HMC 2015 exam Flashcards
Commanders will ensure what report on any suspected or confirmed malaria case is sent out as soon as possible to all required addresses whenever a malaria threat exists?
Disease Alert Report (DAR)
Individuals who were treated for malaria in the past must wait how long from the date treatment was finished until they are eligible to donate blood?
3 years
Individuals who visited a malaria-risk area and remained asymptomatic, but were not required to take chemoprophylaxis because of negligible risk of exposure, must wait how long until they are eligible to donate blood?
6 months
Any person who is deficient in what has a risk of hemolysis associated with taking primaquine for chemoprophylaxis or treatment?
G6 PD
Report suspected or confirmed malaria cases in a DAR via what precedence message?
Priority
Measures consist of effective mosquito control programs of what type?
Anopheles
Traditionally, malaria chemoprophylaxis has been effectively accomplished with use of chloroquine and primaquine, however, in the past several years, resistance to what has been demonstrated among malaria parasites in certain areas of the world into which Navy and Marine Corps personnel deploy or live?
Chloroquine
Because malaria, in particular what type of malaria, can progress into a rapidly fatal course, the most important aspect of malaria treatment is suspecting this disease in the differential diagnosis of the patient and beginning immediate treatment?
Plasmodium Falciparum
How long is the waiting time to achieve desired FAC
30 mins
what are the rules for super chlorination
100 PPM for four hours at which time the FAC can not drop below 50 PPM. If it does drop below 50 PPM super chlorination must be repeated.
how often do you test water in the field
daily
how often is bacteriological testing done
weekly
how often should temperature reading in refrigerators In the field be taken
at least 3 times during meal periods
how often should refrigerator spaces be emptied and cleaned
weekly
how long are fruits and vegetable
100ppm for 15 mins or 50ppm for 30
Out of the Five field dishwashing Metal GI cans (approx 32 gallons) which of those contain brushes
GI Vat CANS 2 and 3
Purpose of Field Dishwashing Metal GI CAN #1?
collecting garbage
Purpose of Field Dishwashing Metal GI CAN #2?
prewash and will contain a hot detergent solution and a brush
Parenteral chloroquine hydrochloride, quinidine gluconate, and quinine dihydrochloride can be used in the treatment of severe cases of malaria where the patient is exhibiting signs of central nervous system involvement, has a very high and life-threatening parasitemia, or cannot take what type of drugs?
Oral drugs
What is a comprehensive hardcover textbook of clinical tropical medicine?
Hunter’s Tropical Medicine
Who conducts tropical medicine research and can provide information on the epidemiology of malaria, antimalarial drug resistance, and mosquito vectors within their countries or geographic areas of research?
Naval Medical Research Units
Purpose of Field Dishwashing Metal GI CAN #3?
washing and will contain a hot detergent solution and a brush.
Purpose of Field Dishwashing Metal GI CAN #4?
rinsing and will contain clean hot water held at a rolling boil.
Purpose of Field Dishwashing Metal GI CAN #5?
final sanitizing rinse and will contain clean hot water held at a rolling boil
how long are MRE’s good for
48 months
how high can MRE’s be stacked
not more than 3 pallets high
what is the definition of rubbish
boxes, paper, plastics
Minimum distance waste must be from water
100 feet
Minimum distance waste must be from the mess hall
100 yards
Minimum distance waste must be from berthing
50 feet
how many people will a saddle trench serve
25 people
how many deep pit latrines are needed per 50 people
1 deep pit latrine that seats 4 people
when do you burn out the wastes in a burn barrel latrine
when it is 1/3 to 2/3 full
how many tubes are used for a urine
6
how many people will one pipe accommodate in a urine soakage pit
20
how many men will a urine trough serve
100
how many people will a soakage pit serve
200
for a garbage disposal pit how large and how many people does it serve
4 sq feet and 4 feet deep and serves 100 people
how long does acclimization take
3 weeks
what is the optimum temperature for drinking water
50 to 60
when does immersion foot occur?
Trench foot occurs when feet are cold and damp while wearing constricting footwear. Unlike frostbite, trench foot does not require freezing temperatures and can occur in temperatures below 50 degrees.
Within the DoD, who is eligible for TRICARE?
Army, Navy, Air Force, Marine Corps, Coast Guard, Commissioned Corps of the U.S. Public Health Service, and the Commissioned Corps of the National Oceanic and Atmospheric Administration
When can family members of the National Guard or Reserve Member become eligible for TRICARE?
When called to active duty for more than 30 consecutive days
If you are an active duty service member, what are your program options?
Prime
If you are an active duty service member who lives and works more than 50 miles or an hour’s drive from an MTF, what are your program options?
Prime Remote
If you are an active duty family member, what are your program options?
Prime
Standard
Extra
US Family Health Plan
If you are an active duty family member with an active duty service member who lives and works more than 50 miles or an hour’s drive drive from MTF, what are your program options?
Prime Remote for Active Duty family members
Standard
Extra
US Family Health Plan
If you are a retiree and have eligible family members who are not eligible for Medicare, what are your program options?
Prime
Standard
Extra
US Family Health Plan
If you are a Medicare-eligible beneficiary under age 65, what your program options?
Prime
For Life
US Family Health Plan
If you are a Medicare- eligible beneficiary age 65 or over, what are your program options?
For Life
US Family Health Plan
If you are a Congressional Medal of Honor recipient or recipient’s family member , or a certain former spouse of an active or retired service member, what are your program options?
Prime Standard Extra For Life US Family Health Plan
What is Tricare Prime Split Enrollment?
Allows families living in separate Tricare regions to enroll in Tricare Prime together
What are the Tricare Prime Access Standards?
- The wait time for an urgent care appointment will not exceed 24 hours
- The wait time for a routine appointment will not exceed one week
- The wait time for a specialty care appointment or wellness visit will not exceed four weeks
Where is Tricare Extra not available?
Overseas
What is Tricare for Life?
Offers Medicare-wraparound coverage to Tricare beneficiaries regardless of age, provided that are entitled to Medicare Part A and also have Medicare Part B
In what ways can enrollment in Tricare be achieved?
Mail or a Tricare Service Center
Who is required to pay an annual enrollment fee?
Retired service members and their families
Eligible former spouses
Medal of Honor recipients
Who administers Tricare For Life?
