Primary Care Medicine

Question 1

At what level can lead poisoning cause cognitive damage?

Answer 1

10-20 = mild cognitive delay, >60 = severe headaches/toxicity/encephalopathy anemia ; needs chelation at 45

Question 2

When are the Dtap and Tdap vaccines given?

Answer 2

Dtap = 2,4,6,15mo and 4-6 years (kindergarten visit). Cannot give to anyone over 7 years. Tdap should be given at 11, then every 10 years

Question 3

Wound management and tetanus prophy/imm?? Clean vs. dirty wounds

Answer 3

Clean wounds = never need Tetanus IG. If imm status unknown or has gotten

Question 4

When is hep B vaccine given?

Answer 4

0, 2, 6 months - usually get an extra dose at 4 months if use combo vaccine, if vaccinating after newborn peropd or not completely immunized as a baby, begin the complete 3 part series

Question 5

When do you give MMR?

Answer 5

12 mos, 4-6 years. MMR can be given at any visit as long as at least 4 weeks have elapsed

Question 6

What should you do if a child under a year has been exposed to the measles?

Answer 6

If less than 6 mos, give measles IgG, if >6mos and within 72 hours of exposure, give MMR, if >72hours,

Question 7

What if a child is traveling to a measles endemic area before age 1

Answer 7

give MMR (but this is short term and still needs 12 month dose)

Question 8

What percent of kids get fever after MMR?

Answer 8

15% within 12 days of vaccination last 1-2 days

Question 9

What is the relationship between MMR and Tb?

Answer 9

Can place a PPD with MMR (no mitigation of PPD effect). A PPD should not be placed 4-6 weeks after MMR has been given. A positve PPD is not a contraindication to getting MMR, however, if TB is confirmed, start treatment before giving MMR (vaccine can worsen Tb)

Question 10

Which vaccines have enough egg protein to worry about concurrent egg allergy?

Answer 10

Yellow fever and influenza vaccines. Any kid with egg allergy/reaction should be skin tested to confirm since will affect receiving vaccines

Question 11

Who do you use epipen Jr for?

Answer 11

kids

Question 12

Which ages is prevnar indicated?

Answer 12

2,4,6,12mos

Question 13

When is rotavirus given?

Answer 13

2, 4, 6 mos

Question 14

Must give first dose of rota at what age?

Answer 14

between 6 and 14 weeks (not after 15 weeks), the series must be complete by 8 months, have to give 4 weeks in between doses. If give first dose after 15 weeks, still complete course

Question 15

If an infant gets rotavirus, do they still need immunization?

Answer 15

yes because only infers partial immunity

Question 16

What is spit up the rotavirus vaccine?

Answer 16

Do not redose, continue with series

Question 17

If fail the hearing screen, hen do newborns need to be referred to audiologist?

Answer 17

before 3 months of age

Question 18

What is Myositis ossificans traumatica?

Answer 18

Ectopic bone formation in a muscle group following trauma to the muscle. Myositis ossificans traumatica should be considered in a patient with a history of a direct blow to a muscle that exhibits persistent pain or worsening several weeks after injury

Question 19

Below what age should not use monospot?

Question 20

above which age do babies need sedation for ABR testing?

Answer 20

> 6 months

Question 21

Catch up vaccine for Dtap:

Answer 21

If got one dose before 12 months, need 4 total doses. If first dose is after 12 months, need 3 total doses. Need 4 weeks between dose 1 and 2, and 6 months between second to last dose and last dose.

Question 22

What if mother is hep B pos or unknown Hep B status?

Answer 22

Newborn needs hep B vaccine and Hep B Ig, give normal vaccine schedule, 2 and 6 months, but then check titers around 9 months

Question 23

If have had anaphylaxis to streptomycin, neomycin or polymixin do not give which vaccine?

Answer 23

IPV

Question 24

If have had anaphylaxis to neomycin, do not give which vaccine?

Answer 24

MMR and VZV

Question 25

If have had anaphylaxis to gelatin, do not give:

Answer 25

MMR, VZV, Yellow fever

Question 26

Definition of colic

Answer 26

excessive, unexplained crying is an otherwise well-nourished, normal infant lasting >3 hours per day and occuring >3 days a week for at least 3 weeks. 30-50% of infants have colic. Usually occurs in first week of life and resolves at 3-4 months

Question 27

Disciple strategies age 1-5 then 5 and above

Answer 27

age 1-5 time out. >5 - loss of priveleges

Question 28

When can kids sit in front seat

Answer 28

age 13

Question 29

How long after diagnosis of CT or GC should patients be tested for repeat infection?

Answer 29

3 months

Question 30

Which drugs cannot be tested in urine

Answer 30

LSD, bath salts.

Question 31

How long can drugs be tested in urine?

Answer 31

Most 24-48 hours, except PCP is 8-10days and MJ is 4-6 weeks

Question 32

Which drug is approved for adolescent/child depression

Answer 32

fluoxetine in patients >8

Question 33

Which SSRI is best for bulimia?

Answer 33

fluoxetine

Question 34

primary amenorhhea

Answer 34

lack of menstruation by age 16

Question 35

Most common cause of secondary amenorrhea

Answer 35

pregnancy

Question 36

What tanner stage does menstruation usually happen?

Answer 36

Tanner 4

Question 37

How long after starting menstruation on average do cycles consistently become ovulatory?

Answer 37

20 months

Question 38

Vaginal PH of BV infection

Answer 38

> 4.5

Question 39

vaginal pH of candida

Answer 39

<4.5

Question 40

Treatment of inpatient PID

Answer 40

cefotetan or cefoxitin plus doxycycline

Question 41

Inpatient treatment of PID if PCN all

Answer 41

Clinda plus gentamicin

Question 42

Outpatient treatment of PID

Answer 42

rocephin 250mg IM or Cefoxitin2GM IM +Probenecid PLUS doxy and flagyl

Question 43

Which problems do pregnant adolescents have higher rates of?

Answer 43

Pregnant adolescents have a higher risk of complications including placenta previa, pregnancy-induced hypertension, premature delivery, and higher rates of infant mortality