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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 3 things should always be done in an office visit?
Total cholesterol - FOBT
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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...

2. How much vit D should adults > 50 take?
In adults with sustained BP > 135/80 mmHg
1000 IU/day
> 2 yo and less than 40 lbs
Femoral neck

3. What is the most important way to screen for CAD in an asymptomatic patients?
Every 5 years
> 2 yo and less than 40 lbs
HISTORY
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

4. In which group of patients should aspirin be given as primary prevention for stroke?
Total cholesterol - FOBT
During 2nd - 3rd trimester
Women 55 - 79 yo
Stroke and DVT

5. What are some RFs for DMT2?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
More than 15
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

6. When should tetanus immunoglobulin be given?
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

7. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
BP - Height - Weight
Starts at 20 for both M and W
Total cholesterol - FOBT
NEVER

8. When should chest X-ray be used for 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
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER

9. How often do asplenic patients receive pneumococcal vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One time abdominal X-ray for all MALES who ever SMOKES

10. Who are at increased risk for adverse effect catching a flu?
Starts at 20 for both M and W
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
One time abdominal X-ray for all MALES who ever SMOKES

11. What are the guidelines for pap smear?
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)
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

12. What are the USPSTF guidelines for mammogram?
Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children up to 7 yo and < 5' should be placed in a booster seat.

13. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 mg/day
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

14. What is the USPSTF guideline for DMT2 screening?
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Meningitis and Epiglottitis

15. What are the risks of combination HRT?
Children up to 7 yo and < 5' should be placed in a booster seat.
In adults with sustained BP > 135/80 mmHg
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

16. When should pregnant women get a flu shot?
Forearm
During 2nd - 3rd trimester
1200 mg/day
Starts at 20 for both M and W

17. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 - 0.8 mg/day for 1 month prior to conception
1200 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

18. Which children should use a semi-upright/forward facing carseat?
Stroke and DVT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
> 2 yo and less than 40 lbs

19. When should Gardasil be given and for what purposes?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 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

20. What kind of sunscreen SPF is recommended for sun protection?
More than 15
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
> 2 yo and less than 40 lbs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

21. What tests are appropriate to order in an asymptomatic 57 yo male?
2mo - 4 mo - 6mo and 12-15 mo
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after
Total cholesterol - FOBT

22. What can decrease fall in the elderly?
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
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)

23. What is the USPSTF guideline for fall prevention in the elderly?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day
Exercise or physical therapy and vit D for patients > 65
800 IU/ day

24. What is the schedule for Gardasil?
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
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
Total cholesterol - FOBT

25. What is the schedule for DTap vaccine?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years

26. What are the guidelines for colon cancer screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

27. How much calcium should adolescents (9 -18) take?
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

28. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.
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...
> 2 yo and less than 40 lbs

29. How much folate should all women of child bearing age take?
To get IgA protection
BP - Height - Weight
0.4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

30. Who should get Tdap vaccine and how often?
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

31. What is the schedule for Hib vaccine?
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
Forearm
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day

32. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 mg/day
In adults with sustained BP > 135/80 mmHg

33. Some contraindications for aspirin
NEVER
More than 15
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

34. What type of illnesses does Hib vaccine prevent?
Men 45 - 79 yo
Meningitis and Epiglottitis
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

35. When can children sit in a booster seat?

36. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Rear facing
> 2 yo and less than 40 lbs
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

37. What is the schedule for rotavirus vaccine?
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

38. What is the schedule for polio vaccine?
Persons with no known risk factors
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. What is USPSTF guideline for abdominal aortic aneurysm screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES

40. When is intensive individualized home-based intervention recommended?
More than 15
Stroke and DVT
65 (earlier if have increased risk factors)
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

41. What is the schedule for MMR vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
When they are > 40 lbs and still less then 5'
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...
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

42. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
NEVER
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

43. What is the schedule for Hep A vaccine?
BP - Height - Weight
12 - 23 mo - 2 doses are to be given 6 mo apart
During 2nd - 3rd trimester
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

44. If traveling to endemic areas - Why should one get a dose of live vaccine?
More than 15
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

45. In which group of patients should aspirin be given as primary prevention for MI?
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
> 2 yo and less than 40 lbs
Exercise or physical therapy and vit D for patients > 65

46. How much vit D should adults < 50 take?
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
800 IU/ day

47. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day
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

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

49. How much calcium should adults (19 - 50) take?
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 - 4mo - 6-18 mo and 4-6 yrs
1000 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...

50. What are the guidelines for visual 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
> 2 yo and less than 40 lbs