FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Peak infectivity of hep A - (ANSWER)Before jaundice onset
Continued exposure to hep B after vaccination - (ANSWER)Single dose of HBV vaccine
Routine HBsAg screening should be done in - (ANSWER)Pregnant women
HBV vaccine CI'd in allergy to - (ANSWER)Baker's yeast (Think Hep *B* = *B*aker's yeast)
Sexually active w/HBV+ partner, not vaccinated - (ANSWER)Give HBIG and HBV series
Offer HBV vaccine for un-immunized adults who: - (ANSWER)Are being tx'd for STIs
Incubation length flu virus - (ANSWER)1-4 days
Amantadine and rimantadine - (ANSWER)Significant resistance to select strains of influenza limits their
usefulness
Measles, mumps, rubella - (ANSWER)Pts born before 1957 have a high likelihood of immunity d/t hx of
natural infection
MMR - (ANSWER)2 doses at least 1mo apart for young adults not immunized
PCV13 - (ANSWER)Routinely used in childhood, assoc. w/greater immunogenicity
PPSV23 - (ANSWER)Routinely used 65+, not licensed in children <2yo
Poliovirus transmission - (ANSWER)Fecal-oral route
Smallpox vaccine - (ANSWER)Live vaccinia virus
,FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Smallpox transmission - (ANSWER)Direct deposit of infective droplets
Smallpox characteristics - (ANSWER)Lesions all at the same stage during the eruptive phase
Tetanus series for un-immunized adult - (ANSWER)Tdap w/dose of Td at 1 and 6mos
Tobacco brief intervention - (ANSWER)*A*sk, *A*dvise, *A*ssess, *A*ssist, *A*rrange
Varicella transmission - (ANSWER)Droplet
Varicella vaccination after pregnancy - (ANSWER)Two doses after giving birth
CN in Bell's Palsy - (ANSWER)VII (7)
Bell's Palsy - (ANSWER)Do Lyme titer
Bell's Palsy tx - (ANSWER)Prednisone ASAP after facial paralysis onset
Loss of corneal reflex (blink) - (ANSWER)CN V (trigeminal)
Tongue and throat, swallowing - (ANSWER)CN IX
EOMs - up and in - (ANSWER)CN III
Confirm dx of giant cell arteritis - (ANSWER)Bx of temporal artery
,FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Giant cell arteritis - (ANSWER)Normal sections of arteries can be found in-between affected sections;
results in a tender or nodular, pulseless vessel
Giant cell arteritis tx - (ANSWER)Systemic steroid
Giant cell arteritis risk fx - (ANSWER)Older age, female, Northern European
Giant cell arteritis concomitant therapy (w/prednisone) - (ANSWER)ASA, bisphosphonate and ca/vit d,
PPI
Migraine - (ANSWER)Pulsating pain
Migraine supplements - (ANSWER)Butterbur, riboflavin, feverfew
HA red flag - (ANSWER)Onset w/exertion, coughing, or sneezing
Tension type HA - (ANSWER)"Pressing" pain
Triptan MOA - (ANSWER)Selective serotonin receptor agonist
Cluster HA risk fx - (ANSWER)Heavy ETOH, heavy smoking, male
1st line cluster HA tx - (ANSWER)NSAIDs, O2, triptans
1st line prophylactic TTH tx - (ANSWER)TCA
Ergotamines - (ANSWER)NOT effective for TTH
Bacterial meningitis CSF - (ANSWER)Glucose at 30% of serum levels
, FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Aseptic or viral meningitis CSF - (ANSWER)Predominance of lymphocytes
Physical findings in papilledema - (ANSWER)Optic disc bulging
N.meningitidis - (ANSWER)Gram negative diplococcus
Sx suggest menigitis caused by N.meningitidis - (ANSWER)Purpura or petechial rash
Kernig sign - (ANSWER)Pt lying supine and hip flexed 90 degrees, present when extension of knee from
this position elicits resistance or pain in lower back or posterior thigh
N.meningitidis incubation period - (ANSWER)3-4 days
N.meningitidis chemoprophylaxis - (ANSWER)Single dose of ceftriaxone, multiple doses of rifampin,
single dose of meningococcal conjugate vaccine (MCV4 or Menactra)
MS sx - (ANSWER)Numbness or weakness in limbs, double vision or blurred vision, cold sensitivity
MS tx to attenuate disease progression - (ANSWER)Interferon beta-1b
MS dx - (ANSWER)MRI, CSF analysis, evoked potential test
Parkinson's drugs - (ANSWER)MAO B inhibitors, dopamine agonists, COMT inhibitors, anticholinergics
Findings most consistent w/Parkinson's - (ANSWER)Tremor at rest and bradykinesia
