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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 schedule for varicella vaccine?
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after

2. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
1000 mg/day
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...
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

3. How much calcium should adolescents (9 -18) take?
1300 mg/day
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
Start at 20 for all M and W regardless of RFs

4. When is area of induration > 10 mm considered TB positive?
Persons with no known risk factors
Rear facing
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

5. What are the risks of combination HRT?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
More than 15
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

6. When should chest X-ray be used for screening?
1000 IU/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
NEVER
Rear facing

7. How much fluoride should military children in HI be given?
Starts at 20 for both M and W
1300 mg/day
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Starts at 20 for both M and W
More than 15
Forearm
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

9. Who should get shingles vaccine?
Femoral neck
BP - Height - Weight
Adults > 60
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

10. How much vit D should adults < 50 take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
NEVER
800 IU/ day

11. In which group of patients should aspirin be given as primary prevention for stroke?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
When they are > 40 lbs and still less then 5'
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

12. 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
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
Forearm

13. What are the guidelines for visual screening?
Forearm
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

14. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Men 45 - 79 yo
800 IU/ day
Femoral neck

15. When should tetanus immunoglobulin be given?
To get IgA protection
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Every 5 years

16. What is the schedule for rotavirus vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
BP - Height - Weight
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children up to 7 yo and < 5' should be placed in a booster seat.

17. When is intensive individualized home-based intervention recommended?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

18. What are some risk factors for CAD?
Forearm
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
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

19. Which children should use a semi-upright/forward facing carseat?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Start at 20 for all M and W regardless of RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs

20. What is the schedule for polio vaccine?
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...
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
BP - Height - Weight
2mo - 4mo - 6-18 mo and 4-6 yrs

21. What is the schedule for Hep B vaccine?
Men 45 - 79 yo
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day

22. What are the guidelines for colon cancer screening?
When they are > 40 lbs and still less then 5'
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
4 mg/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)

23. How often do asplenic patients receive pneumococcal vaccine?
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)
Women 55 - 79 yo
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

24. How much vit D should adults > 50 take?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 IU/day

25. What 3 things should always be done in an office visit?
During 2nd - 3rd trimester
NEVER
BP - Height - Weight
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

26. 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)
When they are > 40 lbs and still less then 5'
Starts at 50 (recommends against starting at 40) and every 2 years
Men 45 - 79 yo

27. How much calcium should women > 50 take?
Children up to 7 yo and < 5' should be placed in a booster seat.
Stroke and DVT
1200 mg/day
During 2nd - 3rd trimester

28. How much folate should all women of child bearing age take?
0.4 mg/day
Adults > 60
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT

29. What is the USPSTF guideline for chlamydial screening?
0.4 - 0.8 mg/day for 1 month prior to conception
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
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

30. What is the NCEP III guideline for cholesterol screening?
1200 mg/day
0.4 mg/day
More than 15
Start at 20 for all M and W regardless of RFs

31. What are some RFs for DMT2?
> 2 yo and less than 40 lbs
1000 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)
Children up to 7 yo and < 5' should be placed in a booster seat.

32. What kind of sunscreen SPF is recommended for sun protection?
More than 15
> 2 yo and less than 40 lbs
To get IgA protection
Total cholesterol - FOBT

33. What kind of car seat should children < 2 yo be placed in?
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism
Rear facing
Forearm

34. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 20 for both M and W

35. What is USPSTF guideline for abdominal aortic aneurysm screening?
Persons with no known risk factors
One time abdominal X-ray for all MALES who ever SMOKES
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

36. When is area of induration > 5mm considered TB positive?
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
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

37. When is area of induration > 15 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

38. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

39. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
1200 mg/day
Smoking - Alcoholism

40. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Total cholesterol - FOBT

41. What are some safety issues you should counsel parents with young children?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 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
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...
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)

42. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

43. What is HI law for booster seat?

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44. What can decrease fall in the elderly?
Femoral neck
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

45. What type of illnesses does Hib vaccine prevent?
1000 IU/day
Men 45 - 79 yo
More than 15
Meningitis and Epiglottitis

46. In which group of patients should aspirin be given as primary prevention for MI?
Exercise or physical therapy and vit D for patients > 65
To get IgA protection
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

47. What is the most important way to screen for CAD in an asymptomatic patients?
When they are > 40 lbs and still less then 5'
HISTORY
Forearm
Persons with no known risk factors

48. Measurement of which anatomic structure is best predictor for hip fracture?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 mg/day
Femoral neck

49. How much calcium should adults (19 - 50) take?
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...
Every 5 years
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
1000 mg/day

50. How much folate and for How long should a woman take for planned pregnancy?
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4mo - 6-18 mo and 4-6 yrs