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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 type of illnesses does Hib vaccine prevent?
Femoral neck
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
HISTORY
Meningitis and Epiglottitis

2. How much fluoride should military children in HI be given?
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck

3. What is the USPSTF guideline for fall prevention in the elderly?
One time abdominal X-ray for all MALES who ever SMOKES
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...
BP - Height - Weight
Exercise or physical therapy and vit D for patients > 65

4. What are some risk factors for CAD?
Start at 20 for all M and W regardless of RFs
Forearm
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

5. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
One time abdominal X-ray for all MALES who ever SMOKES
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

6. What tests are appropriate to order in an asymptomatic 57 yo male?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

7. What is HI law for booster seat?

8. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
Rear facing

9. What kind of car seat should children < 2 yo be placed in?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing

10. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
One time abdominal X-ray for all MALES who ever SMOKES

11. What is the schedule for varicella vaccine?
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
NEVER

12. What are the USPSTF guidelines for mammogram?
Every 5 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
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years

13. What are the guidelines for colon cancer screening?
Women 55 - 79 yo
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
Children up to 7 yo and < 5' should be placed in a booster seat.
Men 45 - 79 yo

14. Some contraindications for aspirin
NEVER
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise - Environmental hazard reduction - Close monitoring of medication
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

15. How much calcium should women > 50 take?
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day
Persons with no known risk factors

16. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Stroke and DVT
Smoking - Alcoholism

17. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

18. When is area of induration > 10 mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Meningitis and Epiglottitis
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
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

19. What is the schedule for DTap vaccine?
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/day

20. When should chest X-ray be used for screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65
NEVER

21. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
1300 mg/day
Persons with no known risk factors

22. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
800 IU/ day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Women 55 - 79 yo

23. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
1000 IU/day

24. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

25. Who should get shingles vaccine?
Men 45 - 79 yo
Adults > 60
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo

26. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day
Every 5 years
Persons with no known risk factors

27. How much flouride should non military children in the state of HI be given?
4 mg/day
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

28. When should the meningococcal vaccine be given and to which group?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day

29. How much calcium should adults (19 - 50) take?
Rear facing
1000 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
Exercise or physical therapy and vit D for patients > 65

30. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Femoral neck
Exercise or physical therapy and vit D for patients > 65
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

31. What are the guidelines for visual screening?
0.4 mg/day
1000 IU/day
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

33. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Stroke and DVT
1000 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
To get IgA protection

34. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 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...
Adults > 60

35. What is USPSTF guideline for abdominal aortic aneurysm screening?
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
To get IgA protection
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

36. How much vit D should adults > 50 take?
1000 IU/day
To get IgA protection
NEVER
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

37. When should tetanus immunoglobulin be given?
To get IgA protection
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 IU/day
NEVER

38. Which children should use a semi-upright/forward facing carseat?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
HISTORY
> 2 yo and less than 40 lbs

39. What are some safety issues you should counsel parents with young children?
2mo - 4mo - 6-18 mo and 4-6 yrs
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...
2mo - 4 mo - 6mo and 12-15 mo
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

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

41. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15

42. How much folate should all women of child bearing age take?
During 2nd - 3rd trimester
Men 45 - 79 yo
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. How much calcium should adolescents (9 -18) take?
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
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1300 mg/day

44. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

45. Who are at increased risk for adverse effect catching a flu?
Femoral neck
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
Stroke and DVT

46. Unopposed estrogen increases risks for what conditions?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Stroke and DVT
Starts at 20 for both M and W
Exercise - Environmental hazard reduction - Close monitoring of medication

47. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
When they are > 40 lbs and still less then 5'
To get IgA protection

48. What is the USPSTF guideline for DMT2 screening?
0.4 - 0.8 mg/day for 1 month prior to conception
In adults with sustained BP > 135/80 mmHg
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

49. What is the ADA guideline for DMT2 screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
HISTORY

50. When is intensive individualized home-based intervention recommended?
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
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy