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Sally brings her 4 month old in for a well-child visit and immunizations.  The child’s grandmother lives at home with Sally and the baby and is undergoing chemotherapy for breast cancer. Which of the following vaccines are live attenuated virus vaccines provided at the 4 month visit and should therefore not be given to the child at this visit due to the risk of shedding live virus and causing illness in the grandmother?    

When should an otherwise healthy child be screened for hypertension?  

The patient with BPH is seen for follow-up. He has been taking finasteride (Proscar) for 6 months. The clinician should assess this patient for which of these side effects?  

You are caring for a 15-year-old sexually active girl. She has received routine childhood immunizations through 6-years of age. Vaccines that should be updated at this visit include:

Vaccination of women against human papillomavirus (HPV) is done with the intention of reducing rates of cervical cancer, which is known to be caused by certain strains of HPV. Which two types of high risk HPV are responsible for approximately 70% of worldwide cervical cancers?    

The clinician is counseling a 17-year-old female about smoking cessation. The patient acknowledges that smoking is unhealthy for her but states she is young and not too concerned about her health right now. According to the Transtheoretical Model of Change, this patient is in what stage?  

A 4-year-old presents to the clinic with a 2-day history of sore throat, headache, fever and chills. Today she developed small slightly raised deep pink lesions over most of her body. Based on this information, what is the likely diagnosis of this skin condition? (see image)    

A 38 year old woman is pregnant with her third child. Her first two children ages 11 and 18 are alive and well. You are offering patient education at this prenatal visit and she asks about risks during pregnancy. What is the most significant risk factor this woman has for having a child with a trisomy disorder?    

The clinician understands that motivational interviewing (MI) is an effective technique to use when counseling adolescents because:

A 44-year-old gravida 2 para 0 presents to your office to discuss contraception options. Her medical history is positive for chronic migraines, well controlled hypertension, hyperlipidemia, and type 1 diabetes diagnosed when she was 20 years old. She has no plans for a future pregnancy. Her weight is 160 pounds and height is 63 inches. What is the best recommendation for this patient?