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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 are some risk factors for CAD?
Starts at 20 for both M and W
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis
Rear facing

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
1000 mg/day

3. How much vit D should adults > 50 take?
Smoking - Alcoholism
1000 IU/day
0.4 mg/day
65 (earlier if have increased risk factors)

4. Who should get Tdap vaccine and how often?
Persons with no known risk factors
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
When they are > 40 lbs and still less then 5'
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

5. What is the USPSTF guideline for chlamydial screening?
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
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 up to 7 yo and < 5' should be placed in a booster seat.
In all W < 24 who are sexually active - In W > 24 with increased risk

6. When should chest X-ray be used for screening?
NEVER
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

7. Who should get shingles vaccine?
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

8. What kind of sunscreen SPF is recommended for sun protection?
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo
65 (earlier if have increased risk factors)

9. How much folate should all women of child bearing age take?
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD
HISTORY
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. If traveling to endemic areas - Why should one get a dose of live vaccine?
1300 mg/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
To get IgA protection
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

11. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
Starts at 20 for both M and W

12. Which children should use a semi-upright/forward facing carseat?
Men 45 - 79 yo
Total cholesterol - FOBT
1000 IU/day
> 2 yo and less than 40 lbs

13. How much calcium should adults (19 - 50) take?
NEVER
4 mg/day
1000 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

14. How much folate and for How long should a woman take for planned pregnancy?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception

15. What are the guidelines for visual screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

16. What is the NCEP III guideline for cholesterol screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Start at 20 for all M and W regardless of RFs

17. In which group of patients should aspirin be given as primary prevention for MI?
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk

18. What is the USPSTF guideline for DMT2 screening?
Men 45 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
In adults with sustained BP > 135/80 mmHg
1000 mg/day

19. Who are at increased risk for adverse effect catching a flu?
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)

20. In which group of patients should aspirin be given as primary prevention for stroke?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
Women 55 - 79 yo

21. What is the schedule for MMR vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

22. What is the schedule for varicella vaccine?
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after
Children up to 7 yo and < 5' should be placed in a booster seat.

23. Measurement of which anatomic structure is best predictor for hip fracture?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Femoral neck

24. When is intensive individualized home-based intervention recommended?
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
Rear facing
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

25. What is the schedule for Gardasil?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Men 45 - 79 yo
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

26. What is the schedule for Hep A vaccine?
Rear facing
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
Starts at 20 for both M and W

27. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
2mo - 4mo - 6-18 mo and 4-6 yrs
When they are > 40 lbs and still less then 5'
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

28. What is the USPSTF guideline for fall prevention in the elderly?
Femoral neck
Exercise or physical therapy and vit D for patients > 65
800 IU/ day
0.4 mg/day

29. What is the most important way to screen for CAD in an asymptomatic patients?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
HISTORY

30. What are some RFs for DMT2?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
During 2nd - 3rd trimester

31. How much flouride should non military children in the state of HI be given?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis

32. What are some safety issues you should counsel parents with young children?
Starts at 20 for both M and W
More than 15
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. How much calcium should women > 50 take?
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
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day

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

35. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
HISTORY
Starts at 20 for both M and W

36. What is the schedule for Hib vaccine?
Men 45 - 79 yo
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

37. 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
1000 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Stroke and DVT

38. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise - Environmental hazard reduction - Close monitoring of medication

39. What are the USPSTF guidelines for mammogram?
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD

40. What is the schedule for rotavirus vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

41. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W
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

42. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
Adults > 60
More than 15

43. When is area of induration > 10 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
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 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)
Exercise or physical therapy and vit D for patients > 65

44. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Women 55 - 79 yo
1000 IU/day

45. What is the schedule for Hep B vaccine?
Start at 20 for all M and W regardless of RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

46. Some contraindications for aspirin
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
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day

47. What kind of car seat should children < 2 yo be placed in?
In adults with sustained BP > 135/80 mmHg
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...
Rear facing

48. How often do asplenic patients receive pneumococcal vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65
Every 5 years

49. At what age should women have DEXA scan?
1000 mg/day
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
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

50. How much calcium should adolescents (9 -18) take?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo