A 14-year-old female who is sexually active is brought in by her
mother for an immunization update. According to the mother,
her daughter had 1 dose of hepatitis B vaccine. Which of the
following vaccines would you administer at this visit?
A) Td and hepatitis B
B) DTaP (diphtheria, tetanus, acellular pertussis) and hepatitis B
C) Hepatitis B only
D) MMR (measles, mumps, rubella) and Td Correct Answers
A) Td and hepatitis B
The CDC recommends Td and hepatitis B for 14-year-old
females. It is recommended for her to continue the hepatitis
series, which includes a total of 3 injections.
A 26-year-old female patient being evaluated for eye discharge.
She says that for the last few days she has developed this sticky,
string-like discharge in both eyes. She denies any pain or visual
changes, but does admit to a sense of "something in my eyes"
and that her eyes itch a lot. Physical examination reveals
injected conjunctiva, rope-like discharge bilaterally; pupil
response is equal and brisk in both eyes. Which factor in the
patient's history would be supportive of the most likely
diagnosis? Correct Answers Symptoms occurring bilaterally
supports the dx of allergic conjunctivitis.
A 30-year-old chef complains of pruritic hives over her chest
and arms but denies difficulty swallowing or breathing. She
reports a family history of allergic rhinitis and asthma. Which of
the following interventions is most appropriate?
A) Perform a complete and thorough history
, B) Prescribe an oral antihistamine such as diphenhydramine 25
mg PO QID
C) Give an injection of epinephrine 1:1000 intramuscularly stat
D) Call 911 Correct Answers A) Perform a complete and
thorough history
Prior to prescribing medications, a complete and thorough
history must be performed to determine possible causes of hives.
The patient denied difficulty with swallowing and breathing, so
there was no medical emergency to require calling 911.
A 31-year-old male presents to urgent care because he has
something in his eye. He was changing the oil under his car and
says that something dropped into his eye. He is not having any
pain, in fact he waited a day before coming in because he
thought it would work itself out. Physical exam reveals a black 1
mm foreign body visible on the corneal surface. The most
appropriate intervention is to: Correct Answers Attempt to
remove the foreign body with a saline soaked sterile swab since
it is visible on exam.
A 36-year-old male patient who presents for treatment of eye
pain. He has no significant medical history and does not take
any daily or over-the-counter medications. His only recent
history is nighttime allergies for which he takes occasional
diphenhydramine with good relief. He has had some throbbing
in his eye for the last few days on and off but just ignored it;
today he says it is flat out painful and he had to come to the
emergency department. The eye is throbbing and painful, and he
reports generalized decreased vision. The pupil is dilated to 5
mm and non-reactive to light. The eye conjunctiva is reddened.
The next step in the diagnostic evaluation should be: Correct