Health Promotion

Question 1

USPSTF grade A recommendation

Answer 1

high certainty of benefit

Question 2

USPSTF grade B recommendation

Answer 2

recommends this service, high certainty of NET benefit

Question 3

USPSTF grade C recommendation

Answer 3

Recommends selectively offering this service, net benefit is small

Question 4

USPSTF grade D recommendation

Answer 4

Dont do it

Question 5

USPSTF grade I recommendation

Answer 5

Inconclusive data

Question 6

Definition of Obesity in adults

Answer 6

BMI > 25 is overweight

BMI > 30 is obese

Question 7

Definition of Obesity in Pediatrics

Answer 7

Overweight = BMI at or above 85th percentile for same age and sex
Obese = BMI at or above 95th percentil for children of same age and sex

Question 8

What are the aerobic activity level recommendations for adults?

Answer 8

SOR C

Moderate activity 150 min/wk
Vigorous activity 75 min/wk

Even 10 minutes is beneficial

Question 9

At what BMI should physicians refer adult pts to intensive multicomponent behavior interventions

Answer 9

> 30

B recommendation

Question 10

At what age do you begin to screen kids for obesity

Answer 10

Age 6

B recommendation

Question 11

Definition of heavy drinking

Answer 11

Women: more than 1 drink per day on average
Men: more than 2 drinks per day on average

Question 12

Definition of binge drinking

Answer 12

Women: 4 or more during single episode
Men: 5 or more drinks during single episode

Question 13

What are the two validated tools recommended by USPSTF to screen for alcohol abuse

Answer 13

CAGE and AUDIT

SOR A

Question 14

What Audit score indicates strong likelihood of hazardous alcohol consumption. What score indicates dependence?

Answer 14

Hazardous consumption:

• men 8
• women 7

Dependence: 20

Question 15

Definition of primary prevention

Answer 15

avoids development of a disease

Ex: immunizations

Question 16

What gauge of needle reduces risk of adverse reaction to vaccinations?

Answer 16

25mm vs 16 mm

SOR A

Question 17

If someone misses a vaccination does the series need to be restarted?

Answer 17

NO

Question 18

Are antipyretics recommended for routine prophylaxis before immunizations?

Answer 18

NO

SOR A

Question 19

Is breastfeeding a contrainditation to vaccines?

Answer 19

NO

Question 20

Can you give both doses of meningitis vaccine on same day?

Answer 20

Yes, just use different sites

Question 21

At what age should children with hx of sexual assault be vaccinated against HPV?

Answer 21

9

Question 22

Which vaccines should wait until after pregnancy?

Answer 22

Varicella
MMR
HPV
Influenza LAV

Question 23

What are the indications for PPSV 23 ONE dose from age 2-64?

Answer 23

• chronic cardiac disease
• liver disease
• DM
• cochlear implants, CSF leak
• Lung disease
• resident of chronic care institution

Question 24

What are the indications for PPSV 23 TWO dose from age 2-64?

Answer 24

• Renal disease
• Asplenia/Sickle cell
• Immunocompromised
• give 3-5 years apart

Question 25

When should PCV 13 be given?

Answer 25

> age 19 if - Immunocompromised - asplenia/sickle cell - CSF/Cochlear implant

Question 26

If I need the PCV 13 but just received PPSV 23 when should I give it?

Answer 26

Wait at least 1 year

Question 27

If I haven't received any pneumoccocal vaccines and need both, how should I give it?

Answer 27

PCV 13 followed by PCV 23 at least 8 weeks later

Question 28

How many doses of Gardasil 9 are needed?

Answer 28

two ONLY IF initiated before age 15 and doses were AT LEAST 5 months apart

Question 29

What is the sequence of smoking cessation medications you should try?

Answer 29

Nicotine replacement --> buproprion (sustained release) --> Chantix Can always add nicotine replacement on top of other meds

Question 30

How many cigarettes per day warrant medications for the aid of cessation

Answer 30

10-15 cigarettes per day SOR A

Question 31

Which TCA has been shown to be effective in smoking cessation?

Answer 31

Nortriptyline - careful about anticholinergic side effects off label use

Question 32

How often should pregnant patients receive Tdap vaccine

Answer 32

every pregnancy between 27-36 weeks

Question 33

What chronic condition was recently added to indications for Hep B vaccine?

Answer 33

- Chronic liver disease including Hep C infection, LFTs twice normal level

Question 34

Definition of secondary prevention

Answer 34

Activities aimed at early disease detection, increasing opportunities for intervention SCREENING

Question 35

How do you decide who needs BRCA testing?

Answer 35

1. Ask about family hx of breast, ovarian, tubal or peritoneal cancer 2. Use a risk assessment tool

Question 36

What is the USPSTF recommendation on breast cancer screening?

Answer 36

Grade B - biennial screening for women age 50-74 Grade C - women age 40-49 for women who place greater weight on potential benefit than potential harms Grade I - everyone else

Question 37

USPSTF recommendation on prescription of medications to decrease breast cancer risk

Answer 37

Grade B - Offer to prescribe meds if increased risk of cancer but low risk for adverse side effects - tamloxifen, raloxifene, aromatase inhibitors Grade D - don't prescribe for women who are not at increased risk

Question 38

Definition of Tertiary prevention

Answer 38

reduces negative impact of an already established disease by restoring function and reducing disease related complications Example: Heart Failure

Question 39

Definition of Quaternary prevention

Answer 39

Activities to mitigate or avoid consequences of unnecessary or excessive intervention of the health system " do no harm"