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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. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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
In adults with sustained BP > 135/80 mmHg
1000 mg/day

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
One dose at 12-15 mod - Booster at least 4-weeks after
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

3. What is the most important way to screen for CAD in an asymptomatic patients?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day
Forearm
HISTORY

4. When is intensive individualized home-based intervention recommended?
4 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
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
Persons with no known risk factors

5. How much calcium should adults (19 - 50) take?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
1300 mg/day

6. What can decrease fall in the elderly?
In adults with sustained BP > 135/80 mmHg
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
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
Exercise - Environmental hazard reduction - Close monitoring of medication

7. 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
1300 mg/day
Total cholesterol - FOBT
Rear facing

8. What is the schedule for DTap vaccine?
Women 55 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

9. When is area of induration > 5mm considered TB positive?
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
Rear facing
Breast CA - thromboembolic event - stroke and CAD

10. Who are at increased risk for adverse effect catching a flu?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Meningitis and Epiglottitis

11. What are some risk factors for CAD?
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...
Breast CA - thromboembolic event - stroke and CAD
4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. When is area of induration > 15 mm considered TB positive?
Exercise - Environmental hazard reduction - Close monitoring of medication
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

13. What type of illnesses does Hib vaccine prevent?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
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...

14. What is the schedule for Gardasil?
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. Which children should use a semi-upright/forward facing carseat?
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...
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo
> 2 yo and less than 40 lbs

16. What is the schedule for Hep B vaccine?
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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)

17. What are the guidelines for colon cancer screening?
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
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...
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

18. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

19. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day

20. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One time abdominal X-ray for all MALES who ever SMOKES
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

21. What are some safety issues you should counsel parents with young children?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...
0.4 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

22. When should pregnant women get a flu shot?
Femoral neck
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
During 2nd - 3rd trimester
In all W < 24 who are sexually active - In W > 24 with increased risk

23. Who should get Tdap vaccine and how often?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
Rear facing
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

24. What is the schedule for varicella vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
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...
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after

25. What is the USPSTF guideline for chlamydial screening?
To get IgA protection
In all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day

26. What kind of sunscreen SPF is recommended for sun protection?
2mo - 4 mo - 6mo and 12-15 mo
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo
During 2nd - 3rd trimester

27. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 IU/day
0.4 mg/day

28. What is the USPSTF guideline for DMT2 screening?
1200 mg/day
Meningitis and Epiglottitis
In adults with sustained BP > 135/80 mmHg
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

29. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
HISTORY
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1300 mg/day

30. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 mg/day

31. When should the meningococcal vaccine be given and to which group?
During 2nd - 3rd trimester
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
Rear facing

32. Measurement of which anatomic structure is best predictor for hip fracture?
When they are > 40 lbs and still less then 5'
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

33. How much calcium should adolescents (9 -18) take?
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

34. What is the schedule for MMR vaccine?
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck

35. What are the guidelines for visual screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo

36. What is the schedule for Hib vaccine?
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo - 6mo and 12-15 mo
1200 mg/day

37. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after

38. When should chest X-ray be used for screening?
NEVER
In adults with sustained BP > 135/80 mmHg
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years

39. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
> 2 yo and less than 40 lbs

40. When should Gardasil be given and for what purposes?
Total cholesterol - FOBT
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 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

41. In which group of patients should aspirin be given as primary prevention for stroke?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day
Women 55 - 79 yo
Forearm

42. What are the USPSTF guidelines for mammogram?
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
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication

43. How much vit D should adults > 50 take?
Stroke and DVT
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

44. How much folate should all women of child bearing age take?
0.4 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
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

45. In which group of patients should aspirin be given as primary prevention for MI?
Meningitis and Epiglottitis
Men 45 - 79 yo
1200 mg/day
Smoking - Alcoholism

46. 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
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
800 IU/ day

47. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)

48. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT
Women 55 - 79 yo

49. What kind of polio vaccine is preferred?
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

50. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
800 IU/ day