Preventative Medicine

Question 1

What are the 3 cancers in which regular screening is recommended?

Answer 1

1. breast
2. colon
3. cervical

Question 2

What is the recommended screening tool for breast cancer?

Answer 2

yearly mammograms starting at 40 - 74 y/o

Question 3

What is the recommended screening tool for skin cancer?

Answer 3

skin screening during well visit yearly

Question 4

What is the recommended screening tool for cervical cancer?

Answer 4

pap smears starting at 21 y/o -65 y/o

every 3 years if no co-testing; every 5 years if co-test with HPV testing

Question 5

What is used as prophylaxis for traveler’s diarrhea?

Answer 5

1. Bismuth subsalicylate (Pepto-bismol)

2. consume clean water and food

Question 6

When should immunoglobulin be given along with hep A vaccine?

Answer 6

if pt traveling within 2 weeks; give with first dose if never vaccinated

Question 7

What is the agent of choice for malaria prophylaxis?

Answer 7

mefloquine (doxycycline is alternative)

Question 8

Who should be vaccinated for Rabies?

Answer 8

traveling to India, mexico or asia and interacting with domestic animals; work in animal lab

Question 9

What vaccines are contra-indicated in pregnacy and immunocompromised?

Answer 9

1. Typhoid (oral)
2. tdap (pertussis)
3. MMR
4. Varicella

Question 10

How often should an adult recieve a tetanus booster?

Answer 10

every 10 years (one of which should contain pertussis)

Question 11

Who should recieve gardisil vaccination?

Answer 11

any age 9-26 y/o

given as 3 dose: 0 months, 2 months and 6 months

Question 12

Who can receive the flumist (live attentuated flu) vaccine?

Answer 12

pts 5-49 y/o without co-morbidities

not healthcare workers b/c in contact with immunocompromised pts

Question 13

Who should recieve a pneumococcal vaccine?

Answer 13

1. if older than 65 y/o

2. if immunocompromised, renal disease or asplenic (give 2nd dose after 5 years)

Question 14

When should an individual recieve a shingles vaccine (varicella zoster)?

Answer 14

starting at age 60 y/o

Question 15

What is the screening tool for osteoporesis and who should recieve it?

Answer 15

DEXA scan; women > 65 y/o

Question 16

What is the screening tool for abdominal aortic aneurysm and who should recieve it?

Answer 16

abdominal ultrasound; men > 65 y/o with hx of smoking

Question 17

What is the screening tool for hypercholestermia and when should it be started?

Answer 17

fasting cholesterol levels
1. 35 years old in males
2. 45 years old in females
(if increased risk factors for CAD, start at 20)

Question 18

What is the target LDL for pts with heart disease or eqivualent (diabetes, peripheral vascular disease, stroke, carotid artery disease?

Answer 18

LDL <100

Question 19

What is the target LDL for pt with 2 or more risk factors (smoking, HTN, HDL45 y/o)?

Answer 19

LDL < 130

Question 20

What is the target LDL for a patient with 0-1 risk factor?

Answer 20

LDL <160

Question 21

What is considered stage 1 hypertension?

Answer 21

SBP 140-159; DBP 90-99

Question 22

What is considered stage 2 hypertension?

Answer 22

SBP >160; DBP >100

Question 23

What is the goal blood pressure for patients with diabetes or kidney disease?

Answer 23

BP < 130/80

Question 24

What is the screening recommendations for diabetes?

Answer 24

1. every 3 years of 45
2. if BMI >25
3. if HTN

Question 25

What are the side effects of sibutramine (used for weight loss)?

Answer 25

1. HTN

2. tachycardia

Question 26

what is the side effect of orlistat (used for weight loss)?

Answer 26

Steatorrhea

Question 27

When should someone be considered for gastric bypass?

Answer 27

BMI >40

Question 28

What is considered alcohol abuse?

Answer 28

1. 2 or more yes on CAGE question
2. drink more than 2 drinks daily
3. binge drinking (4-5 drinks in sitting)