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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 tests are appropriate to order in an asymptomatic 57 yo male?
BP - Height - Weight
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
Every 5 years

2. How much folate should all women of child bearing age take?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Women 55 - 79 yo
0.4 mg/day
BP - Height - Weight

3. Some contraindications for aspirin
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Total cholesterol - FOBT
HISTORY

4. When is area of induration > 5mm considered TB positive?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
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

5. What are the guidelines for colon cancer screening?
Forearm
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
BP - Height - Weight

6. Measurement of which anatomic structure is best predictor for hip fracture?
> 2 yo and less than 40 lbs
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day

7. What are some safety issues you should counsel parents with young children?
Rear facing
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...
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 - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

8. How much calcium should adolescents (9 -18) take?
1000 mg/day
1000 IU/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
1300 mg/day

9. Who should get Tdap vaccine and how often?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
65 (earlier if have increased risk factors)
Starts at 20 for both M and W
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

10. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Femoral neck
Total cholesterol - FOBT

11. What is the most important way to screen for CAD in an asymptomatic patients?
Total cholesterol - FOBT
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
HISTORY
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. What are some risk factors for CAD?
Start at 20 for all M and W regardless of RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing

13. When can children sit in a booster seat?

14. What is the USPSTF guideline for DMT2 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg

15. What is the schedule for DTap vaccine?
During 2nd - 3rd trimester
Women 55 - 79 yo
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'

16. What type of illnesses does Hib vaccine prevent?
1000 IU/day
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
12 - 23 mo - 2 doses are to be given 6 mo apart

17. 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

18. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
NEVER
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception

19. At what age should women have DEXA scan?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

20. What is the schedule for varicella vaccine?
Femoral neck
4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
NEVER

21. In which group of patients should aspirin be given as primary prevention for MI?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men 45 - 79 yo
To get IgA protection
Total cholesterol - FOBT

22. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W

23. When is area of induration > 15 mm considered TB positive?
2mo - 4mo - 6-18 mo and 4-6 yrs
More than 15
HISTORY
Persons with no known risk factors

24. How much calcium should adults (19 - 50) take?
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
800 IU/ day
1000 mg/day

25. What is the schedule for Hep A vaccine?
Starts at 20 for both M and W
Children up to 7 yo and < 5' should be placed in a booster seat.
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

26. What is the USPSTF guideline for chlamydial screening?
Women 55 - 79 yo
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
Breast CA - thromboembolic event - stroke and CAD

27. What are the risks of combination HRT?
Starts at 20 for both M and W
Men 45 - 79 yo
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD

28. 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)
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
Starts at 20 for both M and W
Adults > 60

29. When should chest X-ray be used for screening?
NEVER
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...
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
Breast CA - thromboembolic event - stroke and CAD

30. What kind of car seat should children < 2 yo be placed in?
BP - Height - Weight
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing

31. How much calcium should women > 50 take?
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Total cholesterol - FOBT
1200 mg/day

32. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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 overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1300 mg/day

33. When should tetanus immunoglobulin be given?
During 2nd - 3rd trimester
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60

34. 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
NEVER
Exercise or physical therapy and vit D for patients > 65
When they are > 40 lbs and still less then 5'

35. What is the USPSTF guideline for fall prevention in the elderly?
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise or physical therapy and vit D for patients > 65
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

36. Who are at increased risk for adverse effect catching a flu?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

37. In which group of patients should aspirin be given as primary prevention for stroke?
HISTORY
Women 55 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

38. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
Smoking - Alcoholism
Persons with no known risk factors

39. What is the schedule for Hep B vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors

40. Who should get shingles vaccine?
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
Men 45 - 79 yo
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after

41. When should pregnant women get a flu shot?
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
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs

42. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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 or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What is the ADA guideline for DMT2 screening?
Femoral neck
Forearm
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

44. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In adults with sustained BP > 135/80 mmHg
More than 15
Stroke and DVT

45. When is area of induration > 10 mm considered TB positive?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
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

46. What is the schedule for polio 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)
HISTORY
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
2mo - 4mo - 6-18 mo and 4-6 yrs

47. What is the schedule for Hib vaccine?
1200 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)
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

48. What 3 things should always be done in an office visit?
Forearm
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day

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

50. What are 2 conditions that have been proven to be beneficial to screened for?
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
Total cholesterol - FOBT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo