1.  Which statement/s is/are true regarding risk factors? 

1)      Something that increases a person's chances of developing a disease

2)      Biological characteristics of a person making them more vulnerable to disease

3)      Cannot be altered

4)      Can be reduced

5)      Are only behavioral/lifestyle/social

6)      Are biologic/behavioral/environmental/immunologic/nutritional/genetic/social 

Answer: 1,2,4,6

1)      Something that increases a person's chances of developing a disease

2)Biological characteristics of a person making them more vulnerable to 

4)      Can be reduced 

6) Are biologic/behavioral/environmental/immunologic/nutritional/genetic/social 

A risk group is a group of people at higher risk of disease who share in common same or similar race/ethnicity, occupation, age, socio-economic status, zip code. 

true or False

 Match the type of response with the correct level of prevention (4-9)

a.       Primary Prevention

b.      Secondary prevention

c.       Tertiary prevention

 4.      Rehabilitation for late symptomatic disease

5.      Specific protection 

6.      Pre-symptomatic diagnosis

7. Health Promotion

8. Disability limitation for early symptomatic diseas.

9. Treatment 

4.) C

5.) A

6.) B

7.) A

8.) C

9.) B

4.      Effective primary prevention programs can target:

a.       Whole populations irrespective of individual risk levels

b.      High risk individuals

c.       High risk groups

d.      All of the above

e.      None of the above 

4.      The purpose of disease control is to reduce:

a.       The incidence of disease

b.      The duration of disease and consequently the risk of transmission 

c.       The effects of infection, including both the physical and psychosocial complications

d.      The financial burden to the community

e.      All of the above

4.      During the 20^th century and already in the 21^st century, modern medicine has eradicated many diseases. a.True

b.False

4.      What are included in clinical preventive services?

a.       Primary, secondary, and tertiary prevention

b.      Public policies that provide for improved access to healthcare

c.       The Affordable Care Act

d.      Preventive medications, behavioral counselling, health screening

e.      All of the above 

Whish of the following are Not included in the Top tanked Clinical Preventative Services for the U.S. Population in general?

a.       Childhood immunizations

b.      Pancreatic cancer screening

c.       Colorectal cancer screening — adults 50+

 d.      Cervical cancer screening — women 

     Diet to reduce LDL-Cholesterol and lower blood pressure include all EXCEPT which of the following

a.       Eat plenty of vegetables, fruits, and whole grains

b.      Consume no more than about 1 tsp of salt a day

c.       Take one 1000mg fish oil capsule TID

d.      Limit alcohol; drink no more than 1-2 drinks a day

e.      Reduce percent of calories from saturated fat and saturated fat (reduce consumption of red meat)  

4.      Recommended level of physical activity to reduce LDL-Cholesterol and lower blood pressure

1)      3–4 sessions per week, lasting on average 40 min per session, and involving moderate- to vigorousintensity physical activity

2)      Engage in regular aerobic physical activity at least 30 minutes a day, most days of the week, target 2 ½ hours a week

a.       1 only

b.      2 only

c.       1 or 2

d.      Neither 1 nor 2 

4.      Identify the recommended weight loss targets

1)      5-10% weight loss

2)      3-5% weight loss

3)      Waist circumference < 35 inches for men, < 30 inches for women 

4)      Waist circumference < 40 inches for men, < 35 inches for women

5)      For overweight persons: Body mass index under 25

6)For obese persons: Body mass index under 30

a.       1, 3, 5, 6

b.      1, 3, 5

c.       2, 4, 5, 6

d.      2, 4, 6 

4.      Identify the recommended dietary approaches to weight loss

1)      Weight loss diet 1,200-1,500 kcal/d (women), 1,500-1,800 kcal/d (men)

2)      Reduce consumption by 500-750 kcal/d

3)      Evidenced-based diet that restricts certain food types in order to create an energy deficit

a.       1 and 2

b.      All of the above

19.Which four groups would benefit by statin therapy 

1)Persons with history of clinical atherosclerotic cardiovascular disease (ASCVD) 

2)LDL-Cholesterol ≥240 mg/dL, Age ≥35 years 3) LDL-Cholesterol ≥190 mg/dL, Age ≥21 years 

4) Diabetes: Age 40-75 years, LDL-Cholesterol 200-239 mg/dL 5) Diabetes: Age 40-75 years, LDL-Cholesterol 70-189 mg/dL 

6) No Diabetes: ≥7.5% 10-year ASCVD risk, Age 40-75 years, LDL-Cholesterol 200-239 mg/dL 7) No Diabetes: ≥7.5% 10-year ASCVD risk, Age 40-75 years, LDL-Cholesterol 70-189 mg/dL 

a.1, 2, 4, 6 

b.1, 3, 5, 7 

c.1, 2, 5, 7 

20.What are the Diabetes ABC’s of diabetes control 

1)A for the A1C test,  

2)A for Activity,   

3)B for Blood glucose,  

4)B for Blood pressure  

5)C for Cholesterol  

6)C for Circulation  

a.1, 3, 6 

b.1, 4, 5 

c.2, 3, 5 

d.2, 4, 6 

e.2, 4, 5 

21.Signs and symptoms of diabetes (either type) 

1)Frequent urination 

2)Blood in the urine 

3)Increased thirst 

4)Fever 

5)Slow healing 

6)Headache 

7)Blurred vision 

a.1, 2, 3, 5, 7 

b.2, 3, 5, 6, 7 

c.2, 4, 6, 8 

d.1, 3, 5, 7 

e.All of the above 

22.Manage pre-diabetes to prevent or delay the onset of type 2 diabetes by which strategy? 

