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70 Cards in this Set
- Front
- Back
At what age should an adolescent have a full physical exam?
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Start between ages 11 and 14; then there are 3 recommended visits:
ages: 11 - 14 15- 17 18 - 21 |
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What should be included in the physical exam of an adolescent?
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height/weight (checking for eating disorders)
Skin exam Oral Cavity (gingivitis, cavities, etc.) Hearing Abuse/neglect (depression) BP (normal: 120/80 or less) |
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What age should the female patient recieve vaccination for HPV with Gardisil?
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between age 11 - 26
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What age should the female patient recieve vaccination for HPV with Cervarix?
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Between age 10 - 25
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How are the HPV vaccinations scheduled? (i.e. how many and when)
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Three over six months:
2nd - two months after first 3rd - two and six months after first (Series of 3 shots - zero, one, and six months schedule) |
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WHen should screening for syphyllis in males and females begin?
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Upon becoming sexually active
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When should Self-Breast/Testicular Exam begin?
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During adolescence and monthly
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What is the leading cancer killer for adolescents?
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Testicular cancer
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When should screening for HIV begin?
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Depends on level of sexual activity, assess knowledge of prevention)
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When should vaccination wit the Tetanus- diphtheria vaccine occur?
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in adolescence, then every 10 years
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What does TDAP cover?
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accellular pertussis
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When should the meningococcal vaccine be given?
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between ages 11 - 18
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What groups are recommended to receive the meningococcal vaccine?
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Those going to live in a dorm, traveling to Africa, entering the military
This is NOT a routine vaccination for adults |
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Who should get the influenza vaccine?
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everybody 6months of age and older
Given annually |
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When is the PPD screening begun
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Once during adolescence, every 2 years if at risk
Really depends on where they live and what conditions they live in (i.e., Manhatten vs. rural Kansas) |
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What is the age group for the Young adult?
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Between age 20 and 39
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How often should those in the young adult category have a complete physical exam?
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every 5 - 6 years if everything is normal
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What should be included for females during a physical exam in the young adult group?
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Pap smear
Should include screens for GC and Chlamydia) for all under age 25 and annually till age 29, then may go to every 2-3 years if several negative results obtained |
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When should pap smears begin for young adult females?
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Begins at age 21
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When should mammograms begin?
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Unless there is a strong famly history, age 40 - 49 at every 1 - 2 years schedule, then annually ages 50 -74
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What is the recommended age to stop mammograms
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Continue through age 74 if in good health
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72 y/o female comes into office for regular female exam; she has been seen in your clinic for 10+ years, but you've never seen her, noted in chart is she has been consistent with regular pap smears and mammograms all with normal results; what will you order for her today?
a. mammogram b. pap smear c. mammogram and pap smear d. neither of these is needed |
a. mammogram
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When should males perform self-breast and testicular exams?
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Monthly
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How often should BP be checked during the adolescence period?
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every 2 years and every office visit
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When should total cholesterol checks begin?
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age 20, then every 5 years if WNL
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How would you manage an abnormal lipid panel?
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By "hammering" the LDL until it gets to goal; once LDL is in goal, the total will be relatively ok
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PPD in the young adult?
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annually for high-risk populations
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Complete physical exams for middle-aged adults?
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every 5-6 years
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What should be included in the PE of a female in the middle-aged adults?
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Pap Smear (every 2 -3 years with 3 negative cytology tests)
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How often should the middle-aged female have a clinical breast exam?
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annually
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Middle aged female should have a mammogram how often?
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every 1-2 years for ages 40-49; then annually for ages 50-74
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When should males begin having prostate screenings?
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age 40 if positive family history, otherwise age 50
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When should PSA's begin
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age 50 unless African American or strong family history
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What group has the highest rate of Prostate cancer?
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African American
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When should an initial ECG be obtained?
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age 40 for baseline
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Colorectal Cancer screening should begin with a colonscopy at what age?
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age 50, then every 10 years
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What is the second leading cause of cancer deaths?
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Colo-rectal Cancer
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When should glaucoma screening begin?
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age 40
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What is the test for glaucoma called and what is the normal result of this test?
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Tonometry and normal intra-ocular pressure is 10-20mmHg
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What is the number one cause of death in adults in the US?
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Cardiovascular disease
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What is the leading cancer killer for both men and women?
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Lung
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Cancer with highest incidence in women other than skin?
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breast
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At what age should the vaccine for Herpes Zoster (Zostavax) be given and how often?
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50 and only once
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What age is considered the beginning of the elderly or older adult category?
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60
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How often should the older adult have a complete Physical exam? What should be included that hasn't been included with other age groups?
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every 2 years and now should include lab assessments
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What age should receive the pneumococcal vaccine?
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65, and only once if not in a high-risk category
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WHat kind of pneumoniae does the vaccine cover?
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Strep pneumoniae
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Sensitivity
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(+) True positives show positives, the degree to which those who have a disease screen/test positive
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Specificity
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(-) True negative: the degree to which those who do not have a disease screen/test negative
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Incidence
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The frequency with which a disease or disorder appears in a particular population or area at a given time; the rate in which new cases occur during a specific time period
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Prevalence
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The proportion of a population that is affected by a disease or disorder at a particular time; Ex. the prevalence of lupus in women living in Illinois during 2010 was <1%.
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Major causes of death for adolescent group:
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Motor vehicle crashes
Suicide Other accidents Homicide Malignancy Cardiovascular or Congenital disease |
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Major causes of death for Young Adults
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MVC
Homicide Suicide Injuries heart disease AIDS: if this is one of the major killers in this age group; what does it say about when they are contracting HIV? In their TEENS |
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The leading killer of African Americans in the US <40 y/o
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AIDS
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Leading killer of African American Men <35 y/o
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Homicide
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Major causes of death for the Middle Aged
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Heart disease
Accidents Lung Cancer CVA Breast and colorectal cancer COPD |
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Major causes of death for the elderly
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Heart disease
CVA COPD Pneumonia and/or influenza: The elderly with these Diagnoses will most likely require hospitalization IVF's, antibiotics since these are killers in this age group Lung and colorectal cancer |
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Primary Prevention
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Includes measures to promote health prior to any recognizable problems:
Examples: Healthy diet, exercise, avoiding tobacco, wearing seat belts, immunizations/vaccinations, safety initiatives, etc. |
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Secondary Prevention
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Focus on early identification and treatment of existing problems
Examples: Pap smear screening, prostate cancer screening, cholesterol screening, etc. |
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Tertiary Prevention
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Includes rehabilitation and restoration of health
Examples: Cardiac rehab following MI, PT following MVC, etc. |
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What is My Plate?
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Make half your plate fruits and vegetables
Switch to skim or 1% milk Make at least half your grains whole Vary your protein food choices |
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What is the USDA recommendation for carbohydrates in the diet?
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55-60%
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What is the recommended amount of fat in the diet?
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= <30% total calories with <10% being saturated fats
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What is the recommended amount of protein in the diet?
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0.8-1.0g/kg/day (remainder of diet); these are the needs of someone not septic or trauma, etc.
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What are some of the positive effects of exercise?
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Decreasing low density LDL's
Increased the basal metabolic rate Reducing stress Improving cardiovascular fitness Decreasing signs of aging |
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What should patients over 35 have before instituting an exercise program?
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Complete history
Physical Exam Exercise Stress Test |
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What is Active immunity
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Conferred by antibody formation stimulated with a specific antigen such as typhoid fever immunization and toxoids
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What is Passive immunity?
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Conferred by the introduction of antibody proteins such as gamma globulin injections or maternal immunity transferred to the fetus (Can be mom to baby, but also gamma globulin, which is given or Hep B exposure
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WHo should get the vaccine for Hepatitis A?
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military personnel, travelers to endemic areas, and men who have sex with men
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Admitting 82 y/o female for cellulitis, which of the following immunizations would it be most important to ensure that she has had
a. Zosivax b. Meningococcal c. Pneumococcal d. Seasonal Influenza |
c. Pneumococcal
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