Fitzgerald Exam Review
Full-term - 39 - 40w6d
To what populations do you not administer a live virus vaccine? - Pregnant women due to theoretical
risk of passing virus to unborn child
Immune suppression due to lack of clinical effect
AIDS (CD4 <200)
Common immunization adverse effects - Discomfort
Erythema at immunization injection site common and expected
This is an immune response to an injected antigen
Kids have a more noted response because they have a more robust/active immune system
Can use Benadryl cream if itchy
What should you use OTC to treat itchy/inflamed immunization sites? - Benadryl cream
What flu vaccine is most appropriate for an elder >65 with no allergies? - High-dose trivalent IIV or
quadrivalent IIV
,How should you modify vaccine administration for an adult who has a hive-form reaction when exposed
to eggs (no hx of angioedema or respiratory distress)? - No modification
Administer any vaccine appropriate for age and health status
Immunization against herpes zoster is recommended by the CDC for all adults > what age? - 50 for
Shingrix or 60 for Zostavax
What is secondary prevention? - Early case finding of a symptomatic disease via the use of a screening
test
Diseases we screen for have a long asymptomatic period with a known natural history ex. HTN,
dyslipidemia, pap
Prochaska and DiClemente Stages of Change theory - Change occurs dynamically. Theory notes five
stages of preparation and maintenance for change (trans theoretical model)
1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance/relapse
Precontemplation stage of change - #1 in the transtheoretical model of change. The patient is not
interested in change and might not be aware that the problem exists/minimizes the problem's impact.
The healthcare provider should help the patient to move toward thinking about changing the unhealthy
behavior.
Contemplation stage of change - #2 in the transtheoretical model of change. The patient is considering
change and looking at its positive and negative aspects. At the same time, the person reports feeling
"stuck" with the problem. The healthcare provider should help the patient to examine benefits and
barriers to change.
,Preparation stage of change - #3 in the transtheoretical model of change. The patient exhibits some
change behaviors or thoughts and often reports feeling that he or she does not have the tools to
proceed. The healthcare provider should assist the patient in finding and using tools to help with
change, continuing to work to lower barriers to change.
Action stage of change - #4 in the transtheoretical model of change. The patient is ready to go forth with
change, often takes concrete steps to change, but is inconsistent with carrying through. The healthcare
provider should work with the patient on use of tools, encouraging the healthy behavior change,
praising the positive, acknowledging reverting back to former behavior as a common but not
insurmountable problem.
Maintenance/relapse stage of change - #5 in the transtheoretical model of change. The patient learns to
continue the change and has adopted and embraced the healthy habit. At the same time, relapse can
occur and the person learns to deal with backsliding. The healthcare provider should give positive
reinforcement for the behavior change.
The 5 A's of smoking cessation - Ask - Identify and document tobacco use status
Advise - Urge every tobacco user to quit
Assess - Is the tobacco user willing to make a quit attempt at this time
Assist - Use counseling and pharmacotherapy to help the patient quit
Arrange - Schedule follow up contact within the 1st week of the quit date
Leading causes of death in the US - Heart disease
Malignant neoplasms
Chronic lower respiratory disease
#1 cause of cancer death in the US - Lung and bronchus
Most prevalent cancer in men - Prostate
, Most prevalent cancer in women - Breast
Who should receive TB screening? - People who have spent time with a TB-infected individual
People from Latin America, Africa, Asia, Eastern Europe, Russia, Carribean
People who live or work in a homeless shelter, long-term care facility, prison, nursing home
Healthcare workers
People with HIV infection
People with symptoms of TB
IVD users
TB Booster phenomenon - Often seen in individuals who have previously been infected with TB — will
have initial negative TST but a positive TST when retested up to 1 year later because the first test
"boosts" the immune system
S/s of active TB - Significant cough lasting >3 weeks
Chest pain
Hemoptysis or sputum production
Weakness/fatigue
Weight loss
Lack of appetite
Fever
Chills
Night sweats
First-line anti-TB agents that form the core of treatment regiments include... - INH
