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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 are at increased risk for adverse effect catching a flu?
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

2. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Breast CA - thromboembolic event - stroke and CAD
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)

3. Who should get shingles vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
4 mg/day
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception

4. How much calcium should adults (19 - 50) take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after

5. 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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
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

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

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7. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
HISTORY
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk

8. What is the schedule for Hep A vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

9. What are the guidelines for colon cancer 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
1000 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
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. What is the schedule for rotavirus vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

11. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
Starts at 20 for both M and W
1200 mg/day

12. How much vit D should adults > 50 take?
Women 55 - 79 yo
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

13. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
In adults with sustained BP > 135/80 mmHg
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
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day

14. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day

15. What is HI law for booster seat?

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16. Who should get Tdap vaccine and how often?
Meningitis and Epiglottitis
BP - Height - Weight
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

17. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

18. When should chest X-ray be used for screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Total cholesterol - FOBT
NEVER
When they are > 40 lbs and still less then 5'

19. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

20. What is the schedule for MMR vaccine?
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 mg/day
Starts at 20 for both M and W

21. Unopposed estrogen increases risks for what conditions?
800 IU/ day
Stroke and DVT
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

22. How much calcium should adolescents (9 -18) take?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 mg/day
During 2nd - 3rd trimester
More than 15

23. What is the schedule for Gardasil?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Meningitis and Epiglottitis

24. What are some risk factors for CAD?
1200 mg/day
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children up to 7 yo and < 5' should be placed in a booster seat.

25. What kind of polio vaccine is preferred?
NEVER
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD

26. What are some safety issues you should counsel parents with young children?
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...
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

27. What kind of car seat should children < 2 yo be placed in?
Rear facing
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk

28. How often do asplenic patients receive pneumococcal vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Every 5 years
When they are > 40 lbs and still less then 5'
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)

29. When should tetanus immunoglobulin be given?
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

30. 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
Start at 20 for all M and W regardless of RFs
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

31. 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
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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

32. When can children sit in a booster seat?

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33. How much folate should all women of child bearing age take?
1000 mg/day
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart

34. Which children should use a semi-upright/forward facing carseat?
Children up to 7 yo and < 5' should be placed in a booster seat.
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

35. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
To get IgA protection
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)

36. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

37. When is area of induration > 15 mm considered TB positive?
BP - Height - Weight
Exercise or physical therapy and vit D for patients > 65
Persons with no known risk factors
1000 IU/day

38. What kind of sunscreen SPF is recommended for sun protection?
0.4 - 0.8 mg/day for 1 month prior to conception
800 IU/ day
Starts at 50 (recommends against starting at 40) and every 2 years
More than 15

39. What is the schedule for DTap vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
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

40. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD
0.4 - 0.8 mg/day for 1 month prior to conception
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

41. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication

42. What is the schedule for Hep B vaccine?
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
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

43. How much calcium should women > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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...
NEVER
1200 mg/day

44. How much vit D should adults < 50 take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Breast CA - thromboembolic event - stroke and CAD
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

45. What is the most important way to screen for CAD in an asymptomatic patients?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER
HISTORY
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...

46. When should Gardasil be given and for what purposes?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

47. What tests are appropriate to order in an asymptomatic 57 yo male?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
Total cholesterol - FOBT

48. What is the schedule for Hib vaccine?
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
During 2nd - 3rd trimester
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo

49. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Preschool children : 3-4 yo - Elderly patients: > 65 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
Smoking - Alcoholism

50. How much flouride should non military children in the state of HI be given?
Children up to 7 yo and < 5' should be placed in a booster seat.
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
NEVER
One time abdominal X-ray for all MALES who ever SMOKES