Immunizations, Diagnostic Imaging, Lab Finding

Question 1

What vaccine should be given at EACH pregnancy, regardless of prior vaccination history?

Answer 1

Answer: Tdap

Question 2

T or F: FluMist LAIV4 is approved for the 2019-2020 Flu season?

Answer 2

Answer: True

Question 3

T or F: FluMist LAIV4 is approved for the 2017-2018 Flu season?

Answer 3

Answer: False; due to concern for effectiveness

Question 4

In efforts to prevent CAP, all patients should receive what vaccine?

Answer 4

Answer: Flu vaccine, annually (dosing schedule determined by age)

Question 5

At what age should all patients receive a pneumococcal vaccine?

Answer 5

Answer: 65 years old

Question 6

What important prevention method should be used in pertussis?

Answer 6

Answer: Vaccination (DTaP)

Question 7

T or F: A CXR can identify the causative organism and distinguish bacterial from viral PNA?

Answer 7

Answer: False

Question 8

In an overwhelming infection, what would the WBCs look like (the #)?

Answer 8

Answer: <5,000

Question 9

What is the term for elevated BUN & CREATININE?

Answer 9

Answer: Azotemia

Question 10

What would you expect the albumin level to be in a patient with chronic alcoholism?

Answer 10

Answer: Low

Question 11

What lab is dependent on albumin? What would this cause the lab to be?

Answer 11

Answer: Calcium (50% is bound to albumin); In a patient with chronic alcoholism, you would expect the calcium to be low (Think, if you are
malnourished you don’t drink milk - you drink alcohol; hence why alcoholics – in addition to their blood being thinner – would be at any even
more increased risk of bleeding)

Question 12

What lab would indicate your patient is dehydrated?

Answer 12

Answer: Elevated BUN, high albumin

Question 13

If a patient with cirrhosis presents to the ED and their ETOH level is 324 - What would you expect their liver panel to look like?

Answer 13

Answer: low ALT/AST, high ALP

Question 14

A patient presents to your clinic to discuss the results of his PSA screening. You are concerned as this test result is 45. What are your differential diagnoses?

Answer 14

Answer: prostate manipulation, prostate cancer, prostate biopsy

Question 15

A patient is having an acute pancreatitis attack. When would you expect amylase to rise, peak, and return to normal?

Answer 15

Answer: 2hr, 12-48hr, 3-4 days

Question 16

A patient presents to your clinic c/o anxiety and appears tachypneic. What lab would be most affected by this patient’s presentation?

Answer 16

Answer: Chloride (decreased Co2 (hyperventilation) = increase CL)

Question 17

What is the earliest indicator of infection (WBC)?

Answer 17

Answer: Bands

Question 18

What WBC is the 1st line of defense:

Answer 18

Answer: Poly neutrophils

Question 19

What’s the strongest WBC that kills/digest FB?

Answer 19

Answer: Monocytes

Question 20

Patient is having allergic rx. What WBC is elevated?

Answer 20

Answer: Eosinophils

Question 21

Which WBC aids with healing and blood clotting?

Answer 21

Answer: Basophils

Question 22

What level will jaundice be visible?

Answer 22

Answer: >3 total bilirubin

Question 23

The patient is exhibiting muscle twitching. What lab would you suspect is the cause of this?

Answer 23

Answer: Low calcium

Question 24

Most specific lab for the kidneys?

Answer 24

Answer: Creatinine

Question 25

If this was elevated it would warrant checking for multiple myeloma?

Answer 25

Answer: total protein

Question 26

If your creatinine is high - your GFR will be?

Answer 26

Answer: Low GFR

Question 27

What lab is expected to be elevated in children (considered normal) but not in adults?

Answer 27

Answer: ALP – rapid bone growth; have more lymphocytes than neutrophils

Question 28

Patient presents to clinic saying they cannot get enough of licorice - you expect what lab to be off?

Answer 28

Answer: decreased K

Question 29

What drug specifically relies on the regulation of sodium?

Answer 29

Answer: Lithium

Question 30

TSH is high in patient. What would you suspect the causes are?

Answer 30

Answer: hypothyroidism, thyroiditis, inadequate hormone therapy (Synthroid)

Question 31

What lab would you use to screen patient that would be at risk for renal injury? What types of patients are most at risk for renal injury?

Answer 31

Answer: creatinine; HTN/DM

Question 32

A patient’s EKG has peaked t waves and a prolonged PR interval. What lab do you suspect is causing this?

Answer 32

Answer: Hyperkalemia

Question 33

Patient presents with sickle cell crisis. What lab would you expect to be elevated?

Answer 33

Answer: Increased Bili