Full-term - 39 - 40w6d
To what populations do you not administer a live virus vaccine? - Pregnant women due to theoretical
risk of passing virus to unborn child
Immune suppression due to lack of clinical effect
AIDS (CD4 <200)
Common immunization adverse effects - Discomfort
Erythema at immunization injection site common and expected
This is an immune response to an injected antigen
Kids have a more noted response because they have a more robust/active immune system
Can use Benadryl cream if itchy
What should you use OTC to treat itchy/inflamed immunization sites? - Benadryl cream
What flu vaccine is most appropriate for an elder >65 with no allergies? - High-dose trivalent IIV or
quadrivalent IIV
,How should you modify vaccine administration for an adult who has a hive-form reaction when exposed
to eggs (no hx of angioedema or respiratory distress)? - No modification
Administer any vaccine appropriate for age and health status
Immunization against herpes zoster is recommended by the CDC for all adults > what age? - 50 for
Shingrix or 60 for Zostavax
What is secondary prevention? - Early case finding of a symptomatic disease via the use of a screening
test
Diseases we screen for have a long asymptomatic period with a known natural history ex. HTN,
dyslipidemia, pap
Prochaska and DiClemente Stages of Change theory - Change occurs dynamically. Theory notes five
stages of preparation and maintenance for change (trans theoretical model)
1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance/relapse
Precontemplation stage of change - #1 in the transtheoretical model of change. The patient is not
interested in change and might not be aware that the problem exists/minimizes the problem's impact.
The healthcare provider should help the patient to move toward thinking about changing the unhealthy
behavior.
Contemplation stage of change - #2 in the transtheoretical model of change. The patient is considering
change and looking at its positive and negative aspects. At the same time, the person reports feeling
"stuck" with the problem. The healthcare provider should help the patient to examine benefits and
barriers to change.
,Preparation stage of change - #3 in the transtheoretical model of change. The patient exhibits some
change behaviors or thoughts and often reports feeling that he or she does not have the tools to
proceed. The healthcare provider should assist the patient in finding and using tools to help with
change, continuing to work to lower barriers to change.
Action stage of change - #4 in the transtheoretical model of change. The patient is ready to go forth with
change, often takes concrete steps to change, but is inconsistent with carrying through. The healthcare
provider should work with the patient on use of tools, encouraging the healthy behavior change,
praising the positive, acknowledging reverting back to former behavior as a common but not
insurmountable problem.
Maintenance/relapse stage of change - #5 in the transtheoretical model of change. The patient learns to
continue the change and has adopted and embraced the healthy habit. At the same time, relapse can
occur and the person learns to deal with backsliding. The healthcare provider should give positive
reinforcement for the behavior change.
The 5 A's of smoking cessation - Ask - Identify and document tobacco use status
Advise - Urge every tobacco user to quit
Assess - Is the tobacco user willing to make a quit attempt at this time
Assist - Use counseling and pharmacotherapy to help the patient quit
Arrange - Schedule follow up contact within the 1st week of the quit date
Leading causes of death in the US - Heart disease
Malignant neoplasms
Chronic lower respiratory disease
#1 cause of cancer death in the US - Lung and bronchus
Most prevalent cancer in men - Prostate
, Most prevalent cancer in women - Breast
Who should receive TB screening? - People who have spent time with a TB-infected individual
People from Latin America, Africa, Asia, Eastern Europe, Russia, Carribean
People who live or work in a homeless shelter, long-term care facility, prison, nursing home
Healthcare workers
People with HIV infection
People with symptoms of TB
IVD users
TB Booster phenomenon - Often seen in individuals who have previously been infected with TB — will
have initial negative TST but a positive TST when retested up to 1 year later because the first test
"boosts" the immune system
S/s of active TB - Significant cough lasting >3 weeks
Chest pain
Hemoptysis or sputum production
Weakness/fatigue
Weight loss
Lack of appetite
Fever
Chills
Night sweats
First-line anti-TB agents that form the core of treatment regiments include... - INH
