Primary Care Boring Stuff

Question 1

What population to consider ASA for primary prevention

Answer 1

Ages 50 - 69 with ASCVD >10%

Question 2

Frequency of NODAT screening post-txp

Answer 2

Qweek x4wk then Q3 mo x1 year then annually

FBG, A1c, OGTT

Question 3

Dx of DM

Answer 3

FBG >126
A1c > 6.5%
OGTT >200

Question 4

Dx Pre-Dm

Answer 4

FBG >100
A1c >5.7%
OGTT >140

Question 5

HLD Screening

Answer 5

2-3 months post-txp then annually

Question 6

Statin benefit groups

Answer 6

1. LDL >190 [high]
2. DM, age 40-75 [mod-high]
3. ASCVD 7.5-20%, Age 40-75, no DM [moderate]
4. ASCVD >20%, Age 40-75, no DM [high]
5. Clinical ASCVD [mod-high pending age, individual risk]

Question 7

Breast CA Screening

Answer 7

Q2 years at age 50-74

Question 8

Prostate CA Screening

Answer 8

PSA in men 55 - 69

Question 9

PTLD Screening

Answer 9

Exam Q3 months

Question 10

Colon CA Screening

Answer 10

Screening at age 50: colo Q10 OR flex sig Q5 OR stool-test annually

Question 11

Cervical CA Screening

Answer 11

Q3 years

Question 12

Skin CA Screening & how soon to get first exam

Answer 12

Annual exam:

• within 2 years if high risk caucasian (old, thoracic txp, male)
• within 5 years if AA or low-risk caucasian

Question 13

RCC Screening

Answer 13

For high risk (acquired cystic, family hx, smoker), native kidney US Q1-2 years

Question 14

Screening for HCC Patients

Answer 14

CT/MRI Q6-12 months x3 years

+/- AFP measurements

Question 15

PSC with IBD Screening for Colon CA

Answer 15

Colo annually with biopsy

Question 16

How soon can inactive vaccine be given pre-txp?

Answer 16

At least 2 weeks

Question 17

How soon can live vaccine be given pre-txp?

Answer 17

At least 4 weeks

Question 18

How soon to give inactive vaccine post-txp

Answer 18

Flu: at least 4 weeks

All others: at least 8 weeks

Question 19

Vaccine series of Zoster (Shingrix)

Answer 19

0 months

2-6 months

Question 20

Age for Shingrix

Answer 20

50+

Question 21

TIme to wait between Shingles and Shingrix vaccine

Answer 21

1 year

Question 22

Who should get PCV13 vaccine? (adults)

Answer 22

Everyone x1 in lifetime

Question 23

PPSV23 Schedule

Answer 23

#1: 8 weeks after PCV13
#2: 5 years after #1
#3: after age 65 (and 5 years after #2)

Question 24

Hepatitis B Schedule

Answer 24

Engerix or Recombivax: 0, 4 weeks, 24 weeks
Heplisav-B 0, 4 weeks

Consider checking HbsAb titer ~4 weeks after final dose. If HBsAb <10 consider completing series again using high-dose

Question 25

Vaccines required if eculizumab

Answer 25

1. MenACWY (Menactra, Menveo - interchangable)

2. MenB (Bexsero, Trumenba - not interchangable)

Question 26

Which mening vaccine cannot be given with PCV13?

Answer 26

Menactra. Associated with reduced PCV IgG.

Question 27

Vaccines required if asplenic

Answer 27

1. MenACWY (Menveo pref if needed to give PCV13 at same time)
2. MenB
3. Hib
4. PCV13
5. PPSV23

Question 28

BMD screening

Answer 28

Kidney: within first 3 months if on CS-containing regimen or high risk for osteoporosis
Liver: annually if osteopenic; Q2-3 years if normal BMD

Question 29

Who should get MenACWY vaccine?

Answer 29

Recommended for everyone: 1st dose at 11-12 years and 2nd dose at 16 years

Question 30

For adults at risk:
Menveo schedule?
Menactra schedule?

Answer 30

For BOTH MenACWY:

2 doses 8 weeks apart then re-vaccinate Q5 years if risk remains

Question 31

Who should get MenB vaccine?

Answer 31

People 10+ at risk for meningococcal disease (asplenia, eculizumab)

Question 32

For those at risk:
Trumenbo schedule?
Bexsero schedule?

Answer 32

Trumenba: 3 doses, at 0, 1-2, and 6 months
Bexsero: 2 doses, 4 weeks apart

1 dose MenB booster 1 year after primary series and revaccinate every 2–3 years if risk remains

Question 33

Who should get HPV vaccine?

Answer 33

Males & females 9 - 45 yeras of age

Question 34

HPV vaccine schedule

Answer 34

3 doses at 0, 1-2 and 6 months

Question 35

MMR schedule (pediatrics)

Answer 35

2 doses at 12-15 months and 4-6 years

may accelerate to 4 weeks betwen the 2 doses

Question 36

Adults without immunity to MMR/born AFTER 1958: vaccine schedule

Answer 36

1 dose