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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?
Persons with no known risk factors
Breast CA - thromboembolic event - stroke and CAD
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
HISTORY

2. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

3. What is the schedule for DTap vaccine?
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
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

4. When can children sit in a booster seat?

5. What are the risks of combination HRT?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

6. At what age should women have DEXA scan?
Persons with no known risk factors
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)

7. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs
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

8. How much calcium should adults (19 - 50) take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 mg/day
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

9. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years

10. How much folate and for How long should a woman take for planned pregnancy?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
> 2 yo and less than 40 lbs
0.4 - 0.8 mg/day for 1 month prior to conception

11. What kind of car seat should children < 2 yo be placed in?
BP - Height - Weight
Rear facing
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
2mo - 4 mo - 6mo and 12-15 mo

12. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

13. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Children up to 7 yo and < 5' should be placed in a booster seat.
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
When they are > 40 lbs and still less then 5'
Smoking - Alcoholism

14. What is the ADA guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

15. What are the USPSTF guidelines for mammogram?
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
Starts at 50 (recommends against starting at 40) and every 2 years
Femoral neck
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

16. What 3 things should always be done in an office visit?
BP - Height - Weight
4 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)
In all W < 24 who are sexually active - In W > 24 with increased risk

17. What kind of polio vaccine is preferred?
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
1200 mg/day

18. What are some RFs for DMT2?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
Starts at 20 for both M and W
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

19. How much vit D should adults < 50 take?
NEVER
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
800 IU/ day

20. What are 2 conditions that have been proven to be beneficial to screened for?
Femoral neck
1000 IU/day
Adults > 60
Smoking - Alcoholism

21. What type of illnesses does Hib vaccine prevent?
0.4 - 0.8 mg/day for 1 month prior to conception
1200 mg/day
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.

22. What is the schedule for Hib vaccine?
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
2mo - 4 mo - 6mo and 12-15 mo
Femoral neck

23. What is the schedule for Gardasil?
Stroke and DVT
> 2 yo and less than 40 lbs
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

24. When is area of induration > 5mm considered TB positive?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Persons with no known risk factors
Stroke and DVT

25. 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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication
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

26. 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...
One dose at 12-15 mod - Booster at least 4-weeks after
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg

27. In which group of patients should aspirin be given as primary prevention for MI?
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day
Men 45 - 79 yo
0.4 mg/day

28. What is the schedule for polio vaccine?
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs

29. How often do asplenic patients receive pneumococcal vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Every 5 years
Men 45 - 79 yo

30. When is area of induration > 15 mm considered TB positive?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'
Persons with no known risk factors
Smoking - Alcoholism

31. When should the meningococcal vaccine be given and to which group?
Adults > 60
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Rear facing
When they are > 40 lbs and still less then 5'

32. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Femoral neck
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

33. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism
Starts at 20 for both M and W

34. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

35. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Smoking - Alcoholism
Starts at 20 for both M and W
1300 mg/day

36. What are some risk factors for CAD?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

37. What can decrease fall in the elderly?
1200 mg/day
0.4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication

38. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
Every 5 years
Femoral neck

39. When should pregnant women get a flu shot?
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
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...

40. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 20 for both M and W

41. What are the guidelines for pap smear?
Persons with no known risk factors
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)
In adults with sustained BP > 135/80 mmHg

42. What is HI law for booster seat?

43. What is the schedule for rotavirus vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

44. 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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

45. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

46. How much vit D should adults > 50 take?
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart
Meningitis and Epiglottitis

47. Who should get shingles vaccine?
Adults > 60
1000 IU/day
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

48. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

49. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1200 mg/day
0.4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

50. Which children should use a semi-upright/forward facing carseat?
Women 55 - 79 yo
Smoking - Alcoholism
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
> 2 yo and less than 40 lbs