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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. When should Gardasil be given and for what purposes?
Exercise or physical therapy and vit D for patients > 65
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
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
> 2 yo and less than 40 lbs

2. When can children sit in a booster seat?

3. When is area of induration > 15 mm considered TB positive?
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Persons with no known risk factors
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...

4. What is the schedule for DTap vaccine?
1000 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
During 2nd - 3rd trimester

5. How often do asplenic patients receive pneumococcal vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs
Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.

6. What kind of polio vaccine is preferred?
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 20 for both M and W
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

7. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis
Total cholesterol - FOBT
1000 IU/day

8. What is the schedule for Gardasil?
During 2nd - 3rd trimester
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Adults > 60
Persons with no known risk factors

9. How much calcium should women > 50 take?
More than 15
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)
1200 mg/day
Forearm

10. What are some safety issues you should counsel parents with young children?
800 IU/ day
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
2mo - 4 mo - 6mo and 12-15 mo
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...

11. What is the USPSTF guideline for fall prevention in the elderly?
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
NEVER
Forearm
Exercise or physical therapy and vit D for patients > 65

12. When should tetanus immunoglobulin be given?
In all W < 24 who are sexually active - In W > 24 with increased risk
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Patients > 75 - Patients 70 - 74 who are on psychoactive or cardiac meds - who are on > 4 meds and who have impaired cognition - strength - balance and vision

13. What is the schedule for varicella vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One dose at 12-15 mod - Booster at least 4-weeks after
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

15. How much flouride should non military children in the state of HI be given?
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after

16. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors
Femoral neck
Men 45 - 79 yo

17. What 3 things should always be done in an office visit?
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
HISTORY
Adults > 60
BP - Height - Weight

18. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

19. Who should get shingles vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Start at 20 for all M and W regardless of RFs
Adults > 60
Forearm

20. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 years

21. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Rear facing
1200 mg/day
Men 45 - 79 yo

22. How much calcium should adolescents (9 -18) take?
1300 mg/day
1000 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT

23. In which group of patients should aspirin be given as primary prevention for MI?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

24. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
800 IU/ day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

25. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after

26. How much folate and for How long should a woman take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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 USPSTF guidelines for cholesterol screening in people with increased risks?
2mo - 4mo - 6-18 mo and 4-6 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 20 for both M and W
One time abdominal X-ray for all MALES who ever SMOKES

28. What is the ADA guideline for DMT2 screening?
1200 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Persons with no known risk factors
65 (earlier if have increased risk factors)

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
More than 15
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
Stroke and DVT

30. Who should get Tdap vaccine and how often?
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
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Rear facing

31. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
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

32. What is the schedule for Hib vaccine?
1000 mg/day
800 IU/ day
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo

33. What are the guidelines for pap smear?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

34. When should chest X-ray be used for screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
NEVER
More than 15

35. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg

36. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

37. What can decrease fall in the elderly?
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication

38. Unopposed estrogen increases risks for what conditions?
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
1300 mg/day
Stroke and DVT
0.4 mg/day

39. What is the schedule for Hep B vaccine?
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)

40. Who are at increased risk for adverse effect catching a flu?
Patients > 75 - Patients 70 - 74 who are on psychoactive or cardiac meds - who are on > 4 meds and who have impaired cognition - strength - balance and vision
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism
800 IU/ day

41. When should pregnant women get a flu shot?
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
More than 15
During 2nd - 3rd trimester

42. What tests are appropriate to order in an asymptomatic 57 yo male?
Breast CA - thromboembolic event - stroke and CAD
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What is the schedule for rotavirus vaccine?
To get IgA protection
2mo - 4 mo - 6mo and 12-15 mo
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

44. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Women 55 - 79 yo
To get IgA protection

45. How much vit D should adults > 50 take?
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs
1000 IU/day
Smoking - Alcoholism

46. Some contraindications for aspirin
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

47. When is area of induration > 5mm considered TB positive?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Stroke and DVT
Adults > 60

48. What are the USPSTF guidelines for mammogram?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years
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...
NEVER

49. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In adults with sustained BP > 135/80 mmHg

50. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
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
HISTORY