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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. Who should get Tdap vaccine and how often?
Total cholesterol - FOBT
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...
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/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

2. What 3 things should always be done in an office visit?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
BP - Height - Weight
Femoral neck
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

3. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
To get IgA protection
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

4. 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
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 - 6mo and 12-15 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

5. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children up to 7 yo and < 5' should be placed in a booster seat.

6. What can decrease fall in the elderly?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
Total cholesterol - FOBT
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

7. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
BP - Height - Weight
> 2 yo and less than 40 lbs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

8. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
Rear facing
Start at 20 for all M and W regardless of RFs

9. What is the schedule for MMR vaccine?
To get IgA protection
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...
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

10. How much vit D should adults < 50 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
800 IU/ day
During 2nd - 3rd trimester
Breast CA - thromboembolic event - stroke and CAD

11. How much folate should all women of child bearing age take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4 mo - 6mo and 12-15 mo

12. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Femoral neck

13. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day

14. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication

15. What is the ADA guideline for DMT2 screening?
0.4 - 0.8 mg/day for 1 month prior to conception
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
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...

16. What are the USPSTF guidelines for mammogram?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 50 (recommends against starting at 40) and every 2 years
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

17. What is the schedule for Gardasil?
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

18. Some contraindications for aspirin
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
Women 55 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism

19. In which group of patients should aspirin be given as primary prevention for stroke?
Exercise - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

20. What kind of car seat should children < 2 yo be placed in?
Rear facing
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo - 6mo and 12-15 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

22. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
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
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...

23. Who are at increased risk for adverse effect catching a flu?
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)
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
0.4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

24. What are the risks of combination HRT?
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
Total cholesterol - FOBT

25. How much calcium should adults (19 - 50) take?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. When should pregnant women get a flu shot?
In adults with sustained BP > 135/80 mmHg
During 2nd - 3rd trimester
0.4 mg/day
Adults > 60

27. When is intensive individualized home-based intervention recommended?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
To get IgA protection
Meningitis and Epiglottitis
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

28. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

29. How much calcium should women > 50 take?
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

30. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
Exercise - Environmental hazard reduction - Close monitoring of medication

31. If traveling to endemic areas - Why should one get a dose of live vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
To get IgA protection

32. When should Gardasil be given and for what purposes?
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
Forearm
Femoral neck

33. How much calcium should adolescents (9 -18) take?
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
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

34. What is the schedule for polio vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2mo - 4mo - 6-18 mo and 4-6 yrs

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

36. Which children should use a semi-upright/forward facing carseat?
> 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

37. How much fluoride should military children in HI be given?
1000 IU/day
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis

38. What are the guidelines for colon cancer screening?
4 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
> 2 yo and less than 40 lbs
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...

39. How much vit D should adults > 50 take?
In adults with sustained BP > 135/80 mmHg
Stroke and DVT
1000 IU/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

40. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Every 5 years
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...

41. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
12 - 23 mo - 2 doses are to be given 6 mo apart

42. What is the schedule for rotavirus vaccine?
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
Women 55 - 79 yo
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 USPSTF guideline for abdominal aortic aneurysm screening?
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
One time abdominal X-ray for all MALES who ever SMOKES
Total cholesterol - FOBT

44. What are the guidelines for pap smear?
Forearm
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)
> 2 yo and less than 40 lbs
2mo - 4 mo - 6mo and 12-15 mo

45. What is the schedule for varicella vaccine?
Women 55 - 79 yo
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
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication

46. What tests are appropriate to order in an asymptomatic 57 yo male?
1200 mg/day
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

47. When should chest X-ray be used for screening?
NEVER
2mo - 4 mo - 6mo and 12-15 mo
More than 15
To get IgA protection

48. What is HI law for booster seat?

49. What is the schedule for Hep A vaccine?
Smoking - Alcoholism
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
12 - 23 mo - 2 doses are to be given 6 mo apart

50. Who should get shingles vaccine?
NEVER
Adults > 60
> 2 yo and less than 40 lbs
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