Wisconsin Physicians Service
Which two program options do not have an enrollment process?
Standard and Extra
What does the catastrophic cap do?
It limits the out-of-pocket expenses on annual deductibles, cost shares, and other costs.
At an MTF, how much medication supply can be filled if the medication is on the MTF formulary?
90 days
How may refills through the Mail Order Pharmacy be order?
Mail, phone, or online
How long does it take for medications to be delivered after receiving the prescription via the mail order pharmacy?
14 days
What is the Tricare Extended Care Health Option
It provides financial assistance to active duty family members who qualify based on specific mental or physical disabilities, and offers an integrated set of services, and supplies not available through the basic Tricare program
What is the Transitional Assistance Management Program?
It provides 180 days of transitional health benefits after leaving active duty.
What is Tricare Reserve Select?
Is a premium based health plan that National Guard and Reserve members who qualify may purchase
What are the Tricare regions?
North, South, West
What is a cost-share?
he maximum out of pocket expenses for which Tricare beneficiaries will pay for inpatient and outpatient care.
HR colors 0 - O 1 - G 2 - Y 3 - G 4 - T 5 - B 6 - W 7 - B 8 - P 9 - R
Oh God you got that big whale barbara pregnant retard
What is the NAVMED 1300/1
Overseas Screening
What is the NAVMED 6150/7
Health Record Receipt
What is the NAVMED 6600/3
Dental Health Questionnaire
What is the NAVMED 6630/2
Precious Metals Issue
What is the NAVMED 6630/3
Precious Metals Inventory
What is the NAVMED 6710/6
Poly prescription
What is the EZ 603
Dental Exam Form
What is the EZ 603A
Dental Exam Continuation Form
What is the SF 522
REQUEST FOR ANESTHESIA
What is the SF 515
TISSUE EXAMINATION
What is the DD 1289
Prescription Pad
What is contained in MANMED P117 CHAPTER 23
REPORTS & FORMS
What is contained in MANMED P117 CHAPTER 21
PHARMACY
What is contained in MANMED P117 CHAPTER 6
DENTAL
Nerve agents include the following:
Tabun (GA ), Sarin (GB), Soman (GD), GF, and VX.
Nerve agents are potent what?
And smell like what
Organophosphates which stimulate muscarinic and nicotinic stimulation.
Fruity
Symptoms of Nerve Agent Exposure:
Muscanaric and nicotinic overstimulation:
ABD pain, diarrhea, vomiting, excessive salivation, sweating, bronchospasms, copious bronchial secretions, muscle fasciculations, weakness and respiratory distress. Seizures, tachycardia or bradycardia may be present.
One of the most important treatments in nerve gas exposure is…
to remove the patient from the source of the
exposure.
Which vesicant has a garlic odor?
Mustard gas
Cyanides include the following:
Hydrogen Cyanide AC and
Cyanogen chloride CK
Pulmonary Agents
Phosgene CG
List the Riot Control Agents
CN -Mace,
CS and
which blood agent Smells like bitter almonds
AC Cyanogen Chloride
What are the Blister aka vesicant agents?
vesicant, Mustard Gas-HD, Nitrogen Mustard-HN, Lewisite-L, Phosgene- CX.
A latent period without symptoms is the hallmark of exposure to what type of agent.
Mustard Gas
Name a pulmonary irritant that can produce pulmonary edema when inhaled.
Phosgene
The cyanide antidote kit includes what?
amyl nitrite, sodium
thiosulfate and sodium nitrite.
Blood agent is a…? And what is the treatment?
Systemic Poison AC, CK. Treatments include amyl nitrate ampules under gas mask, and sodium thiosulfate IV 100-200mg/kg of body weight.
What is AC and what does it smell like?
Cyanogen and it smells like Almonds
What is CK and what does it smell like?
Hydrocyanic Acid and it is an irritating odor
What does CG smell like?
Phosgene- smells like New mown grass
What is DP and what does it smell like?
diphosgene smells like new mown grass
NAVMED P-5041
Treatment of chemical agents casualties and convental military chemical injuries
Where should the location of the dump be?
75 yards (meters) downwind from the MTF and living quarters.
Who advises the commander on the health of the command and the adequacy of internal FSSG HSS
Group surgeon
Which commanders are responsible for coordinating and integrating HSS within their area of operations
Marine Corps Forces (MARFOR)
A MAW has how many Marine aircraft groups (MAGs)
Four
Each Surgical Company contains 60 beds and how many operating rooms?
3
A MAW has how many Marine aircraft groups (MAGs)?
4
The United States is a signatory to the Geneva Conventions of what
year and has directed its military forces to abide by its articles?
1949
Temporary casualty holding facilities and services are used to hold
sick, wounded, and injured personnel for a limited time, usually not
to exceed what time frame?
72 hours
What provide rapid peacetime response teams of pre-identified medical department personnel trained to augment elements of the
operating forces?
MMARTs
The T-AH is designed to receive patients primarily by what means?
Helicopter
What FSSG is a supply operation directly responsible to the FSSG supply battalion commanding officer
Med Log Co, Supply Battalion
Fleet surgical teams (FSTs) are HSS augmentation teams assigned to the fleet CINCs. Combined, the Pacific and Atlantic fleets have how many teams that are considered the fleet CINC’s assets in both
peacetime and wartime?
Nine
A unit’s what includes items necessary for basic support of the Organization?
Table of Equipment (T/E)
ATF ships suitable for use as CRTSs are what classes
LHD, LHA, and LPH
The total T/E and AMALs/ADALs are designed to support a MEF in an estimated worst case scenario for a period of combat of how long?
60-days
What have the largest medical capability of any amphibious ship in the ATF?
CRTSs
HSS logistics is normally a Service responsibility. However, in
joint operations, what system may be designated to provide central
logistical support to all participating Services in the combatant
CINC’s area of responsibility?
Supplementary Integrated Medical Logistics Manager (SIMLM)
The primary role of a beach evacuation station is to evacuate
assault force casualties to designated what?
CRTSs
During the movement phase of amphibious operations, who has overall
responsibility for HSS services to embarked personnel?
Commander, Amphibious Task Force (CATF)
Medical material and supplies are protected under the law of land
warfare and the what?
Geneva Conventions
What is the BUMEDINST 6440.5C Health Services Augmentation Programs (HSAP) Purpose?
To issue policy and procedure guidelines for active duty Navy Medical Department personnel assigned to augment operational platforms and/or units during contingency or wartime situations.
who Directs, coordinates, and monitors the execution of the HSAP.
Chief, Bureau of Medicine and Surgery
BUMED
Ensures coordination of official Navy message takers from higher authority.
Provides recommendation or nominations for commanding officers, executive officers, and command master chiefs for Navy medical platforms.
BUMED
BUMED
Provides input to N093 regarding augmentation platform personnel fill rates and training for the Joint Quarterly Readiness Report.
BUMED
Establishes guidelines for developing Deployment Support Centers (DSC) at sourcing commands.
NAVMED
Monitor capability of sourcing commands to meet augmentation requirements, gender ratio, and training status via Expeditionary Medicine Platform Augmentation Readiness and Training System (EMPARTS).
Assist sourcing commands within their areas of responsibility (AOR) with filling platform assignments to the maximum extent possible and support BUMED in managing shortfalls and residual personnel.
NAVMED
Employ global sourcing as a mitigating strategy within their perspective AOR to source shorfalls
NAVMED
NAVMED
Conduct quarterly readiness reviews using EMPARTS.
Provide HSAP assists visits, technical guidance, and administrative support to activities within their AOR when requested.
NAVMED
NAVMED
Provide assistance, as needed, to soucing commands in establishing HSAP augments.
Annually review the HSAP policy and procedures manuals.
NAVMED
Commanding Officers of Sourcing Commands (COSC)
Appoint in writing, a command readiness officer (CRO) or plans, operations, and medical intelligence (POMI) officer to address operational readiness issues
Command Readiness Officer (CRO )or POMI plans, operations, and medical intelligence officer.
Maintain knowledge of platform requirements as reflected in CUIC (component Unit Identification Code) billets and AMDs
CRO
Update EMPARTS to maintain readiness status of HSAP personnel.
CRO
Use the HSAP to ensure deployable personnel complete administrative requirements within 30 working days of reporting.
CRO
Conduct entry and exit interviews for staff personnel executing PCS orders and coordinate with contingency offices and military personnel (MILPERS) departments to ensure database files are correctly annotated.
Assign all qualified residual personnel to vacant platform billets.
CRO
CRO
Appoint in writing an operational support officer (OSO).
Operational support officer (OSO)
Familiar with policies and procedures governing the HSAP, DSC, and local readiness programs.
OSO
Able to assume readiness officer or POMI officer functional responsibilities, including HSAP responsibilities for sourcing commands.
Past deployment history
personnel will not deploy for a minimum of 6 months following the end of their last deployment.
Deployment history
personnel will not deploy earlier than 6 months from their report date. personnel may participate in pre-deployment or inter-deployment training beginning 60 days after reporting.
Navy Medical Personnel
complete administrative readiness requirements within 30 days of check-in
Navy Medical Personnel
Update and report results of delinquent administrative requirements to the POMI/OSO within 15 days of notification of change in A- or T- status.
CRO additional responsibilities
Establishes a DSC and develop a local policy and procedures manual implementation of DSC and execution of HSAP.
Coordinates with manpower officer/staff to ensure appropriate CUIC billets
CRO
Manning priority is based on contingency support requirements in this order:
1.Marine Forces (MARFOR)
2.Casualty Receiving and Treatment Ship (CRTS)
3.Forward Deployment Preventive Medicine Unit (FDPMU)
4.Expeditionary Medical Facility
5.Construction Battalion Unit (CPU)
6/Hospital Ships (T-AH)
7.Outside Continental United States (OCONUS) MTF
8. Blood Processi
Marine Forces (MARFOR)
HSAP billets assigned to USMC units will be filled with qualified personnel up to staffing goal (minimum of 80 percent peacetime and 95 percent wartime)
Casualty Receiving and Treatment Ships
Medical platform of 84 personnel each that provide up to Level 2 HSS (health services support)
In support of Naval Mobile Construction Battalions (NMCB) that provide up to Level 1 HSS. All Hospital Corpsman will be assigned NEC 8404 for assignment to NMCB.
Construction Battalion Units (CBU)
EMF
Provide Level 3 HSS
CO’s designated by BUMED
OCONUS MTF (USNAVHOSPs Yokosuka, okinawa, and Guam)
Provide up to Level 4 HSS
Hospital Ships (T-AH)
Provide Level 3 HSS. Ships owned by Military Sealift Command (MSC) and operated by civilian mariners. T-AH MTF CO and XO are nominated by BUMED.
Forward Deployment Preventive Medicine Unit (FDPMU)
Provide task organized preventive medicine services beyond the organic capability of the supported force.
Designated by the CO, Navy Environmental Health Center.
FDPMU OIC
Blood Program Unit (BPU)
In support of Armed Services Whole Blood Processing Laboratory (ASWBPL) and Blood Donor Centers (BDCs) whose staff increases during contingencies.
Personnel Readiness
Personnel will report to gaining command with the following:
- ID Tags
- Armed Forces ID Cards (CAC)
- DD 2766, Deployment Medical Records
- Copy of NAVPERS 1070/604, Enlisted Qualifications History
- NAVPERS 1070/602W, Dependency Application/Record of Emergency Data Worksheet
- SGLI
Combatant Commander (COCOM)
Responsible for travel and TAD expenses for the duration of the deployment.
How many SORTS Categories are there?
5 C1-C5
C1
Full wartime mission ready
C2
Capable of undertaking the bulk of its wartime mission, minor deficiencies reported.
C3
Capable of undertaking a major portion of its wartime mission, major deficiencies.
C4
Unit is unable to perform its wartime mission unless it it provided additional resources or training.
C5
Unit is not able to perform its wartime mission and it is not mission capable.
T-AH
Mercy Class Hospital Ships
Embarked Military Force
EMF
Routine Deployable
Two FDPMU maintain ready FDPMU status on a 6 month rotating basis. Ready to deploy within days.
Surge Ready
Two FDPMU deployed within 30 days
Two FDPMU deployed within 60 days of notification.
Emergency Surge
CRO (command readiness officer)
Officer identified by the command, generally from operations office, who is responsible for monitoring and advising the commander on operational readiness.
EMPARTS (Expeditionary medicine platform augmentation, readiness, and training system)
Web-based automated information system used to track the readiness status of BSO 18 personnel.
Operational Support Officer (OSO)
Formerly known as the Reserve Liaison Officer (RLO); coordinates Reserve utilization within sourcing command
infectious waste also called
regulated medical waste
containers
lined with plastic bags, labeled or color coded
anatomical pathology waste
double wall corrugated boxes or equivalent rigid container with double plastic bags
limited storage of non-pathological waste
7 days without refrigeration
transportation infx waste
refer to federal, state and local laws, regulations and sofa
treatment infx waste
destruction, incineration, inactivation by heat, chemicals or radiation without disintegration cells
sterilization infx waste
121 C (250 F) for at least 90 minutes, 15 psi
approval infx waste
bureau of medicine and surgery (med-04) approval required before purchase/lease of
pathological waste disposal
incineration/cremation
microbiology waste disposal
sanitary landfill
sharps waste disposal
steam sterilization/incineration
bulk blood waste
sanitary sewer/landfill
disinfecting spills
epa approved disinfectant or bleach diluted with 1:10 clear water
federal regs
maintain shipping paperwork/manifests for 2 years after rmw was accepted by waste carrier
pathological waste storage
refrigerated and kept frozen if more than 24 hours
frozen storage of pathological waste
no more than 30 days
segregation
separating infectious waste from noninfectious wast at its point of origin
sterilization testing
bacillus stearothermophilus spore strips
sterilize infectious waste before
compacting or grinding
Adenovirus
1 dose, po.
HBV(Hep B recombinant)
0,1,6 months
JE Vaccine
0,7,30 days
Plague
3 doses, 1ml at 0, .2ml at 1-3 months after, .2ml 3-6 months after second dose.
Rabies
5 doses, 0,3,7,14,28 days
Typhoid (VICPS)
1 dose every 2 years
Varicella
2 doses 0 and 4-8 weeks
Avoid pregnancy ____ months after varicella and ____ months after all other vaccines
1 month and three month
Pneumococcal vaccine should be routinely given to personnel over age ____
65
Anthrax
0,2 week,4 week, 6 month, 12 months, 18 months.
Commanders, COs, and OICs ensure
all personnel under their jurisdiction receive required immunizations
Who is responsible to maintain international, federal, state, and local records of all required immunizations?
Commanders, COs, and OICs
Who must be immediately available when immunizations are being given?
any person who is basic cpr certified
If someone presents with a hypersensitivity to an immunization, what is done?
They are deferred, adn then referred to an allergy specialist.
What does ACIP stand for?
U.S. Public Health Service Advisory Committee on Immunization Practices.
Recruits receive what shots?
- adenovirus types 4 and 7
- influenza
- mmr
- meningococcal
- oral polio virus
- tentanus-diptheria
When deploying or traveling to high risk areas personnel may receive?
- JE vaccine
- meningococcal
- typhoid
What precautions must a female take if she is given a live virus vaccine?
avoid becoming pregnant for 3 months
What is VAERS?
Vaccine Adverse Reporting System
What makes a reaction adverse?
Hospitalization is required or more than 24 hrs of duty is lost.
Who grant immunization waivers for Navy and Marine Corps personnel?
Chief, BUMED
Adenovirus types 4 and 7
administered orally and simultaneously on a one time basis to recruits
When is the flu season?
October to March, in the Northern Hemisphere
what prevention counseling is given
mosquito avoidance, personal protective measures and chemoprophylaxis
During what period of duty must personnel have documentation of a TST?
Excess of 30 days when first entering duty.
For periodic screenings, to whom screenings do NOT apply to?
A)Active Duty and Civil Service
B)Ready Reservists
C)Health Care Workers
D)Medical/Dental facility workers(not MEDICAL staff)
B) Ready Reservists
Who can recommend annual screenings in certain high risk overseas duty
Navy Environmental and Preventive Medicine Unit
For Triennial Screening, which personnel only need a screening every 3 years.
Active Duty and Reserve shore based personnel in the U.S. that are in low risk areas.
During which appropriate times should periodic testing be done?
1) Physical Exams
2) Receipt of PCS orders
3) Review of medical records
4) Reporting for A.D. training
Within how long should a TST be done before separation?
Within 1 year period before separation.
When entering/separating from Naval Service, when should a chest x-ray be done for TB screening?
When diagnosis or evaluation of suspected TB.
When are chest x-rays indicated? A)Newly identified TB reactor B)Active disease is suspected C)Previous TB reactor with known contact with disease D)All of the above
D)All of the above
What is the preferred method or test for a PPD injection?
Mantoux test
What type of syringe and size of needle should be used for administration?
1 ml TB syringe with .1ml intervals and fitted with a 25-gauge 5/8in needle.
For PPD administration, what is NOT to be used as a form of administration?
hypodermic jet injector.
What is the preferred dose and strength used for a PPD administration?
1ml of intermediate strength (5 TU)
After PPD administration into the forearm and no wheal appears on skin can indicate_____
PPD was injected subcutaneously. Another PPD test should be administered on the second
How should the induration be measured?
In millimeters at the widest transverse diameter of forearm
What should NOT be entered if measurements are less than 5mm?
“non significant” or “zero” or similar phrases. “zero mm” is what needs to be entered if no induration.
If a measurement is between zero and 14mm after 72hrs, what should be documented?
“not read” on SF 601
If measurement is greater than 15mm after 72hrs, but before or on the 10th day, what actions must be done?
Manage person as a TB reactor since results are significant.
What should be done if the rate of newly identified reactors are greater than 2.5% among any group tested?
Consider searching for an active case of TB in the command.
What does BCG vaccination stand for?
Bacillus Calmette-Guerin
The prevention of STDs is based on five major concepts what are they?
1) Education 2) detection 3) effective dx and tx 4) partner notification 5) Immunization of persons at risk for vaccine preventable STDs
AD PT will be screened for HIV how
per SECNAVINST 5300.30 AD pt will be screened at a minimum of every two years and 12 months within transfer to overseas location.
Women sexually active age 25 and younger shall have regular well woman exams how often?
Annually per CDC STD prevention and protocols.
How many Naval HIV tx facilities are there?
Three- NMC Bethesda, Portsmouth, and San Diego
What is ESSENCE?
Early Notification of Community based epidemics- is a tool for local use to ascertain growth and spread of particular syndromes.
Importance of Med surveillance
Surveillance information is critical in both preparing for and responding to public health emergencies.
Syndromic Surveillance
is critical in identifying emerging or re-emerging infectious diseases that pose a substantial risk of a significant number of human fatalities or severe disabilities.
What is the minimum staffing for ESSENCE monitoring?
ESSENCE monitoring requires a min of two MTF staff members to check ESSENCE at least once each routine workday.
Navy Marine Corps Public Health Center (NMCPHC) conducts analysis of ESSENCE how often?
Shall conduct quarterly analysis of ESSENCE data to maintain situational awareness of long term trends and identify areas for improvement.
NMCPHC shall provide reports to Navy Medicine Regional Commanders when?
NMCPHC shall provide reports monthly describing MTF monitoring compliance.
MER analysis is performed when?
Annually and published quarterly to examine navy and marine corps trends.
Definition of “outbreak”
An outbreak is defined as the occurrence, in a community or region, of cases of an illness or other health related events in excess of normal expectancy.
HIPAA act of ____
Health insurance Portability Accountability Act of 1996
MERs sent via message must be IDd by what report symbol?
NAVMED 6220-3 in the subject line
Routine Reports must be submitted within how many days?
30
Urgent Reports must be submitted within how many days?
24 hours (1 day) to the responsible NEPMU
How long must routine QA program related documents be maintained in a secure location?
Five (5) years before disposal
How long must QA program related documents related to a potentially compensable event and JAG investigation be maintained in a secure location?
Minimum of two (2) years or as long as needed thereafter.
What are the eight (8) program objectives in summary?
1) Systematically monitor services 2) Identify, assess, and decrease risk. 3) Justify resources needed to exceed acceptable standards of PT care. 4) Communicate important QA info to effect clinical decision making at all levels. 5) Integrate, track, and trend QA information. 6) Support credentials review and privileging activities. 7) ID edu and training needs. 8) Gain and sustain compliance with Joint Commission accreditation standards.
Program minimums include:
1) Program objectives 2) Organization and responsibilities. 3) Scope of QA program and customer input. 4) required QA functions including what is to be done by whom and when. 5) Information flow and review needs. 6) Annual review of program. 7) Methodology by which data is generated.
what is a Nosocomial Infection?
An inpatient acquired infection not present or incubating at the time of admission. It is considered Nosocomial if the infection becomes apparent 72 or more hours after admission.
What is a potentially compensable event? (PCE)
An event or outcome during the process of med or dental care in which the pt suffers lack of improvement, injury, illness of severity greater than ordinarily experienced by pt with similar proc or illness.
When was the QA program originally issued?
1984 for MTF and 1987 for DTF. The CNO and the Commandant are committed to providing the highest quality medical and dental care to DON beneficiaries.
What is Joint Publication 4-02
HEALTH SERVICE SUPPORT-
HSS has three joint functions: sustainment, movement and maneuver, and protection. HSS promotes, improves, conserves or restores health within a military system.
What is MCWP 4-11.1
HEALTH SERVICE SUPPORT OPERATIONS-
HSSO is a process that deliver on demand to the warfighter a healthy, fit, and medically ready force. The mission is to minimize the effects that wounds, injuries, and disease have on units’ effectiveness, readiness, and morale with the use of Prev Med.
What is NAVMED P-5041
TX OF CHEMICAL WARFARE AGENT CASUALTIES AND CONVENTIONAL MILITARY CHEMICAL INJURIES
What is NAVMED P-5042
TX OF BIOLOGICAL WARFARE AGENT CASUALTIES
What is MANMED CHAPTER 6
DENTAL CORPS-
Navy Dental Corps was est by provisions of an act August 22, 1912.
What is MANMED CHAPTER 21
PHARMACY OPERATION AND DRUG CONTROL
What is MANMED CHAPTER 23
FORMS, REPORTS, AND RECORDS
What is NAVMEDCOMINST 5360.1
DECEDENT AFFAIRS MANUAL
What percent of combat fatalities occur forward of medical care?
90% * Half of these casualties bleed to death,1/5 from extremity trauma (10%-15% of all deaths).
What is the most effective and preferred method of hemorrhage control?
Direct pressure at site of injury
If direct pressure fails to stop the hemorrhage, it signifies?
Deep, massive, or arterial injury, and will require surgery or advanced hemostatic agents. Apply direct pressure to the wound for how long before looking to see if it is effective. At least 5 minutes * Impaled foreign bodies should not be removed because profuse bleeding may occur.
What are the negative factors of bandages?
A Bandage Does Not Equal Direct Pressure! A bandage may wick blood from the wound without stopping the bleeding. A bandage hides ongoing bleeding.
what method of hemostasis is more likely to cause additional injury than to control bleeding?
Blind clamping
how long may it take to provide hemostasis when compressing at a pressure point?
20 minutes.
What is the pressure point and artery for the lower arm?
Axilla
Axillary
What is the pressure point and artery for the thigh?
Below the groin crease
Femoral
What is the pressure point and artery for the leg?
Behind the knee
Popliteal
Application of a tourniquet for longer than _____ will increase limb loss.
2 hours
What may be used to clamp a vessel if the damage is easily identified?
Hemostat
What are the possible pitfalls of MAST? (Military Anti-Shock Trousers)
- Protracted MAST use leads to compartment syndrome and ischemic limbs
- Respiratory compromise due to diaphragmatic elevation
- Increased torso bleeding
- requires close monitoring in aircraft’s due to pressure changes
What may reduce pelvic bleeding besides stabilization of pelvic fracture with MAST garment?
Wrapping the pelvis tightly with a wide strap (such as a folded sheet)
Open torso injuries. If direct pressure does not stop the hemorrhage, consider doing what method?
inserting a balloon tamponade with a (Foley) catheter into the wound, and then with balloon inflated pulling back to compress the bleeding site.
What must be asses before and after applying a dressing or bandage?
Neurological status and circulation of extremity
What four things should you remember concerning Coagulopathy?
- Keep patient warm (above34°C).
- Use warm fluids.
- Use crystalloid fluids sparingly.
- Transfuse with fresh whole blood
what two agents are recommended by the US Tactical Combat Casualty Care Committee?
- HemCon
2. QuikClot
Pressure must be applied for how long at the bleeding site, after application of a hemostatic dressing?
3-5 minutes
What is Q fever?
Bacteria named Coxielle burnetii. Highly resistent to heat.
What is the reservoir for Q fever?
Sheep, dogs, cattle, cats
How is Q fever transmitted?
Usually via aerosols
What are some signs and symptoms of atypical pneumonia?
fever, fatigue,chills, sweats,myalgia
approximately 33 percent of Q fever will develop what?
Acute hepatitis
What is a pre-exposure prophylaxis for Q fever?
A formalin inactivated whole cell vaccine, which provides exposure for 5 years.
What is a post-exposure medication for Q-fever?
Tetracycline 500 mg PO every 6 hours for 5 days. or doxy 100 mg every 12 hours for 5 day. effective if begun 8-12 days
What are treatment meds for Q fever?
Administer 100 mg doxycycline orally every 12 hours for at least 2 days after patient is afebrile or 500 mg tetracycline every 6 hours for at least 2 days.
What are the reservoir for Tularemia?
Rabbits, hares, rodents
Francisella Tularensis is limited to what hemisphere?
Northern Hemisphere
How are Tularemia transmitted?
By arthropod vectors such as: ticks and deer flies or direct contact with infected animals.
What are the signs and symptoms of Tularemia?
Acute pneumonia, fever, chest tightening, coughing .
What are some post-exposure prophylaxis for Tularemia?
Doxycycline 100 mg po every 12 h
Tetracycline 500 mg orally every 6 hours for 2 weeks, or cipro 500 mg every 12 hours for 2 weeks
When administering streptomycin for Tularemia what is the dose?
7.5 to 10mg per kg IM every 12 hours for 10-14 days
When administering Gentamycin for Tularemia, what is the dose?
3 to 5 mg per kg IV daily for 10-14 days
When administering Ciprofloxacin for Tularemia what is the proper dose?
400 mg IV every 12 hours then switch to oral cipro 500 mg every 12 hours after the patient
How are Anthrax transmitted?
contact with infected animals, ingesting contaminated meat or Inhaling spores during the processing of wool for textiles.
Cutaneous anthrax accounts for more that what percent of all anthrax cases?
90%
What are some signs of Cutaneous
Painless necrotic ulcer with black eschar and local edema
What are some post exposure chemoprophylaxis for anthrax?
All personnel exposed to aerosolized Anthrax should be administered ciprofloxacin 500mg tabs orally every 12 hours for 60 days
What are some signs and symptoms of Anthrax?
Fever, Malaise, cough,. also improvement for 3 days then acute respiratory symptoms
What are some treatments for anthrax
Ciprofloxacin 400 mg IV every 12 hours.
Doxycycline 200 mg IV loading dose followed by 100mg IV every 12 hours
What are the 4 members of Brucellosis?
Melitensis, abortus,suis,canis
What are the Reservoirs for Brucellosis?
sheep,goats,cattle swine, dogs and cayotes
How are Brucellosis transmitted?
inhalations, ingestion or inoculations
What is the most common symptoms of Brucellosis?
Bone and Joint disease
Cardiovascular problems presents only 2% of Brucellosis but accounts for the most?
Death
How are Brucellosis treated?
Doxy 200 mg and Rifampin 600 mg daily for 6 weeks or Doxy 200 mg daily for 6 weeks and streptomycin 1 gm Intramuscularly daily for 2 weeks.
True or False Brucellosis is not communicable from person to person
True
What are the reservoir for Melioidosis?
soil and water throughout the world between 20 degrees north and south latitudes
True or False Acute pulmonary disease is the most common form of melioidosis.
True
Case fatality rate for acute septicemic disease exceeds ?
90 %
What is another name for Plague?
Yersinia pestis
What is the primary reservoir for plague?
Rodents
How are Plague transmitted?
Via infected fleas from rodents to humans, dog or cat to humans.
What are some signs and symptoms of plague?
Acute onset of fever and prostration with acute painful lymphadenitis draining the site of the fleabite
Bacillus anthracis appears as what under the microscope during dx?
Encapsulated, aerobic, Gram positive, spore forming, rod shaped bacterium.
what are the four systems that Bacillus Anthracis can effect?
Skin/cutaneous which is most common, Respiratory rare, GI - rare in the rear, and Oropharyngeal which is least common
Cutaneous Anthrax sx
Usually start within 1 day, localized itching followed by 1) papular lesions that turn vesicular 2) subsequent black eschar within 7-10 days.
Cutaneous Anthrax Tx
Cipro 500 mg po q12hr
Rickettsial (spotted & Typhus Fevers) appears as what under the microscope during dx?
gram negative bacteria, pink-red cocci
Transmission of Rickettsial is done by?
ectoparasites such as fleas, lice, mites, and ticks by scratching infected feces into the skin or by inhaling their terd dust. Don’t inhale ectoparasite terd dust.
When is Rickettsial transmission likely?
More likely during spring and summer.
What is the incubation period for
Rickettsial has a 5-14 day incubation period.
Geographically where is Rickettsial most common?
Mediterranean, Southern Euro, Africa, India, Israel, Thailand, and Australia. HOWEVER ROCKY MOUNTAIN SPOTTED FEVER OR RICKETTISA PARKERI IS FROM THE AMERICAS.
Clinical presentation of Rickettsial?
Common symptoms develop 1-2 weeks into infection and include fever, headache, malaise, and sometimes nausea and vomiting. Rocky mountain fever may be fatal in 20-60% of untreated cases.
Clinical diagnosis of Rickettsial
PCR- Polymerase chain reaction- DNA basically, skin biopsy of rash or eschar, or EDTA - unclotted blood- to identify specific cells.
Treatment of Rickettshial?
Standard CDC regimen consists of 200mg of Doxycycline daily for 3-14 days. For children 2.2 mg/kg body weight per dose admin twice daily orally or IV for children under 100lb. Antibiotics of the tetracycline class have a high degree of efficacy and low toxicity in the tx of Ricketts
PATIENTS SHOULD BE TREATED FOR AT LEAST THREE DAYS AFTER THE FEVER SUBSIDES!!
Hepatitis A
Ingestion of fecal matter from persons with Hep A. Incubation period is 15-50 days. Rarely fatal. IgM Anti HAV test for acute infection to properly diagnose.