Dx of Parkinson's - (ANSWER)Eval of 6 cardinal features
Peak infectivity of hep A - (ANSWER)Before jaundice onset
Continued exposure to hep B after vaccination - (ANSWER)Single dose of HBV vaccine
Routine HBsAg screening should be done in - (ANSWER)Pregnant women
HBV vaccine CI'd in allergy to - (ANSWER)Baker's yeast (Think Hep *B* = *B*aker's yeast)
Sexually active w/HBV+ partner, not vaccinated - (ANSWER)Give HBIG and HBV series
Offer HBV vaccine for un-immunized adults who: - (ANSWER)Are being tx'd for STIs
Incubation length flu virus - (ANSWER)1-4 days
Amantadine and rimantadine - (ANSWER)Significant resistance to select strains of influenza limits their
usefulness
Measles, mumps, rubella - (ANSWER)Pts born before 1957 have a high likelihood of immunity d/t hx of
natural infection
MMR - (ANSWER)2 doses at least 1mo apart for young adults not immunized
PCV13 - (ANSWER)Routinely used in childhood, assoc. w/greater immunogenicity
PPSV23 - (ANSWER)Routinely used 65+, not licensed in children <2yo
Poliovirus transmission - (ANSWER)Fecal-oral route
Smallpox vaccine - (ANSWER)Live vaccinia virus
,FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Smallpox transmission - (ANSWER)Direct deposit of infective droplets
Smallpox characteristics - (ANSWER)Lesions all at the same stage during the eruptive phase
Tetanus series for un-immunized adult - (ANSWER)Tdap w/dose of Td at 1 and 6mos
Tobacco brief intervention - (ANSWER)*A*sk, *A*dvise, *A*ssess, *A*ssist, *A*rrange
Varicella transmission - (ANSWER)Droplet
Varicella vaccination after pregnancy - (ANSWER)Two doses after giving birth
CN in Bell's Palsy - (ANSWER)VII (7)
Bell's Palsy - (ANSWER)Do Lyme titer
Bell's Palsy tx - (ANSWER)Prednisone ASAP after facial paralysis onset
Loss of corneal reflex (blink) - (ANSWER)CN V (trigeminal)
Tongue and throat, swallowing - (ANSWER)CN IX
EOMs - up and in - (ANSWER)CN III
Confirm dx of giant cell arteritis - (ANSWER)Bx of temporal artery
,FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Giant cell arteritis - (ANSWER)Normal sections of arteries can be found in-between affected sections;
results in a tender or nodular, pulseless vessel
Giant cell arteritis tx - (ANSWER)Systemic steroid
Giant cell arteritis risk fx - (ANSWER)Older age, female, Northern European
Giant cell arteritis concomitant therapy (w/prednisone) - (ANSWER)ASA, bisphosphonate and ca/vit d,
PPI
Migraine - (ANSWER)Pulsating pain
Migraine supplements - (ANSWER)Butterbur, riboflavin, feverfew
HA red flag - (ANSWER)Onset w/exertion, coughing, or sneezing
Tension type HA - (ANSWER)"Pressing" pain
Triptan MOA - (ANSWER)Selective serotonin receptor agonist
Cluster HA risk fx - (ANSWER)Heavy ETOH, heavy smoking, male
1st line cluster HA tx - (ANSWER)NSAIDs, O2, triptans
1st line prophylactic TTH tx - (ANSWER)TCA
Ergotamines - (ANSWER)NOT effective for TTH
Bacterial meningitis CSF - (ANSWER)Glucose at 30% of serum levels
, FITZGERALD QUESTIONS WITH COMPLETE SOLUTIONS
Aseptic or viral meningitis CSF - (ANSWER)Predominance of lymphocytes
Physical findings in papilledema - (ANSWER)Optic disc bulging
N.meningitidis - (ANSWER)Gram negative diplococcus
Sx suggest menigitis caused by N.meningitidis - (ANSWER)Purpura or petechial rash
Kernig sign - (ANSWER)Pt lying supine and hip flexed 90 degrees, present when extension of knee from
this position elicits resistance or pain in lower back or posterior thigh
N.meningitidis incubation period - (ANSWER)3-4 days
N.meningitidis chemoprophylaxis - (ANSWER)Single dose of ceftriaxone, multiple doses of rifampin,
single dose of meningococcal conjugate vaccine (MCV4 or Menactra)
MS sx - (ANSWER)Numbness or weakness in limbs, double vision or blurred vision, cold sensitivity
MS tx to attenuate disease progression - (ANSWER)Interferon beta-1b
MS dx - (ANSWER)MRI, CSF analysis, evoked potential test
Parkinson's drugs - (ANSWER)MAO B inhibitors, dopamine agonists, COMT inhibitors, anticholinergics
Findings most consistent w/Parkinson's - (ANSWER)Tremor at rest and bradykinesia
Dx of Parkinson's - (ANSWER)Eval of 6 cardinal features