1)5-10% weight loss. 

2)Infrared light therapy. 

3)30 minutes of moderate activity at least 5 days per week. 

4)Reduced calories, reduced fat, and fewer calorie-dense foods. 

5)Nutritional protocol to kill microbes and parasites damaging the pancreas. 

6)Medication to suppress glucose production by the liver. 

7)Cardiovascular disease risk management 

a.6 only 

b.1 and 4  

c.1, 3, 4, 6, 7  

d.2, 4, 5, 6, 7 

e.All of the above 

23.Which is NOT a risk factor for type 2 diabetes 

a.History of gestational diabetes mellitus (GDM) or               giving birth to a baby weighing ≥ 9 lbs. 

b.History of Guillain-Barre syndrome 

c.Hypertension 

d.HDL-Cholesterol ≤ 35mg/dL  

e.Atherosclerotic cardiovascular disease 

24.What are the three key fall risk assessment questions that a YES answer will prompt an evaluation of gait, strength, and balance? 

1)Fell in past year? 

2)Often have to rush to the toilet? 

3)Feels unsteady when standing or walking? 

4)Take medicine to help me sleep or improve my mood? 

5)Often feel sad or depressed? 

6)Worries about falling? 

7)Need to push with my hands to stand up from a chair? 

a.1, 3, 7 

b.3, 4, 6 

c.2, 4, 7 

d.1, 3, 6 

e.3, 5, 7 

Match the following with the corresponding test (25-27)

a.       Strength

b.      Gait

c.       Balance

4-Stage Balance Test 

Match the following with the corresponding test (25-27) 

a.Strength 

b.Gait 

c.Balance 

Match the following with the corresponding test (25-27) 

a.Strength 

b.Gait 

c.Balance 

28.The Timed Up and Go (TUG) Test asks the patient to      walk  

a.10 feet 

b.15 feet 

c.20 feet 

29.‘Round-trip’ walk of how many seconds constitutes high risk? 

a.≥10 seconds 

b.≥12 seconds  

c.≥15 Seconds 

d.≥20 seconds 

30.The 30-Second Chair Stand Test asks the patient to  

a.Stand on a chair for 30 seconds 

b.Stand up and sit down continuously for 30 seconds 

c.Stand for 30 seconds while holding the back of a chair 

31.Inability to hold which stance > 10 seconds = high fall risk? 

a.Stand with your feet side by side. 

b.Place the instep of one foot so it is touching the big           toe of the other foot. 

c.Place one foot in front of the other, heel touching                toe. 

d.Stand on one foot 

32.Postural Hypotension is suspected after taking lying and standing blood pressure (Orthostatic Blood Pressure) and noting a systolic/diastolic presser drop of how much? 

a.≥ 10 systolic or ≥ 5 diastolic 

b.≥ 20 systolic or ≥ 10 diastolic 

c.≥ 30 systolic or ≥ 20 diastolic 

33.Vision acuity beginning at which level is considered a fall risk? 

a.20/30 

b.20/40 

c.20/50 

d.20/60 

34.The measurement of which ‘threshold’ parameter will determine the hearing ability of the patient?

a. Frequency 

b. Decibels 

35.Hearing loss in the lower frequency range (Hz) is generally from 

a.Conductive problems 

b.Sensorineural problems 

36.Hearing loss in the higher frequency range (Hz) is generally from  

a.Conductive problems 

b.Sensorineural problems 

From the time a susceptible person is infected until he or she develops symptoms is called the incubation period. From the time a susceptible person is infected until he or she becomes infectious is called the latent period. 

6-10. The latent period is followed by the infectious period. A person may be infectious in the incubation period but not the latent period. 

11-15. In the convalescent period, or after, a person may not have cleared their infection; they may be infectious or even a carrier of the disease. A carrier is asymptomatic and infectious

Infection may be present without symptoms

True or False

Droplet and respiratory transmission are synonymous

true or false

False. Droplet and airborne transmission are both ‘respiratory.’ 

16.  All sexually transmitted infection is bloodborne. 

•       Estimate magnitude of the problem

•       Determine geographic distribution of illness

•       Portray the natural history of a disease

•       Detect epidemics / define a problem

•       Generate hypotheses, stimulate research

•       Evaluate control measures 

•All sexually active adolescents 

•Adults with current STIs or other infections within the past year 

•Adults who have multiple sex partners, and

 • Adults who do not consistently use condoms.

