primary/sec prevention

Question 1

live, attenuated virus vaccine examples

Answer 1

MMR (measles, mumps, rubella)
Varicella (chickenpox)
intranasal influenza virus vaccine

Question 2

recommended vaccines that can be given during pregnancy

Answer 2

influenza
hep B
hep A
meningococcal ACWY

Question 3

varicella vaccine series

Answer 3

recommended 2 doses if born in 1980 or later

2 doses for age 50+ with risk factors

Question 4

Tdap vaccine series

Answer 4

with risk factors: 1 dose for each pregnancy or wound management
withOUT risk: 1 dose then booster every 10 years

Question 5

Zoster recombinant (RZV) series

Answer 5

2 doses for immunocompromised up to age 49

age 50+ require 2 doses

Question 6

human papillomavrius (HPV) vaccine series

Answer 6

age 19-26 require 2-3 doses depending on age of first dose

age 27-49 - shared decision making

Question 7

pneumococcal vaccine series

Answer 7

age ≥65 require 1 dose PCV15 then PPSV23
OR
1 dose PCV20
<65: 2 doses for immunocompromised

Question 8

The 5 A’s for tobacco cessation

Answer 8

ask, advise, assess, assist, and arrange

Question 9

stage of change/NP action: patient is note interested in change and might not be aware that the problem exists or minimizes the problem’s impact

Answer 9

precontemplation

help patient to move toward thinking about changing unhealthy behavior

Question 10

stage of change/NP action: patient is considering change and looking at its positive and negative aspects

Answer 10

contemplation

help patient to examine benefits and barriers t ochange

Question 11

stage of change/NP action: patient exhibits some change or behaviors or thoughts and often reports feeling that they do not have the tools to proceed

Answer 11

preparation

assist patient in finding tools and continue to work to lower barriers to change

Question 12

stage of change/NP action: patient is ready to go forth with change, taking concrete steps to change but is inconsistent with carrying through

Answer 12

action
work with patient on use of tools, encourage healthy behavior change, praise positive, acknowledging reverting back to former behavior as a common but not insurmountable problem

Question 13

stage of change/NP action: patient learns to continue the change and has adopted and embraced the healthy habit. The person learns to deal with backsliding

Answer 13

maintenance/relapse
continued positive reinforcement for the behavior change, put backsliding into perspective of a common but not insurmountable problem

Question 14

common cases of cancer in males

Answer 14

prostate, lung, colon, urinary bladder, melanoma

Question 15

common cases of cancer in females

Answer 15

breast, lung, colon, uterine, melanoma

Question 16

common cases of death in males with cancer

Answer 16

lung, prostate, colon, pancreas, liver

Question 17

common cases of death in females with cancer

Answer 17

lung, breast, colon, pancreas, ovary

Question 18

age and grade of prostate specific antigen screening

Answer 18

men aged 55-69, grade C

grade D for men ≥75 years

Question 19

breast and ovarian cancer screening recommendations

Answer 19

women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have ancestry associated with breast cancer susceptibility 1 and 2 (BRCA 1/2) gene mutations
Grade B

Question 20

colorectal cancer screening recommendations

Answer 20

start at age 45 and continue till age 75. Individualized decision screening age 76-85.
options include:
1. guaiac-based fecal occult blood test or fecal immunochemical test = annually
2. stool DNA test = q 3 years
3. colonoscopy = q 10 years
4. flexible sigmoidoscopy = q 5 years
5. CT colonoscopy = q 5 years

Question 21

endometrial cancer screening recommendations

Answer 21

via endometrial biopsy

at time of menopause women should be encouraged to report unexpected vaginal bleeding, discharge, or spotting

Question 22

women with hereditary nonpolyposis colorectal cancer (HNPCC) screening recommendations

Answer 22

start at age 35

annual endometrial biopsy should be offered

Question 23

lung cancer screening recommendations

Answer 23

low-dose computed tomography (LDCT)
age 50-75 years 
with at 20-pack-year history 
and current or ≤15 years since quitting
screen until it has been 15 yrs or age 74

Question 24

breast cancer screening recommendations

Answer 24

mammogram
age 40-50 = can consider starting annually
age 50-75 = q 1-2 years
>75 = depending on life expectancy

Question 25

cervical cancer screening recommendations

Answer 25

start at age 21-25 = HPV (q5 years) or Pap (q3 years)
age 30-65 = Pap (q3 years), HPV (q5 years) or Pap/HPV co-test (q5 years)
age >65 years = none after adequate negative results

Question 26

candidates for TB testing

Answer 26

1. contact with active TB person
2. countries where active TB is common
3. homeless shelter, prison/jail, nursing home
4. healthcare workers
5. HIV
6. IV drug users

Question 27

Positive reactive mantoux tuberculin skin test (TST) result

Answer 27

induration ≥15 mm

≥5-10 mm with risk factors

Question 28

vaccine against TB given in many countries

Answer 28

BCG (bacille Calmette-Guerin)

Question 29

blood test for TB infection

Answer 29

interferon-gamma release assay (IGRA)

Question 30

TB symptoms

Answer 30

significant cough lasting ≥3 weeks
chest pain
hemoptysis or sputum production
weakness/fatigue
weight loss
lack of appetite
fever/chills/night sweats

Question 31

first-line anti-TB agents

Answer 31

all must be taken 6-9 months

• INH (isoniazid)
• Rifampin
• Ethambutol
• Pyrazinamide

Question 32

Latent TB infection tx

Answer 32

• isoniazid (INH) 6-9 months
• isoniazid and rifapentine (3 months)
• rifampin 4 months