Hepatitis B
Contact with infectious blood, semen, and other fluids through birth, sexual contact, needles/syringes/or other drug equipment, needle sticks, tattoos. Incubation period is 45-160 days. Specific Test include: HBsAg and IgM anti-HBc for acute only.
Hepatitis C
Contact with blood of an infected person through sharing of contaminated needles, syringes, or other IV drug equipment use. Incubation period is 14-180 days. Specific test are not currently available for acute infection
Symptoms for Hepatitis (ALL) include:
Fever, Fatigue, Loss of appetite, Nausea, Vomiting, Abdominal pain, Gray colored stool, Joint pain, jaundice.
Hepatitis A Vaccine schedule?
2 doses given 6mos apart
Hepatitis B vaccine schedule?
3 doses given 6 mos apart
Yellow fever belongs to what Genus?
Flavivirus.
How is Yellow Fever transmitted?
YF is transmitted primarily through the bite of infected Aedes or Haemagogus mosquitoes.
Yellow fever has _____ transmission
3- Jungle - Sylvatic, Intermediate - Savannah, and urban.
Jungle or Sylvatic transmission of YF:
between nonhuman primates and mosquito in the forest. then from infected mosquito to humans.
Intermediate or Savannah transmission of YF:
transmission of virus from mosquitoes to humans living or working in border areas. again from monkey to mosquito to humans.
Urban Transmission of YF:
involves human to urban mosquitoes, primarily Aedes Aegypti.
Symptoms of Yellow Fever:
Incubation period is usually 3-6 days in which patients have no illness or only mild illness. Initial symptoms include, fever, chills, severe headache, back pain, general body aches, nausea, and vomiting, fatigue, and weakness with initial improvement of symptoms. After brief remission or improvement of hours to days, 15% of cases progress or develop high fever, jaundice, bleeding, and eventually shock and failure of organs.
Treatment of Yellow Fever:
No specific treatments have been found to benefit patients with yellow fever. AVOID ASPIRIN AND NSAIDS!!!
Lab Evaluation: for YF
M-IgM and G-IgG, RNA, RT-PCR Reverse Transmission Polymerase Chain Reaction.
Mosquito for
YF
malaria
YF= Adese egypti Malaria = anopheles
TB mask
N-95
fraternization instruction
OPNAVINST 5370.2
Seperation Instruction
MILPERSMAN 1900-1999 PERS 832
AUTOCLAVE
3 MINUTES AT 270 DEGREES
WHERE IS “COPY TO” LINE IN MEMO
UNDERNEATH SIGNATURE LINE ALIGNED TO LEFT HAND SIDE
Signa
to write, a word used to introduce the signature in a prescription; - mark write label
Tricare extra
fee-for-service plan available to all beneficiaries (except active duty service members) in the U.S
can use non network porvider
AC =
hydrogen cyanide abbreviation
lewisite
vesicant blister agent
Blood agents
Cyanogen chloride (CK) Hydrogen cyanide (AC) Arsine (SA)
MER reportable events within 30 days
Gonorrhea Chlamydia syphilis(latent)
Anthrax frequency and dosage
.5 ml 0,1,6,12,18 and 12 month boosters
navmed 6470/1
EXPOSURE TO IONIZING RADIATION
Jelly fish sting can cause cardiac collapse
3 minutes
MER go thru
SMDR maybe SMO
12 mm TB reaction after 72 hours =
“Not read”
ORM risk matrix
An expression of possible loss in terms of severity and probability
What is the minimum pay grade for a commanding officer to appoint IN WRITING as a DAPA?
E-6
SAPR instruction
SECNAVINST 1752.4
3 zones sexual harrassment
R Y G
secondary expenses
Secondary expenses are those expenses incurred for services and supplies for the funeral and interment service. The following expenses may be applied to the interment allowance. The family is responsible for any expenses that exceed that allowance. Burial in a private cemetery – reimbursable up to $4,850, plus transportation for the remains. Burial in a national cemetery – reimbursable up to $3,450, plus transportation for the remains..
primary Expenses
- The military service annually contract with CONUS mortuaries/funeral homes to provide, at a fixed rate and at no cost to the family, the embalming, dressing and casketing of remains of active duty members.
max money for remain not found
(A maximum of $3,000 reimbursable for costs of a memorial service for a member whose remains are not recovered).
retired escort
retains retire pay, all else same as AD
perry quote
“We have met the enemy and they are ours. Two ships, two brigs, one schooner and one sloop. Yours with great respect and esteem”
types of ships
Ships of the line, frigates, sloops of war
Incident of Sex harrassment reported within how long?
72 hours
three p’s
Praise, Performance, and Problems
SIG signa
SIG is a standard part of a written prescription that specifies directions for use of the medicine.
superscription
The superscription section (above the ℞ sign, hence the name) contains the date of the prescription and patient’s name and address;
inscription
The inscription specifies the ingredients and quantities of the medication;
subscription
The subscription section contains dispensing directions to the pharmacist, possibly including compounding instructions or quantities.
SIG
The SIG section contains directions to the patient on how and when to take the medicine prescribed (see SIG, below).
schedule 2 refills authorized?
high potential for abuse
Form for lost or stolen controlled meds
DEA 106
unannounced CSIB inspection when
quarterly or every 3 months
kerlex
6510
A CACO is the official representative of which of the following?
- CNO
- CO
- SECNAV
- Chaplain
SECNAV
Primaquin in G6PD causes
hemalysis
P-117 CH 15
physical exam
p-117 CH 23
reports
p-117 ch 21
pharmacy
pallegra
folic acid
gross autopsy details can be obtained by
NOK written request
PHS 731
yellow immunization form
OTC program authorized by
CO?
tetracycline treats
acne
Otitis media treatment
sulfisoxazole
Spinal blocks
thoracic
what type of block is a ring
nerve
Hepatitis with 28 day incubation period
Hep A
periodontitis
tooth elongation
decreased ADH aka vasopressin results in
Diabetes insipidous
lymphadenapthy fpund in what plague
bubonic
missing ships movement ucmj
ART 87
quid pro quo
this for that
% hypochlorite solution
5.25%
wartime submarine
project seapower work hostile enviroment
how long to submit report on eval?
2 years
QA records
2 years
MRE’s good for
48 months
SECNAV - M5210.1,
SECNAV - M5210.1, Department of the Navy (DON), Navy Records Management Program, Records Management Manual
SF 502
clinic narrative
SF 515
tissue exam
SF516
OP report
SF 509
progress notes
What are the three fundamental
pillars on which United States
military strategy rests?
Deterrence, forward defense,
and alliance solidarity
7th fleet
pacific
decon kit
m256A1
SOFA
status of forces agreement
R-status, C-status
remember
silver nitrate
batteries insecticides
telling subordinate to delegate task instills
confidence
near miss
A near-miss is defined as an event or
situation that could have resulted in harm to a patient,
if it had reached the patient..
metal cans hit deck enough to wake patient out of excitement stage?
stage 2 no
stages of anasteshia
induction
excitement
surgical
danger
document binnacle list on
SF 600
temp record
no original copies
primary pharmacy text
remington
Caudal
umbilicus to the toes
saddle block
spinal
Epidural
epidural
p5010 ch 1
Food sanitation
p5010 ch 8
entomology
p5010 ch 9
ground forces
p5010 ditty
Frank likes very small apples while watching everyone go
SSIC ditty
Military tests require luck and masterchief Frakers outstanding study guide for career enhancing goals
CG - and what does it smell like
phosegene new mown hay
HR ditty
Oh god you got that fat white bitch pregnant retard
AC = what does it smell like
almonds
HBV FREQ
0,1,6 MONTHS
JEV FREQ
0,7,30 DAYS
PNUMOCCOCAL ROUNTINELY GIVEN OVER AGE WHAT
65
Chest xray in TB reactor indicated
all the above
WHAT IS BACILLARY DYSENTERY
SHIGELLOSIS-BACTERIAL DISEASE TO DISTAL SMALL INTESTINE AND COLON WITH LOOSE STOOLS OF SMALL VOLUME, FEVER, NAUSEA, VOMITING, TENESMUS
LENGTH OF SHIGELLOSIS INFECTION
NORMALLY SELF LIMITING AT 4-7 DAYS.
Occurence of shigellosis
600K DEATHS PER YEAR (2/3 CHILDREN UNDER 10). OCCURE IN CROWDING WITH POOR HYGIENE
mode of transmission of shigellosis
Fecal oral transmission
RESERVOIR FOR SHIGELLOSIS
humans
SYMPTOMS OF SMALLPOX
SUDDEN RASH, FEVER, MALAISE, H/A, PROSTRATION ,BACK PAIN, ABDOMINAL PAIN, VOMITING
SMALLPOX INCUBATION
COMMONLY 10-14 DAYS WITH 2-4 DAYS AFTER FOR RASH ONSET
MODE OF TRANSMISSION FOR SMALLPOX
RESPIRATORY, CONJUNCTIVA, PLACENTA
INFECTIOUS AGENT OF SMALLPOX
VARIOLA VIRUS
UCMJ ARTICLE that prevent self incrimination
Article 31
Most destructive stored food pest
Rice weevil
When does person under age 18 not need signature on SF 522?
When married to AD or is AD themself
Amyl nitrate used in what CBR agents
Hydrogen cyanide & cyanogen chloride
Example vomit agent
Adamsite
Flash blindness from nuclear blast at night can last how long?
60 minutes
Form # CPO EVAL
1610/27
3 PFA failures in 4 yrs gets what action on eval?
Not recommend retention
Birthday of CPO
1APR 1893
When embarking disembarking small boat vessel, Senior Officer______________
Last onboard embarking First ashore when disembarking
Phenobarbital indicated for________
Insomnia & siezures
How many officers on CSIB inventory board
3 members, 1 has to be officer
When can Rx be phoned into navy pharmacy?
In emergency or extreme situation
When ordering supplies what pub do you use
P-485
Used in tx of fungal infx of hair skin nails
Griseofulvin
Who approves destruction of expired drugs
C.O.
NOT a factor in selecting site for urinal
Design
What type Dz is rabies?
Zoonotic
What area on oral mucosa?
Leukoplakia
In reference to STA-21, how long does member have to get bachelors degree?
36 months
Dz associated with Wilson Edison test
Malaria(test for presence of chloroquine in urine, thus confirming compliance with chemoprophylaxis)
Tx for beri-beri
Thiamine
What vaccination do recruits NOT recieve
Typhoid
For for lost or theft of controlled substance
DEA form106
Who is normally selected as triage officer
Dental officer
How long after leaving malaria endemic environment can one donate blood
3 yrs
Which publication contains information about special duty physicals
MANMED
What Dz is a concern for all healthcare workers
HBV
If that patient presents 10 days after TB test with 16 mm of induration how was this documented?
Not read
Then another PPD placed in other arm
What disease is a concern for all healthcare workers
HBV
FMF HM’s are separated into what 2 groups
Logistics and support
Med BN has how many Companies?
3
Lead lined wall surrounding an x-ray room offer protection under what principal
Shielding
Who is the primary address see when submitting and MER
Responsible NEPMU
If malaria prophylaxis is taking and you do not travel to a malaria endemic area how soon may you donate blood
1 yr
What happens to Optar when it’s the fourth quarter and you still have funds left over
Funds are balanced and they disappear
How often are AMAL’s inventoried?
Annually
What platoon is not part of MED BN
Preventative Med Plt
What would not be considered infectious waste
2x2 used for venipuncture
Who can make changes to control substance bulk stock
Commanding officer
QA reports are submitted when
15 January every year
If the water table is high in the soil is Rocky what type of the train would you put into place
Burn barrel
MANMED P-5010 chapters
Frank - Food safety Likes -Living spaces Very - Ventilation Small - Swimming pools Apples - ashore water After. -afloat water Watching - wastewater Everyone. -entomology Go. -Ground forces
How many scheduled drugs are there?
5
What schedule are drugs with no acceptable medical use and a very high abuse potential
Schedule 1
What schedule are drugs have acceptable medical use which are considered to have very high abuse potential
Schedule 2
What schedule are drugs having acceptable medical use which I considered to have a lessening degrees of abuse potential
Schedule 3, 4, & 5
Schedule two drugs shall be filled within how many days of the date originally written
7
True or false schedule two drugs shall not be refilled
True
Poly prescription form
NAVMED 6710/6
DOD RX FORM
DD 1289
