22

overall nutritional and protein needs increase with illness, trauma etc

Question 23

benifits of exercise

Answer 23

decreases LDL's 
increases basal metabolic rate'
reduces stress
improves cardiovascular fitness
decreases the signs of aging

Question 24

AHA exercise recs

Answer 24

at lease 30mins or more on most days

Question 25

if you are over 35 and have never exercised you should

Answer 25

complete physical with history physical exam exercise stress test

Question 26

antigens

Answer 26

substences capable of inducing a specific immune response

Question 27

antibodies

Answer 27

molecules synthesized in reaction to antigen

Question 28

active immunity

Answer 28

conferrd by atbody formation stimulated with a specific antigensuch as typhoid fever immunization and toxoids

Question 29

passive immunity

Answer 29

maternal or from gamma globulin

Question 30

PPSV vax who gets it

Answer 30

``` over 65 years old 19-64 who smoke or have asthma heart, lung, kidney, liver disease, chronic disease, like DM, cirrhois, sickle cell, CSF leak, cochlear implant and ETOH weak immune system or no spleen nursing home or LTC patients ```

Question 31

hep A vaccine

Answer 31

for military personel, travelers to endemic areas, dudes banging dudes,

Question 32

hep B vaccine

Answer 32

health care workers, and high risk pts including sexually active adults

Question 33

mumps va for health care workers before and after 1957 birth

Answer 33

born before- 1 dose unless evidence of immunity, clinically diagnosed mumps or positive serology born after 57- 2 doses of vax unless documented immunity

Question 34

in mumps outbreak

Answer 34

give people 2 doses of vax unless immune

Question 35

mumps post vaccine titers

Answer 35

post vax serology may be negative, vax gives lower antibody titers than natural infection.

Question 36

meningococcal vax

Answer 36

approved for ages 2-55, reccomended routinely fr adolescents age 11-12 at the annual visit, and a "catch up" for college students, military personnel, immunocompromised, travelers to africa, clinical effectivness is questionable

Question 37

herpes zoster vax shingrix

Answer 37

CDC preferred , reccomended for immnocompetent adults, aged 50 or older, even if pt has had zostavax previously

Question 38

herpes zoster vax zostavax

Answer 38

for age 60 or older, efficacy waynes after 5 years.

Question 39

cultural considerations AA

Answer 39

may discontinue meds when symptoms resolve touch is viewed as essential, personal space may be minimal rely on religion and ministers health is a gift from god

Question 40

cultural considerations AA folk remidies

Answer 40

cod liver oil to prevent colds copper or siler braclets to protect from harm voodoo for hatians

Question 41

cultural consideratins hispanics

Answer 41

discontinue meds when symptoms abate- particular problems for diabetics high esteem for matriarchs balance of hot and cold and wet dry concepts PCNis a Hot med

Question 42

cultural consideations hispanics mal de ojo

Answer 42

evil eye illness prevention strategies include eating well, working, sleeping with relics and being religious

Question 43

cultural considerations hispanics caranderas

Answer 43

holistic healer- erbs etc

Question 44

cultural consideration hispanic adiction

Answer 44

it is a concern | may expect injections as a componenet of effective treatment oral may be viewed as less effective

Question 45

cultural considerations asians

Answer 45

eye contact my be seen as disrespectful diabetes is less common well insured only 18% uninsured longer life expectancy and lower death rates

Question 46

cultural consideratioons asians religion

Answer 46

shinto relgion- pleasing good spirits is essential to good helath

Question 47

japanese cultural considerations

Answer 47

may prefer femal to femal providers drug safety is more important than effectivness may explain habid of using lower doses to get fewer side effects

Question 48

chinese cultural considerations

Answer 48

yin is cold yang is hot cold illness is diarrhea- treated with erbs and food hot illness HTN treated with cold erbs and food may diagnose illness by pulses texture and or color of tongue

Question 49

traditional chinese medicine

Answer 49

may teach that you can permenantly remote the underlying disorder symptoms and the disease as well. often try traditional medicine first

Question 50

philipino

Answer 50

agin yin and yang | amulets can be a shield

Question 51

native americans CC

Answer 51

50years or older can be an elder | ilness may be imbalance between spirtual and physical world