•Sexually active females aged ≤24 y 

•Females aged >24 y with new or multiple sex partners, a sex partner with concurrent partners, or a sex partner with a STI 

•Females aged >24 y with inconsistent condom use among persons who are not in mutually monogamous relationships 

•Females aged >24 y with previous or concurrent STI •Females aged >24 y who exchange sex for money or drugs

•All pregnant women 

•Men who have sex with men and engage in high-risk sexual behavior 

•Who exchange sex for money or drugs 

•Persons born in countries and regions with a high prevalence of HBV infection (≥2%) 

•U.S.-born persons not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection (≥8%), such as sub-Saharan Africa and central and Southeast Asia •HIV-positive persons 

•Injection drug users 

•Men who have sex with men 

•Household contacts or sexual partners of persons with this infection 

•All pregnant women at the first prenatal visit

•Adults born between 1945 and 1965 

•Received a blood transfusion before 1992 

•Long-term hemodialysis

•Adolescents and adults aged 15 to 65 years 

•Men who have sex with men 

•Injection drug users 

•Pregnant women 

•Those who have acquired or request testing for other STIs 

•Who exchange sex for money or drugs

azithromycin, 1 g orally in a single dose

OR

doxycycline, 100 mg orally 2x/day for 7 days 

ceftriaxone 250 mg IM in a single dose

PLUS

azithromycin 1 g orally in a single dose

Raltegravir (Isentress; RAL) 400 mg PO twice daily,

plus

Truvada, 1 PO once daily

Truvada: (Tenofovir DF [Viread; TDF] 300 mg 

emtricitabine [Emtriva; FTC] 200 mg).

Duration of PEP: 4 weeks

HBV Lab panel results

 HBsAg (-) and anti-HBs (-) 

HBV lab Panel Results

HBsAg (+) and anti-HBs (-) 

HBV lab Panel Results

•       Identifying and treating all persons who have TB disease

•       Finding and evaluating persons who have been in contact with TB patients

    •       Testing high-risk groups for TB infection 

•       Close contacts of those with infectious TB are at the highest risk of becoming infected.

•       TB is spread by droplet nuclei containing tubercle bacilli. 

•HIV-infected persons 

•Those with a history of prior, untreated TB or fibrotic lesions on chest radiograph 

•Children ≤5 years with a positive TST 

•Underweight or malnourished persons 

•Injection drug users 

•Those receiving TNF-α antagonists for treatment of rheumatoid arthritis or Crohn’s disease 

The Quanti-FERON TB (QFT) test and Mantoux tuberculin skin test (TST) are not interchangeable, and do not measure the same components of the immunologic response

•HIV-infected persons 

•Close contacts to an infectious TB case 

•Persons with chest radiographs consistent with prior untreated TB 

•Organ transplant recipients 

•Other immunosuppressed patients (e.g. , those taking the equivalent of > 15 mg/d of prednisone for 1 month or those taking TNF-α antagonists

•Recent immigrants 

•Injection drug users 

•Residents or employees of congregate settings 

•Mycobacteriology laboratory personnel 

•Persons with clinical conditions that place them at high risk 

•Children < 4 years; infants, children, and adolescents exposed to adults at high-risk

•9-month regimen of Isoniazid (INH). This is one of the preferred Latent TB Infection (LTBI) Treatment Regimens 

•2-month Rifampin (RIF) and Pyrazinamide (PZA). This is specifically called out as inappropriate treatment for LTBI 

•8-weeks Isoniazid (INH), Rifampin (RIF), Pyrazinamide (PZA), and Ethambutol (EMB). This is the initial treatment for active TB, not LTBI 

•18-weeks Isoniazid (INH) and Rifampin (RIF). This is the subsequent treatment for TB , not LTBI

Microbial antigens

Adjuvants and Preservatives are found in some vaccines, not all

Hepatitis A, Hepatitis B, Pneumococcal, Diphtheria, Pertussis, Tetanus, Rotavirus, Polio, 

Chickenpox (Varicella), Measles, Mumps, Rubella, Human Papilloma Virus, Haemophilus Influenzae type b (Hib), Meningococcal, Influenza

Pneumococcal, Tetanus, Diphtheria, Pertussis, Zoster, Chickenpox (Varicella), Measles, Mumps, Rubella, Human Papilloma Virus, Influenza

1.Clinical Atherosclerotic cardiovascular disease (ASCVD)

2.LDL-C ≥190 mg/dL, Age ≥21 years

3.Primary prevention – Diabetes: Age 40-75 years, LDL-C    70-189 mg/dL

4.Primary prevention -No Diabetes†: ≥7.5%‡ 10-year          ASCVD risk, Age 40-75 years, LDL-C 70-189 mg/dL

-OVERWEIGHT = BMI 25-29.9 kg/m^2 

-Class I obese= 30-34.9

-Class 2 obese= 35-39.9

-Class 3 obese (extreme obesity)= 40+

-If you want it simpler: 30-39.9 = obese

-Male= 40 inches. 

-Woman= 35 inches

-Measure waist circumference 25-34.9 BMI; don’t             do for 35+ because wouldn’t add additional risk             info