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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 most important way to screen for CAD in an asymptomatic patients?
HISTORY
NEVER
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT

2. What are 2 conditions that have been proven to be beneficial to screened for?
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism
Persons with no known risk factors
Rear facing

3. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Men 45 - 79 yo
Women 55 - 79 yo
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)

4. What is the USPSTF guideline for DMT2 screening?
Femoral neck
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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...
In adults with sustained BP > 135/80 mmHg

5. What is the schedule for rotavirus vaccine?
Women 55 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

6. What kind of car seat should children < 2 yo be placed in?
1000 IU/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...
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Rear facing

7. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
1200 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after

8. What type of illnesses does Hib vaccine prevent?
Adults > 60
Smoking - Alcoholism
Meningitis and Epiglottitis
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

9. What are the guidelines for pap smear?
4 mg/day
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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)

10. What is the NCEP III guideline for cholesterol screening?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Total cholesterol - FOBT
Start at 20 for all M and W regardless of RFs

11. What is the schedule for MMR vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after

12. How much calcium should women > 50 take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

13. What are the guidelines for visual screening?
To get IgA protection
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo

14. Unopposed estrogen increases risks for what conditions?
HISTORY
Stroke and DVT
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo

15. What kind of sunscreen SPF is recommended for sun protection?
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

16. How much calcium should adults (19 - 50) take?
Femoral neck
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day

17. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception

18. When should chest X-ray be used for screening?
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)
65 (earlier if have increased risk factors)
NEVER
In all W < 24 who are sexually active - In W > 24 with increased risk

19. In which group of patients should aspirin be given as primary prevention for MI?
Femoral neck
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
Men 45 - 79 yo

20. What are the USPSTF guidelines for mammogram?
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
During 2nd - 3rd trimester
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

21. What can decrease fall in the elderly?
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
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

22. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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)
65 (earlier if have increased risk factors)

23. What is USPSTF guideline for abdominal aortic aneurysm screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES
Exercise - Environmental hazard reduction - Close monitoring of medication

24. What 3 things should always be done in an office visit?
Total cholesterol - FOBT
BP - Height - Weight
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

25. Measurement of which anatomic structure is best predictor for hip fracture?
4 mg/day
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY

26. What tests are appropriate to order in an asymptomatic 57 yo male?
Smoking - Alcoholism
Total cholesterol - FOBT
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65

27. How much folate and for How long should a woman take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
0.4 - 0.8 mg/day for 1 month prior to conception
1200 mg/day

28. If traveling to endemic areas - Why should one get a dose of live vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA 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...
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

29. When is area of induration > 5mm considered TB positive?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day
Persons with no known risk factors
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

30. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

31. What is HI law for booster seat?

32. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Adults > 60
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Rear facing

33. How much calcium should adolescents (9 -18) take?
Smoking - Alcoholism
Rear facing
NEVER
1300 mg/day

34. What is the schedule for Gardasil?
Every 5 years
Men 45 - 79 yo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

35. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
Children up to 7 yo and < 5' should be placed in a booster seat.
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
> 2 yo and less than 40 lbs
Exercise - Environmental hazard reduction - Close monitoring of medication

37. What is the schedule for varicella vaccine?
Femoral neck
Rear facing
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after

38. How much vit D should adults > 50 take?
1000 IU/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...
Persons with no known risk factors
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

39. What is the schedule for Hib vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
2mo - 4 mo - 6mo and 12-15 mo
Women 55 - 79 yo

40. Who should get Tdap vaccine and how often?
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
To get IgA protection
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

41. Who are at increased risk for adverse effect catching a flu?
When they are > 40 lbs and still less then 5'
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

42. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs

43. What are some risk factors for CAD?
Stroke and DVT
Femoral neck
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

44. How much fluoride should military children in HI be given?
NEVER
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
2mo - 4 mo - 6mo and 12-15 mo

45. At what age should women have DEXA scan?
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
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)

46. How much vit D should adults < 50 take?
Every 5 years
800 IU/ day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day

47. When should Gardasil be given and for what purposes?
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)
When they are > 40 lbs and still less then 5'
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

48. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
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

49. When is intensive individualized home-based intervention recommended?
Preschool children : 3-4 yo - Elderly patients: > 65 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
Total cholesterol - FOBT
Femoral neck

50. What are some safety issues you should counsel parents with young children?
Rear facing
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...
1300 mg/day