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Family Medicine Health Maintenance

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What is the schedule for Hib vaccine?
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
2mo - 4 mo - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD

2. Which children should use a semi-upright/forward facing carseat?
Fires: install smoke detectors - flame-resistant nightwears - Burns: set hot water to 110-120 F. - Poisoning: keep the number for poison control 800-222-1222. Do not use IPECAC. - Helmets - knee/elbow pads...
> 2 yo and less than 40 lbs
Adults > 60
Men 45 - 79 yo

3. When should Gardasil be given and for what purposes?
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
9 - 26 yo - To prevent cervical cancer in W and anal cancer in M and genital warts - Protect against HPV type 11 - 16 and 18
To get IgA protection

4. How much folate and for How long should a woman take for planned pregnancy?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception

5. What 3 things should always be done in an office visit?
BP - Height - Weight
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

6. When should the meningococcal vaccine be given and to which group?
1200 mg/day
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at age 21 regardless of age becoming sexually active and repeats every 3 years - For W > 30 - can extend the interval to every 5 years with HPV testing - Stop at 65 yo (USPSTF)

7. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
BP - Height - Weight
When they are > 40 lbs and still less then 5'
Stroke and DVT

8. How much calcium should adolescents (9 -18) take?
1300 mg/day
NEVER
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W

10. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
12 - 23 mo - 2 doses are to be given 6 mo apart
Every 5 years
9 - 26 yo - To prevent cervical cancer in W and anal cancer in M and genital warts - Protect against HPV type 11 - 16 and 18

11. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Start at 20 for all M and W regardless of RFs
One time abdominal X-ray for all MALES who ever SMOKES
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

12. What is the USPSTF guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
Every 5 years

13. How much vit D should adults > 50 take?
1) Children < 2yo 2) All adults smokers 3) Adults and children > 2 yo with high risk: cardiopulmonary disease - asplenic - Hodgkin's disease - multiple myeloma - chronic liver disease - alcoholism - renal failure - immunocompromised 4) Healthy adults
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day

14. Who should get shingles vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

15. When should tetanus immunoglobulin be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Stroke and DVT

16. What is the schedule for varicella vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester

17. What is the schedule for rotavirus vaccine?
Smoking - Alcoholism
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

18. What are the 4 main groups of people who are candidates for pneumococcal vaccine?

19. What kind of car seat should children < 2 yo be placed in?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing

20. Measurement of which anatomic structure is best predictor for hip fracture?
NEVER
Adults - every 10 years - If sustain deep or contaminated wound - every 5 years - Best to give first dose 11-18 yo - then followed by Td booster
One dose at 12-15 mod - Booster at least 4-weeks after
Femoral neck

21. Who should get Tdap vaccine and how often?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults - every 10 years - If sustain deep or contaminated wound - every 5 years - Best to give first dose 11-18 yo - then followed by Td booster
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

22. What is HI law for booster seat?

23. What is the schedule for Hep A vaccine?
HIV positive patients - Recents contact with TB case - Persons with fibrotic changes on CXR consistent with old healed TB - Patients with organ transplant - Immunocompromised patients
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
12 - 23 mo - 2 doses are to be given 6 mo apart

24. When is area of induration > 15 mm considered TB positive?
Starts at age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors
Starts at age 21 regardless of age becoming sexually active and repeats every 3 years - For W > 30 - can extend the interval to every 5 years with HPV testing - Stop at 65 yo (USPSTF)

25. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

26. What are the USPSTF guidelines for mammogram?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

27. What are the guidelines for visual screening?
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo

28. How much fluoride should military children in HI be given?
HISTORY
Fires: install smoke detectors - flame-resistant nightwears - Burns: set hot water to 110-120 F. - Poisoning: keep the number for poison control 800-222-1222. Do not use IPECAC. - Helmets - knee/elbow pads...
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck

29. What is the ADA guideline for DMT2 screening?
1) Children < 2yo 2) All adults smokers 3) Adults and children > 2 yo with high risk: cardiopulmonary disease - asplenic - Hodgkin's disease - multiple myeloma - chronic liver disease - alcoholism - renal failure - immunocompromised 4) Healthy adults
9 - 26 yo - To prevent cervical cancer in W and anal cancer in M and genital warts - Protect against HPV type 11 - 16 and 18
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

30. When should pregnant women get a flu shot?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
During 2nd - 3rd trimester
Recent arrival (< 5 y) from high prevalence countries - IV drug users - Residents and employees of high risk settings: prison - nursing homes - hospitals - homeless shelters - and residential facilities for AIDS patients - Mycobacterial lab personnel
2mo - 4mo - 6-18 mo and 4-6 yrs

31. What is the USPSTF guideline for fall prevention in the elderly?
BP - Height - Weight
Starts at 20 for both M and W
HIV positive patients - Recents contact with TB case - Persons with fibrotic changes on CXR consistent with old healed TB - Patients with organ transplant - Immunocompromised patients
Exercise or physical therapy and vit D for patients > 65

32. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Starts at 20 for both M and W
1000 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

33. What are the guidelines for colon cancer screening?
Starts at age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
Exercise or physical therapy and vit D for patients > 65
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

34. If traveling to endemic areas - Why should one get a dose of live vaccine?
Total cholesterol - FOBT
1000 IU/day
To get IgA protection
Women 55 - 79 yo

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day
Start at 20 for all M and W regardless of RFs
Forearm

36. How often do asplenic patients receive pneumococcal vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years
More than 15
To get IgA protection

37. When is area of induration > 5mm considered TB positive?
9 - 26 yo - To prevent cervical cancer in W and anal cancer in M and genital warts - Protect against HPV type 11 - 16 and 18
HIV positive patients - Recents contact with TB case - Persons with fibrotic changes on CXR consistent with old healed TB - Patients with organ transplant - Immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

38. When is area of induration > 10 mm considered TB positive?
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
Recent arrival (< 5 y) from high prevalence countries - IV drug users - Residents and employees of high risk settings: prison - nursing homes - hospitals - homeless shelters - and residential facilities for AIDS patients - Mycobacterial lab personnel

39. What tests are appropriate to order in an asymptomatic 57 yo male?
1000 mg/day
800 IU/ day
Total cholesterol - FOBT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

40. What is the schedule for Hep B vaccine?
HISTORY
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after

41. How much calcium should adults (19 - 50) take?
Fires: install smoke detectors - flame-resistant nightwears - Burns: set hot water to 110-120 F. - Poisoning: keep the number for poison control 800-222-1222. Do not use IPECAC. - Helmets - knee/elbow pads...
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

42. What are some risk factors for CAD?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

43. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

44. What kind of polio vaccine is preferred?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. In which group of patients should aspirin be given as primary prevention for stroke?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo
During 2nd - 3rd trimester

46. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at age 21 regardless of age becoming sexually active and repeats every 3 years - For W > 30 - can extend the interval to every 5 years with HPV testing - Stop at 65 yo (USPSTF)
To get IgA protection

47. How much calcium should women > 50 take?
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

48. When can children sit in a booster seat?

49. How much folate should all women of child bearing age take?
0.4 mg/day
Adults - every 10 years - If sustain deep or contaminated wound - every 5 years - Best to give first dose 11-18 yo - then followed by Td booster
Total cholesterol - FOBT
Starts at 20 for both M and W

50. What is the USPSTF guideline for chlamydial screening?
0.4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults - every 10 years - If sustain deep or contaminated wound - every 5 years - Best to give first dose 11-18 yo - then followed by Td booster