••• Chapter 23^ Primary and Preventative Care^237
❍ What are the two most common reasons for a false-positive PPD?
Infection with nontuberculosis mycobacteria and vaccination with Bacillus Calmette-Guerin (BCG).
❍ If a patient has a positive PPD and she tells you that she had the BCG vaccine as a child, is any further
workup needed?
Yes.
❍ What is the appropriate workup for a first-time positive PPD?
A chest X-Ray should be performed and then based on the results treatment initiated.
❍ In 1997, what percentage of American women were using complementary or alternative medicine?
49%—Most patients who use complementary and alternative therapies self-refer and do not tell their physicians.
❍ What is the BMI used for? What are the different categories?
BMI is used as a screening tool to identify weight problems. The calculation is based on the patient’s weight and height.
BMi category
<18.5 Underweight
18.5–24.9 Normal
25–29.9 Overweight
30–39.9 Obese
> 40 Morbidly obese❍ What is the recommendation of physical activity for adults by the CDC and the American College of Sports Medicine?
(1) Adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days per week.
(2) Adults should engage in vigorous-intensity physical activities 3 or more days per week for 20 minutes
minimum per activity.
❍ When are therapeutic interventions recommended for blood pressure management?
When elevations in blood pressure readings are obtained with three measurements performed at different times
over the course of several weeks.
❍ What are the nonpharmacologic interventions for blood pressure management? How long should these
interventions be pursued before they are deemed ineffective?
The nonpharmacologic interventions include weight reduction, exercise, dietary sodium restriction, decreased
alcohol intake, decreased fat consumption, smoking cessation, and stress reduction. If no success after 3 months,
drug therapy is recommended.
❍ What tests other than fasting lipid panel are used to evaluate dyslipidemia?
Other tests include fasting blood glucose, liver function, thyroid function, renal function, and urinalysis to rule out
secondary causes of dyslipidemia.