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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. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
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
Femoral neck
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. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Total cholesterol - FOBT
Exercise or physical therapy and vit D for patients > 65
Starts at 20 for both M and W

3. When should tetanus immunoglobulin be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
To get IgA protection

4. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
1000 IU/day
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

5. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Men 45 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors

6. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
NEVER
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

7. How much calcium should adults (19 - 50) take?
1000 mg/day
Forearm
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. What is the USPSTF guideline for DMT2 screening?
Exercise or physical therapy and vit D for patients > 65
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
In adults with sustained BP > 135/80 mmHg
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

9. What is the USPSTF guideline for chlamydial screening?
Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER
Smoking - Alcoholism

10. When is intensive individualized home-based intervention recommended?
Stroke and DVT
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)
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
Starts at 20 for both M and W

11. What is the schedule for polio vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
2mo - 4mo - 6-18 mo and 4-6 yrs

12. What are some safety issues you should counsel parents with young children?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day

13. How much folate should all women of child bearing age take?
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day
When they are > 40 lbs and still less then 5'

14. What 3 things should always be done in an office visit?
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight
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

15. How much calcium should women > 50 take?
1200 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo

16. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
BP - Height - Weight

17. 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
During 2nd - 3rd trimester
Forearm
HISTORY

18. When can children sit in a booster seat?

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19. When is area of induration > 15 mm considered TB positive?
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
Persons with no known risk factors
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after

20. What is the most important way to screen for CAD in an asymptomatic patients?
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
Rear facing
HISTORY
Exercise or physical therapy and vit D for patients > 65

21. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

22. What is the NCEP III guideline for cholesterol screening?
1300 mg/day
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
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

23. Measurement of which anatomic structure is best predictor for hip fracture?
Forearm
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In adults with sustained BP > 135/80 mmHg

24. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

25. What is the schedule for rotavirus vaccine?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Adults > 60

26. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
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

27. How much folate and for How long should a woman take for planned pregnancy?
During 2nd - 3rd trimester
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
1000 IU/day

28. What kind of sunscreen SPF is recommended for sun protection?
More than 15
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

29. What is HI law for booster seat?

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30. Which children should use a semi-upright/forward facing carseat?
Femoral neck
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)
> 2 yo and less than 40 lbs
Stroke and DVT

31. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Rear facing
4 mg/day
Starts at 20 for both M and W
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

32. Unopposed estrogen increases risks for what conditions?
4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
Stroke and DVT
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...

33. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
HISTORY
> 2 yo and less than 40 lbs

34. What are some RFs for DMT2?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 50 (recommends against starting at 40) and every 2 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
NEVER

35. How much vit D should adults < 50 take?
Persons with no known risk factors
800 IU/ day
Start at 20 for all M and W regardless of RFs
1300 mg/day

36. How much fluoride should military children in HI be given?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

37. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo - 6mo and 12-15 mo
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
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES

38. What is the schedule for Hib vaccine?
BP - Height - Weight
More than 15
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo

39. What kind of polio vaccine is preferred?
To get IgA protection
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

40. 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 45 - 79 yo
1000 IU/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

41. When is area of induration > 10 mm considered TB positive?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

42. What is the schedule for MMR vaccine?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

43. Some contraindications for aspirin
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

44. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

45. How often do asplenic patients receive pneumococcal vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
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

46. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo
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)

47. What is the schedule for Hep B vaccine?
NEVER
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

48. When should the meningococcal vaccine be given and to which group?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Breast CA - thromboembolic event - stroke and CAD

49. How much vit D should adults > 50 take?
1000 IU/day
Persons with no known risk factors
Forearm
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...

50. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
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