health screening

Question 1

breast cancer screen uspstf

Answer 1

50-74 yo, q 2 years. age 40 american cancer society

Question 2

cervical cancer

pap/liquid cytology

Answer 2

21-65, every 3 yrs

Question 3

colorectal

Answer 3

50-75 (older age is the most common risk factor)
high-sensitiy FOBT x 3 consecutive solo samples annually
sigmoidoscopy q 5 years
colonoscopy q10 years

Question 4

lipid

Answer 4

screen after a 9 hour minimum fast
males: age 35
females: age 45
male or females screen starting age 20 if increased risk for heart disease (HTN, strong family hx, MI, stroke)

Question 5

skin cancer

Answer 5

10-24 yo with fair skin. educate avoid sun/spf 10a-4p

Question 6

depression

Answer 6

12yo-18yo. beck depression, geriatric depression scale

Question 7

live attenuated inactivated virus influenza (LAIV)

aka: flu mist

Answer 7

age 2-49yo
do not give aspirin to children 4 weeks after vaccination
avoid antivirals 2 days before, 2 wks after
contraindications: pregnant, chronic disease ( DM, renal failure, copd, asthma)
children on aspirin therapy

Question 8

flu injection from

Answer 8

trivalent inactivated influenze vaccine

avoid is severe egg, gentamicin, gelatin allergy or children on aspirin therapy

Question 9

tetanus shot

Answer 9

TD q 10 years for lifetime
TD boosters : for dirty wounds if last dose >5 years ago
age >7: use TDAP
AGE SEVEN and UP!

1 time dose of Tdap for td booster for

Question 10

what is done if a patient has a tetanus prone sound and unknown vaccine status?

Answer 10

give immediate dose of TD vaccine and tetanus immunoglobulins (TIG) injection

ie: puncture wounds, soil contaminated, crush injuries

Question 11

pneumococcal

Answer 11

ONE TIME DOSE >65 yo

pneumovax 23

if was given pneumovax before 65 yo, give a booster 5 years after initial dose

Question 12

zoster

Answer 12

ONE TIME dose at >60 yo

youngest age of zostavax is 50 yo

Question 13

varicella

Answer 13

LAIV
give TWO doses, 1 month apart
give to teens-adults with no hx of chicken pox

Question 14

MMR

Answer 14

proof of immunity required for healthcare worker (born before 1957, lab confirmation w titers. If not, need TWO doses (1 month apart)

Question 15

hep b

Answer 15

series of 3. DO NOT RESTART, catch up only. check titers within 60 days of 3rd dose

Question 16

BCG

Answer 16

live attenuated ( weakened) form.
follow up with a pt with + PPD who had BCG:
1) evaluate s/s
2) rule out latent infection
3) chest x ray and s/s of TB (chronic cough, weight loss, night sweags)