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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 kind of sunscreen SPF is recommended for sun protection?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
Exercise or physical therapy and vit D for patients > 65

2. What are the guidelines for pap smear?
Rear facing
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
One dose at 12-15 mod - Booster at least 4-weeks after

3. What is the USPSTF guideline for fall prevention in the elderly?
To get IgA protection
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
Exercise or physical therapy and vit D for patients > 65

4. In which group of patients should aspirin be given as primary prevention for MI?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 yo
Exercise or physical therapy and vit D for patients > 65

5. When is area of induration > 5mm considered TB positive?
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
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
> 2 yo and less than 40 lbs

6. What is the USPSTF guideline for DMT2 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
In adults with sustained BP > 135/80 mmHg
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

7. When should tetanus immunoglobulin be given?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Start at 20 for all M and W regardless of RFs
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

8. When should pregnant women get a flu shot?
Adults > 60
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
Forearm
During 2nd - 3rd trimester

9. What is the schedule for polio 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
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

10. What is the NCEP III guideline for cholesterol screening?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Start at 20 for all M and W regardless of RFs
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

11. What is the schedule for MMR vaccine?
1000 IU/day
Starts at 50 (recommends against starting at 40) and every 2 years
In all W < 24 who are sexually active - In W > 24 with increased risk
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

12. What is the schedule for Hep B vaccine?
0.4 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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

13. What is HI law for booster seat?

14. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1200 mg/day
4 mg/day
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
> 2 yo and less than 40 lbs

15. How much vit D should adults > 50 take?
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

16. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
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
4 mg/day
800 IU/ day

17. How much calcium should adults (19 - 50) take?
BP - Height - Weight
1000 mg/day
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

18. When should chest X-ray be used for screening?
NEVER
Start at 20 for all M and W regardless of RFs
Total cholesterol - FOBT
To get IgA protection

19. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

20. What type of illnesses does Hib vaccine prevent?
Breast CA - thromboembolic event - stroke and CAD
Start at 20 for all M and W regardless of RFs
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'

21. How much vit D should adults < 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
800 IU/ day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

22. 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
BP - Height - Weight
More than 15
Men 45 - 79 yo

23. At what age should women have DEXA scan?
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased 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
Women 55 - 79 yo

24. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Women 55 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

26. What is the schedule for rotavirus vaccine?
Rear facing
Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

27. Who should get shingles vaccine?
Adults > 60
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

28. Unopposed estrogen increases risks for what conditions?
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 - 26 yo - To prevent cervical cancer in W and anal cancer in M and genital warts - Protect against HPV type 11 - 16 and 18
Adults > 60
Stroke and DVT

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

30. How much calcium should adolescents (9 -18) take?
2mo - 4 mo - 6mo and 12-15 mo
1300 mg/day
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

31. What is the USPSTF guideline for chlamydial screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
In all W < 24 who are sexually active - In W > 24 with increased risk
BP - Height - Weight

32. Who should get Tdap vaccine and how often?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

33. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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...

34. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
Women 55 - 79 yo

35. What are the risks of combination HRT?
1000 IU/day
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day

36. What can decrease fall in the elderly?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day

37. What kind of car seat should children < 2 yo be placed in?
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication
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

38. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. How much flouride should non military children in the state of HI be given?
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

40. What are the guidelines for colon cancer screening?
Adults > 60
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
0.4 mg/day
65 (earlier if have increased risk factors)

41. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
4 mg/day

42. What are the guidelines for visual screening?
1300 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

43. How much folate should all women of child bearing age take?
0.4 mg/day
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65
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...

44. What are some risk factors for CAD?
One time abdominal X-ray for all MALES who ever SMOKES
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
Forearm

45. What is the schedule for Gardasil?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12 - 23 mo - 2 doses are to be given 6 mo apart
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

46. What is the schedule for Hib vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
Starts at 20 for both M and W
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

47. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Start at 20 for all M and W regardless of RFs

48. How much calcium should women > 50 take?
1200 mg/day
Starts at 20 for both M and W
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

49. In which group of patients should aspirin be given as primary prevention for stroke?
65 (earlier if have increased risk factors)
Women 55 - 79 yo
To get IgA protection
12 - 23 mo - 2 doses are to be given 6 mo apart

50. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
> 2 yo and less than 40 lbs
Persons with no known risk factors
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years