Well-patient exam

Question 1

order of abdomen exam

Answer 1

Inspect, auscultate, percuss, palpate

Question 2

PLAN during well patient visit

Answer 2

recommend specific immuniztions
recommend lifestyle chagnes
recommend screening based on age or testing based on symptoms

Question 3

sources for recommendations

Answer 3

US preventive services taske force
CDC
american cancer society
AAFP

Question 4

what is Tdap

Answer 4

Td is Tetanus diphtheria

ap for acelular pertussis

Question 5

dosage of Tdap
booster every __ years
puncture wound people
tdap and preg

Answer 5

one dose of Tdap

• booster every 10 years after
• people with puncture wound or laceration get updated unless Td booster within previous 5 years
• give tdap once per pregnancy around 32-36 weeks

Question 6

HPV vaccine and women

Answer 6

3 doses up to age 26

Question 7

HPV vaccine and men

-gay men

Answer 7

3 doses up to age 21 for men

-up to age 26 for gay men

Question 8

HPV vaccine is recommended for all boys and girls starting at age __

Answer 8

11

Question 9

varicella dose

Answer 9

2 doses for anyone who doesn’t have documentation of 2 varicella vaccines in lifetime or who hasn’t had chicken pox

Question 10

pneumococcal vaccine reccomendation

Answer 10

all adults 65 or older
all adults who smoke
residents of nursing homes
all adults who are diabetic, have chronic lung disease, CV disease, renal disease, nephrotic syndrome, liver disease, alcoholism, asplenia
-

Question 11

5 years after first dose of pneumococcal vaccine, re-dose people with

Answer 11

chronic renal failure, chronic renal railure, nephrotic syndrome, anatomic asplenia

Question 12

everyibe who has a dose of pneumonia vaccine before age 65 gets another dose when?

Answer 12

at 65 or after age of 65

Question 13

varicella zoster shot should be given to who

Answer 13

all adults starting at age 60

-unless contraindication such as pregnancy or severe immunodeficiency

Question 14

who should get flu vaccine

Answer 14

all people age 6 months or older annually

• contraindications: egg allergies
• age 65 or older may opt for high-dose vaccine

Question 15

screening vs testing

Answer 15

screening is testing an asymptomatic patient for specific disease as recommendation

-testing is testing symptomatic patient for specific disease

Question 16

when to start pap smears and then how often

Answer 16

age 21 then every 3 years until 65

-for women age 30+ opt to do pap plus HPV screening every 5 years

Question 17

when paps not rec

Answer 17

for women after 65

for women with hysterectomy with cervix removal unless high grade precancerous lesion or cervical cancer

Question 18

AAFP recommends mammograms begin at age ___ then do every ___ years until age __

Answer 18

50, 2, 75

Question 19

american cancer association recommends mammograms start at age __

Answer 19

40

Question 20

rec screening for gonorrhea and chlamydia

Answer 20

in women age 24 and younger and in older women at increased risk or disease

Question 21

who should be screened for HIV

Answer 21

adults age 18-65

-all pregnant women

Question 22

colon cancer screening

Answer 22

begin at 50 until 75 years old

-recommend against screening age 76 to 85

Question 23

cancer screening prostate specific antigen

USPSTF/AAFP

Answer 23

recommend against routine screening of PSA

Question 24

american cancer society and prostate screeing

Answer 24

rec discussion with each man and evaluation of risk factors

• men with primary relative with prostate cancer, consider testing at age 45
• other men, age 50

Question 25

screening for abdominal aortic aneurysm, men

-women

Answer 25

AAFP recommends 1 time screening by ultrasonography in men ages 65-75 who have ever smoked

evidence insufficient for women