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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 is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One time abdominal X-ray for all MALES who ever SMOKES
BP - Height - Weight
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. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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
In adults with sustained BP > 135/80 mmHg

3. What is the schedule for Hib vaccine?
Meningitis and Epiglottitis
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo - 6mo and 12-15 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

4. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

5. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY

6. When is intensive individualized home-based intervention recommended?
4 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
Women 55 - 79 yo
When they are > 40 lbs and still less then 5'

7. What are 2 conditions that have been proven to be beneficial to screened for?
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 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

8. When can children sit in a booster seat?

9. How much fluoride should military children in HI be given?
Meningitis and Epiglottitis
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

10. At what age should women have DEXA scan?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
65 (earlier if have increased risk factors)

11. 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)
One dose at 12-15 mod - Booster at least 4-weeks after
1000 IU/day
0.4 mg/day

12. What is the schedule for Hep A vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)
12 - 23 mo - 2 doses are to be given 6 mo apart

13. What are the guidelines for visual screening?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
65 (earlier if have increased risk factors)
Adults > 60

14. In which group of patients should aspirin be given as primary prevention for MI?
800 IU/ day
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 up to 7 yo and < 5' should be placed in a booster seat.
Men 45 - 79 yo

15. How much calcium should adults (19 - 50) take?
NEVER
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)
1000 mg/day
Meningitis and Epiglottitis

16. What are the guidelines for colon cancer screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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.
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

17. 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
Smoking - Alcoholism
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

18. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W

19. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Rear facing
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

20. When should chest X-ray be used for screening?
Breast CA - thromboembolic event - stroke and CAD
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
NEVER
65 (earlier if have increased risk factors)

21. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day

22. What kind of car seat should children < 2 yo be placed in?
Persons with no known risk factors
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing
Starts at 50 (recommends against starting at 40) and every 2 years

23. What is the schedule for MMR vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
Children up to 7 yo and < 5' should be placed in a booster seat.
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

24. How much vit D should adults < 50 take?
Rear facing
Smoking - Alcoholism
800 IU/ 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

25. How much calcium should adolescents (9 -18) take?
Men 45 - 79 yo
1300 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
4 mg/day

26. What are some safety issues you should counsel parents with young children?
Femoral neck
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
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 are the 4 main groups of people who are candidates for pneumococcal vaccine?

28. 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
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
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)
One time abdominal X-ray for all MALES who ever SMOKES

29. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)

30. Who should get shingles vaccine?
Every 5 years
Stroke and DVT
Adults > 60
To get IgA protection

31. What kind of sunscreen SPF is recommended for sun protection?
NEVER
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
Women 55 - 79 yo

32. How much flouride should non military children in the state of HI be given?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - 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
1000 mg/day

33. What is HI law for booster seat?

34. What type of illnesses does Hib vaccine prevent?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

35. What are the USPSTF guidelines for mammogram?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years

36. When is area of induration > 5mm considered TB positive?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

37. What is the schedule for varicella vaccine?
Rear facing
Breast CA - thromboembolic event - stroke and CAD
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

38. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight

39. How much calcium should women > 50 take?
1000 mg/day
1200 mg/day
Starts at 20 for both M and W
1300 mg/day

40. How much folate should all women of child bearing age take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 mg/day
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.

41. When should pregnant women get a flu shot?
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

42. What 3 things should always be done in an office visit?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years

43. What is the schedule for polio vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4mo - 6-18 mo and 4-6 yrs

44. What kind of polio vaccine is preferred?
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 20 for both M and W

46. What are some RFs for DMT2?
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
800 IU/ 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)

47. When is area of induration > 15 mm considered TB positive?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Persons with no known risk factors
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

48. What is the USPSTF guideline for fall prevention in the elderly?
Women 55 - 79 yo
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
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT

49. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
BP - Height - Weight

50. What is the NCEP III guideline for cholesterol 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
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)
Start at 20 for all M and W regardless of RFs