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Select the ONE answer that is BEST in each case.
You are examining a normal term newborn whose mother is hepatitis B virus surface antigen positive. Which of the following protocols is recommended for the child?
Hepatitis B infection is more likely to become chronic when acquired early in life. In 1991, the CDC recommended universal immunization of infants in the United States. The vaccine is given in a three-dose schedule, with the timing dependent on the mother’s hepatitis B surface antigen status. If the mother is hepatitis B surface antigen positive, the first dose of vaccine and a dose of hepatitis B immune globulin must be given within 12 hours of birth. The second dose of vaccine is given at 1–2 months, and the third dose is given at 6 months. For mothers with unknown antigen status, the first dose of vaccine should be given within 12 hours, and maternal blood should be drawn to determine status. If the mother’s surface antigen is positive, the child is given immune globulin as soon as possible, but no later than 1 week of age. For mothers with negative antigen status, the first dose of vaccine is given at 0–2 months, the second at 1–4 months, and the third at 6–18 months.
See all quizzes of the Preventive Medicine at here:
Part 1 | Part 2 |
|1. You are examining a normal term newborn whose mother is hepatitis B virus surface antigen positive. Which of the following protocols is recommended for the child?
a. Hepatitis B vaccination at 0–2 months, a second dose at 1–4 months, and a third dose at 6–18 months of age
|2. You are counseling a mother about her child’s immunization schedule. She asks specifically if her child would benefit from the Haemophilus influenzae type b (Hib) vaccine. Which of the following statements is true about this vaccine?
a. The vaccine is between 95–100% effective in preventing invasive Hib disease
b. The vaccine will help to prevent otitis media caused by H. influenzae
c. Adverse reactions to the vaccine include an unusual high-pitched cry, high fevers, and seizures
d. The first vaccine should be administered at birth
e. The vaccine cannot be given concurrently with other vaccines
|3. You are discussing varicella-zoster vaccination with an adult who does not ever remember having chicken pox. Which of the following statements is true?
a. Varicella-zoster infection is less severe in adults
b. The varicella vaccine is less immunogenic in adults
c. Serologic testing for varicella antibodies is necessary before vaccination
d. If the patient lives with an immunocompromised person, vaccination should be avoided
e. The subsequent risk of zoster is higher among those who have been vaccinated as compared with those who had natural infection
|4. An elderly patient that you follow has recently started hemodialysis for chronic renal failure. You know that hepatitis B vaccination is recommended for people on hemodialysis, and find that he is hepatitis B surface antibody negative. Which of the following would be the best guideline to follow in this case?
a. No vaccination is necessary based on his laboratory evaluation
b. Administer one dose of hepatitis B vaccine
c. Administer two doses of hepatitis B vaccine, at least 1 month apart
d. Administer two doses of hepatitis B vaccine, at least 6 months apart
e. Administer three does of hepatitis B vaccine at the appropriate time interval
|5. You are caring for a 23-year-old healthy homosexual male who works as an accountant and lives alone. He had the “typical childhood vaccinations” and provides documentation of his immunization record. He is up to date on tetanus, and was primarily immunized against diphtheria, pertussis, polio, hepatitis B, measles, mumps, rubella, and H. influenzae type b. Which of the following vaccinations is indicated for this patient?
c. Hepatitis A
e. A booster of the measles, mumps, and rubella (MMR) vaccine
|6. In the prenatal workup for one of your patients, you discover she is rubella nonimmune. When is the best time to vaccinate the patient against rubella?
b. In the second trimester of pregnancy
c. In the third trimester of pregnancy
d. In the early postpartum period
e. At least 4 weeks postpartum
|7. An adult is seen in your office after cutting her hand on a clean broken glass in her kitchen. She received her primary tetanus series as a child. The wound is relatively minor, and does not require suturing. Her last tetanus booster was 7 years ago. Which of the following is true?
a. No vaccination is required
b. The patient should receive a tetanus-diphtheria (Td) booster
c. The patient should receive a Td booster and tetanus immune globulin
d. The patient should receive a diphtheria-tetanus-pertussis (DTP) booster
e. The patient should receive a diphtheria-tetanus-acellular pertussis (DTaP) booster
|8. You are caring for a woman who would like her children vaccinated against influenza. Her children are ages 4 months, 24 months, and 5 years. Which of the following represents current immunization recommendations for influenza?
a. None of her children should be vaccinated
b. The 4-month-old and the 24-month-old should be vaccinated
c. The 24-month-old and the 5-year-old should be vaccinated
d. Only the 24-month-old should be vaccinated
e. All the children should be vaccinated
|9. You are discussing preventive health screening with a college student. He has no family history of hypertension, coronary artery disease, diabetes, or cancer. At what age would you consider screening for lipid disorders?
a. 18 years
b. 21 years
c. 25 years
d. 35 years
e. 50 years
|10. You are seeing a 58-year-old smoker for a routine health examination. You have counseled him on discontinuing tobacco use, and he is considering that alternative. He denies coughing, shortness of breath, or hemoptysis. Which of the following is a recommended screen for lung cancer in this patient?
a. He should not be screened for lung cancer
b. Chest x-ray
c. Chest CT
d. Sputum cytology
|11. You are seeing a healthy 26-year-old woman for a routine health visit. She mentions that she and her husband are thinking about starting a family soon. She has never been pregnant before. Which of the following interventions has been shown to have a clear beneficial outcome at this time?
a. Blood typing and antibody testing
b. Screening for human immunodeficiency virus (HIV)
c. Screening for Chlamydia
d. Screening for asymptomatic bacteriuria
e. Prescribing 0.4–0.8 mg of folic acid daily
|12. You are discussing cancer screening with a patient. Her father was diagnosed with colorectal cancer at age 72. When should you recommend she begins colorectal cancer screening?
a. 40 years
b. 50 years
c. 60 years
d. 62 years
e. 72 years
|13. You are discussing cancer screening with a female patient. She has no family history of breast cancer. At what age should she start getting routine mammograms?
|14. In a routine examination, a 33-year-old woman asks you about self-breast examination as breast cancer screening method. Which of the following best represents current recommendations for breast self-examination (BSE)?
a. There is strong evidence that BSE is an appropriate screening modality
b. There is no evidence that BSE is an appropriate screening modality
c. There is insufficient evidence to recommend for or against BSE
d. There is no evidence that BSE is an inappropriate screening modality
e. There is strong evidence that BSE is an inappropriate screening modality
|15. A 52-year-old man comes to your office for a complete physical examination. He is interested in prostate cancer screening. Which of the following best represents current guidelines for prostate cancer screening?
a. No screening guidelines are recommended
b. Screening should consist of a digital rectal examination
c. Screening should consist of a serum prostate specific antigen (PSA) test
d. Screening should consist of both a digital rectal examination (DRE) and a serum PSA test
e. Screening should include a computed tomography (CT) scan of the prostate in high-risk individuals
|16. You are seeing a 40-year-old healthy man for a routine health examination. He is completely healthy, takes no medications, and has no abnormal physical examination findings. What are the current recommendations regarding obtaining a screening electrocardiogram (ECG) as part of his routine physical?
a. Recommendations strongly support obtaining a screening ECG
b. Recommendations weakly support obtaining a screening ECG
c. Recommendations do not support or oppose obtaining a screening ECG
d. Recommendations weakly oppose obtaining a screening ECG
e. Recommendations strongly oppose obtaining a screening ECG
|17. During an appointment to discuss acne, you find that your 16-yearold female patient has become sexually active. According to current guidelines, when should you begin cervical cancer screening on this patient?
a. At the current time
b. At the age of 18
c. At the age of 19
d. At the age of 21
e. Cervical cancer screening is not recommended
|18. You are seeing a 55-year-old patient for her annual physical examination. She has been married to her husband for 32 years and has never had sex with anyone else during the marriage. She has never had an abnormal Papanicolaou (Pap) smear. At what age is it appropriate to discontinue Pap screening on this patient?
a. 55 years old
b. 60 years old
c. 65 years old
d. 70 years old
e. Never discontinue screening
|19. A 76-year-old male patient of yours is undergoing a left knee replacement for severe arthritis, and you are asked to perform his presurgical clearance. His past medical history is significant for episodic rate-controlled atrial fibrillation, a stroke at age 72 (from which he recovered fully), and uncontrolled hypertension. Last year, an echocardiogram showed he had severe aortic stenosis, but he has elected not to undergo surgical repair. He reports that he is sedentary, and is not able to walk up one flight of steps carrying his groceries without stopping to rest. His blood pressure upon evaluation is 168/92. Which of the described features are clinical predictors of increased perioperative cardiovascular risk for this surgery?
a. Advanced age
b. Rate-controlled atrial fibrillation
c. Uncontrolled hypertension
d. Severe aortic stenosis
e. Poor functional capacity
|20. You are concerned about the cardiac risks of several of your patients undergoing surgical procedures, and are considering further cardiac testing in the preoperative period. Which of the following surgical procedures is considered to have a low surgery-specific risk, and generally does not require additional preoperative cardiac testing, if the patient does not have clinical predictors of increased cardiac risk?
a. Femoral-popliteal bypass
b. Breast surgery
d. Knee replacement
e. Carotid endarterectomy