TB Testing Principles Correct Answer: The PPD is 5 tuberculin units in 0.1 ml is administered
intradermally on the volar aspect of the lower arm and read 48 hours after the test is given. The PPD
result must have induration and measure 10 mm or greater to be positive in a low-risk patient. Greater
than 5 mm is considered positive in high risk population such as those with known exposure to TB.
Any HIV person needs annual testing for TB.
A positive result warrants chest x ray.
Diagnosis confirmation with sputum culture.
TB Risk factors Correct Answer: Compromised immune system, high-risk populations (minorities,
foreign-born people, prisoners, nursing home residents, indigents, migrant workers and healthcare
providers), steroid therapy and blood disorders.
AFP (Alpha Feta Protein) Correct Answer: Produced in the fetal and maternal liver, higher levels are
commonly seen in multiple gestations due to the growing fetuses and enlargement of the livers.
Calcium Channel Blockers Correct Answer: Act by blocking the calcium channels in the heart muscle and
the blood vessels, thereby keeping more calcium in the bones.
Lachman Maneuver Correct Answer: Test performed to assess for knee instability. Knee instability
indicates a tear of the anterior cruciate ligament.
Tanner Staging Correct Answer: After stage III, expect menses.
Stage IV is secondary breast mound
Stage III for males is lengthening of penis.
Stage IV is increased breadth and width.
S2 Correct Answer: Caused by closure of the semilunar valves
Medicare Part B: Correct Answer: 1. outpatient physician visits, lab, and x-ray
2. durable medical equipment
3. mammograms/colonoscopy yearly after age 50
4. rehab
Atopic Dermatitis Correct Answer: Skin condition in which the lesions occur in a linear fashion. they may
have many different stages including erythematous papules and vesicles, with weeping, drainage,
and/or crusting. Lesions are commonly found on the scalp, face, forearms, wrists, elbows, and backs of
knees. commonly pruritic. Also known as eczema.
A positive Coombs test on an Rh-negative pregnant women means. Correct Answer: The mother's
antibodies can attack the fetus's Rh-positive red blood cells and cause destruction of these cells, which
can cause severe anemia and complications in the fetus. Today this is preventable with the
,administration of anti- RhD immunoglobulin to an Rh-negative mother at 28 weeks gestation and after
birth if the newborn is Rh positive.
RhoGAM Correct Answer: Give to mothers with Rh negative blood when the fetus has Rh positive blood.
RhoGAM protects the mother from developing antibodies by destroying the Rh-positive fetal RBCs in the
mother's blood system.
Fitz-Hugh-Curtis Correct Answer: a complication of having pelvic inflammatory disease that was caused
by a vaginal infection, such as gonorrhea or chlamydia. This causes inflammation and infection in the
pelvic cavity. Left untreated, this infection can cause adhesions that stretch from the peritoneum to the
liver.
Presumptive Signs of Pregnancy Correct Answer: These are the signs that are experienced by the
patient such as amenorrhea, breast tenderness, nausea, vomiting, fatigue, increased urinary frequency,
etc.
Probable Signs of Pregnancy Correct Answer: These are the signs that are detected by the examiner
such as enlarge uterus, Hegar's sign, and Chadwick's sign.
Positive Signs of Pregnancy Correct Answer: These are the signs that are direct evidence of pregnancy
such as audible FHT or cardiac activity on ultrasound.
Chadwick's Sign Correct Answer: Bluish discoloration of the cervix and vagina.
Placenta abruptio Correct Answer: Bright red vaginal bleeding, board-like uterus on palpation, and pain.
Jarish-Herxheimer reaction Correct Answer: Immune mediated reaction precipitated by the destruction
of a large number of spirochetes due to the antibiotic injection
BV Correct Answer: Large amount of bacteria coating the squamous cells (Clue Cells) and very few
leukocytes or RBCs.
Proventil (Beta Agonist) vs steroids and luekotriene Correct Answer: Proventil is a short acting
bronchodilator and is used for immediate relief of shortness of breath. It acts quickly to dilate the tubes
of the lungs where as steroids and leukotriene inhibitors help the inflamed channels of the lungs to
remain open and clear over time. They are much slower acting than SABAs.
Hepatitis C Correct Answer: When a patient tests positive for anti-HCV, labs should be ordered and
include hepatitis C PCR (polymerase chain reaction) to further evaluate the patient
When anti-hep C is positive then a HCV RNA should be performed.
, Which of the following viral infections is associated with occasional abnormal forms of lymphocytes
during an acute infection? Correct Answer: A. CMV
B. Epstein Barr -A test for an acute infection of the EBV will show abnormal lymphocytes
Will also demonstrate positive EBV titers, elevated liver enzymes, and elevated BUN and creatinine
C. HPV
D. Coxsackie Virus
Cafe au lait spots are associated with: Correct Answer: Neurofibromatosis or von Recklinhausen's
disease. They are caused by an increase in melanin content, often with the presence of giant
melanosomes. They have irregular borders and vary from light to dark brown.
Treatment for erythema migrans or Lyme Disease Correct Answer: Doxycycline 100 mg BID x 21 days
Risk factors for Coronary Heart Disease Correct Answer: Hypertension
Hypercholesterolemia
Women 55 years and older
Fundoscopic exam Correct Answer: A normal exam includes sharp disc margins, yellow-orange
appearing macula and vein to artery ratio of 3:2
Snellen Chart Correct Answer: If a patient's vision results are 20/30 then the patient can see at 20 ft
what a person with normal vision can see at 30 feet.
Somogi Phenomenon Correct Answer: Nocturnal hypoglycemia (2 a.m. to 3 a.m.) stimulates the liver to
produce glucagon to raise the blood sugar. The fasting blood glucose levels will be elevated from this
glucagon production.
Initial evaluation for intermittent claudication would include: Correct Answer: Checking the ankle and
brachial blood pressure before and after exercise
Peak expiratory flow is determined using Correct Answer: Height, gender, and age.
Retinoblastoma Correct Answer: Retinoblastoma is a rare type of cancer in which a cancerous tumor of
the retina is present. This is diagnosed by noting a pupil that appears white of has white spots on it. One
or both eyes may be affected. It is often seen in photographs, where there will be a white glow in the
eye instead of the usual "red eye" noted in pictures from the flash.
You are reviewing the bilirubin level on a 3 day old full term neonate. You note that it is 10. The infant
has a slight yellow color to his skin, mucous membranes, and sclera. The infant is feeding well, is not
irritable, and has 8 to 10 wet diapers per day. Correct Answer: Keep on monitoring the infant's bilirubin
level until it returns back to normal in about one week.
Bilirubin is excreted through the urine and feces. Increased fluids and wetting 8-10 diapers a day is
sufficient fluid intake/excretion to help bring down the bilirubin level. Levels should continue to be
monitored and should improve in approximately 1 week.
Atrophic Vaginitis Correct Answer: Symptoms include painful intercourse, atrophic squamous epithelial
cells, and a decrease in pH. Vaginal atrophy is caused by lack of or imbalance of estrogen. Normal pH of
the vagina is 4.0-5.0.
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