A 16-year old male becomes ill with fever, chills, headache, myalgia, and arthralgia 6 days after hunting prairie dogs with his cousin at his uncle's farm. Examination reveals extremely large, painful, and tender inguinal lymph nodes and a couple of small papules around his ankles. Which of the following is the most likely diagnosis?
Answer(s): B
Bubonic plague is uncommon in the United States. It is almost always contracted through a bite by an infected flea. Asmall local papule or vesicle, and sometimes a local ulceration, may occur at the site of theF. pestis infecting bite. Mucous membranes and broken skin also can be entry sites. After an incubation period of 26 days, illness is manifested by fever, chills, headache, myalgia, and arthralgia. Eventually, there is painful enlargement (the bubo) of lymph nodes draining the inoculation site.
Ahealth insurance company decides to market its services to a population that will not incur high charges. The use of health services in the United States is most strongly associated with which of the following characteristics?
Answer(s): A
In 1990, there were 3 million persons in the United States aged 65 or more. In 2001, there were 35 million, and by 2030 there may be 71 million. For the population as a whole, usage of health care is high at the time of birth and, to an even greater degree, in the period prior to death.
A hurricane devastates your community. You decide to devote your attention to the aspect of disaster response that is most likely to be inadequate in coping with the disaster. Which of the following is most likely to hamper disaster response?
Answer(s): C
Since the 1950s, the single most important failure in coping with disasters has been poor management by those in charge. There has been no significant problem with resources needed or with triage of casualties.Neither has there been evidence of poor response to the need for volunteer helpers. Telecommunications have improved continuously, especially with satellite communications available.
Repeated thunderstorms have resulted in overflow of municipal wastewater treatment plants by floodwaters. Volunteer sandbaggers downstream from the plants developed health concerns when the overflow became evident. As a public health officer you are asked to evaluate the situation. Which of the following is your most important recommendation to workers in order to prevent illness from exposure to the contaminated water?
Public health sanitation measures in emergency conditions should reduce fecal contamination of food and water supplies. Communicable disease such as typhoid fever, cholera, bacillary and amoebic dysentery, hepatitis, polio, schistosomiasis, various helminthes infestations, and viral gastroenteritis can be transmitted through contact with human feces. Avoiding putting fecal material in the mouth is key to avoiding infection.
A father you are treating for hyperlipidemia brings his 23-month-old son into your clinic for a routine checkup. He reports that he and his wife are separated and that he is uncertain if the child has received appropriate medical care. The child has no known medical problems and is not a member of any high- risk population. The child is new to your clinic, but the father produces an immunization record which states the child has received the following vaccines: diphtheria, tetanus, and acellular pertussis at 2, 5, and 7 months; hepatitis B vaccine at birth, 2 months, and 7 months; H. influenzae type b at 2 and 5 months; inactivated poliovirus at 2, 5, and 7 months; and a measles, mumps, and rubella vaccine at 12 months. You tell the father that the child has received some of the recommended immunizations late, but that the child is adequately protected.The infant should receive varicella immunization in addition to which of the following vaccinations?
Answer(s): D
The fourth DTaP must be at least 6 months later than the third dose. Hepatitis Avaccine is recommended in some high-risk communities, but it is not recommended for all children. Pneumococcus vaccine for children not previously immunized by 23 months should receive two doses 8 weeks apart. Oral polio vaccine should not be used when inactivated poliovirus is available.
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