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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. Measurement of which anatomic structure is best predictor for hip fracture?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck
NEVER

2. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
When they are > 40 lbs and still less then 5'
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

3. How much calcium should women > 50 take?
One time abdominal X-ray for all MALES who ever SMOKES
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...
1200 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

4. What is the schedule for polio vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 mg/day

5. How much vit D should adults < 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
800 IU/ day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day

6. When should tetanus immunoglobulin be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
During 2nd - 3rd trimester
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 50 (recommends against starting at 40) and every 2 years

7. At what age should women have DEXA scan?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo
65 (earlier if have increased risk factors)
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

8. How much fluoride should military children in HI be given?
Children up to 7 yo and < 5' should be placed in a booster seat.
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

9. Unopposed estrogen increases risks for what conditions?
0.4 - 0.8 mg/day for 1 month prior to conception
Stroke and DVT
Men 45 - 79 yo
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

10. What 3 things should always be done in an office visit?
HISTORY
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
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

11. What is the ADA guideline for DMT2 screening?
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

12. What are the guidelines for colon cancer screening?
800 IU/ day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
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

13. What are the USPSTF guidelines for mammogram?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD
NEVER

14. How much calcium should adolescents (9 -18) take?
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
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
1300 mg/day

15. Who are at increased risk for adverse effect catching a flu?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm

16. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Rear facing
Breast CA - thromboembolic event - stroke and CAD
HISTORY

17. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
> 2 yo and less than 40 lbs
1000 IU/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day

18. In which group of patients should aspirin be given as primary prevention for stroke?
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
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.
Women 55 - 79 yo

19. When should Gardasil be given and for what purposes?
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
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

20. How much calcium should adults (19 - 50) take?
Forearm
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
1000 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

21. What is the USPSTF guideline for fall prevention in the elderly?
Meningitis and Epiglottitis
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise or physical therapy and vit D for patients > 65

22. What is the USPSTF guideline for chlamydial screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day

23. What are 2 conditions that have been proven to be beneficial to screened for?
In adults with sustained BP > 135/80 mmHg
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after

24. Some contraindications for aspirin
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck

25. What is the NCEP III guideline for cholesterol screening?
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
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart
Start at 20 for all M and W regardless of RFs

26. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

27. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

28. What are some RFs for DMT2?
Rear facing
HISTORY
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise - Environmental hazard reduction - Close monitoring of medication

29. What is the schedule for Hib vaccine?
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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 - 4 mo - 6mo and 12-15 mo

30. What kind of sunscreen SPF is recommended for sun protection?
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 IU/day
When they are > 40 lbs and still less then 5'
More than 15

31. What is the USPSTF guideline for DMT2 screening?
1300 mg/day
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

32. What are some risk factors for CAD?
During 2nd - 3rd trimester
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

33. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
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
BP - Height - Weight
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...

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

35. What are some safety issues you should counsel parents with young children?
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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
Rear facing

36. What is the most important way to screen for CAD in an asymptomatic patients?
> 2 yo and less than 40 lbs
HISTORY
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
BP - Height - Weight

37. When is area of induration > 10 mm considered TB positive?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
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
1000 mg/day

38. When should chest X-ray be used for screening?
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception
NEVER

39. What is USPSTF guideline for abdominal aortic aneurysm screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

40. What are the risks of combination HRT?
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Breast CA - thromboembolic event - stroke and CAD
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

41. What tests are appropriate to order in an asymptomatic 57 yo male?
65 (earlier if have increased 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...
2mo - 4 mo - 6mo and 12-15 mo
Total cholesterol - FOBT

42. How much folate should all women of child bearing age take?
Meningitis and Epiglottitis
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

43. What is the schedule for rotavirus vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

44. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Forearm
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

45. If traveling to endemic areas - Why should one get a dose of live vaccine?
Persons with no known risk factors
One time abdominal X-ray for all MALES who ever SMOKES
Men 45 - 79 yo
To get IgA protection

46. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Starts at 50 (recommends against starting at 40) and every 2 years

47. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
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
One time abdominal X-ray for all MALES who ever SMOKES
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. When should pregnant women get a flu shot?
One dose at 12-15 mod - Booster at least 4-weeks after
12 - 23 mo - 2 doses are to be given 6 mo apart
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
During 2nd - 3rd trimester

49. 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
HISTORY
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
Women 55 - 79 yo

50. What is the schedule for MMR vaccine?
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester