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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 3 things should always be done in an office visit?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
BP - Height - Weight
1200 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

2. Who should get Tdap vaccine and how often?
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
1000 IU/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

3. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...
More than 15
1000 IU/day

4. What is the USPSTF guideline for DMT2 screening?
To get IgA protection
Smoking - Alcoholism
Men 45 - 79 yo
In adults with sustained BP > 135/80 mmHg

5. How much vit D should adults < 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day

6. When should chest X-ray be used for screening?
NEVER
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
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

7. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Femoral neck
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In all W < 24 who are sexually active - In W > 24 with increased risk

8. In which group of patients should aspirin be given as primary prevention for stroke?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Women 55 - 79 yo
Starts at 20 for both M and W

9. How much flouride should non military children in the state of HI be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

10. What are the risks of combination HRT?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Women 55 - 79 yo
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD

11. When should tetanus immunoglobulin be given?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD

12. How much calcium should adolescents (9 -18) take?
Starts at 20 for both M and W
Stroke and DVT
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

13. When is intensive individualized home-based intervention recommended?
1000 IU/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
Stroke and DVT
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

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

15. What is the schedule for Hib vaccine?
Women 55 - 79 yo
Total cholesterol - FOBT
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo

16. What kind of polio vaccine is preferred?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

17. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day
Starts at 20 for both M and W

18. Which children should use a semi-upright/forward facing carseat?
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
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
2mo - 4mo - 6-18 mo and 4-6 yrs

19. When should pregnant women get a flu shot?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 20 for both M and W
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)
During 2nd - 3rd trimester

20. What type of illnesses does Hib vaccine prevent?
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis

21. How much fluoride should military children in HI be given?
Start at 20 for all M and W regardless of RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

22. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15
Meningitis and Epiglottitis

23. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

24. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

25. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
HISTORY

26. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Adults > 60
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

27. What is the schedule for rotavirus vaccine?
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 and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day
65 (earlier if have increased risk factors)

28. When is area of induration > 5mm considered TB positive?
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 < 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
One dose at 12-15 mod - Booster at least 4-weeks after

29. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
1300 mg/day
Persons with no known risk factors

30. What are the guidelines for pap smear?
During 2nd - 3rd trimester
Children up to 7 yo and < 5' should be placed in a booster seat.
One dose at 12-15 mod - Booster at least 4-weeks after
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)

31. When should the meningococcal vaccine be given and to which group?
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day

32. What is the schedule for varicella vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

33. What kind of car seat should children < 2 yo be placed in?
Rear facing
Stroke and DVT
Starts at 20 for both M and W
Every 5 years

34. If traveling to endemic areas - Why should one get a dose of live vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection
800 IU/ day

35. What are some RFs for DMT2?
2mo - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Every 5 years

36. What are some risk factors for CAD?
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs

37. What is the schedule for Gardasil?
Exercise or physical therapy and vit D for patients > 65
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
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

38. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception
When they are > 40 lbs and still less then 5'

39. What kind of sunscreen SPF is recommended for sun protection?
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

40. At what age should women have DEXA scan?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
Rear facing

41. What are the USPSTF guidelines for mammogram?
Rear facing
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 years

42. How much calcium should adults (19 - 50) take?
800 IU/ 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 mg/day

43. When is area of induration > 10 mm considered TB positive?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
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

44. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
HISTORY
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception

45. In which group of patients should aspirin be given as primary prevention for MI?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
During 2nd - 3rd trimester
Men 45 - 79 yo

46. When can children sit in a booster seat?

47. How much calcium should women > 50 take?
Forearm
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
1200 mg/day

48. What is the schedule for Hep A vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
Starts at 20 for both M and W
12 - 23 mo - 2 doses are to be given 6 mo apart

49. What are the guidelines for visual screening?
Men 45 - 79 yo
Total cholesterol - FOBT
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs

50. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day