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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. Who are at increased risk for adverse effect catching a flu?
More than 15
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

2. How much calcium should adolescents (9 -18) take?
Stroke and DVT
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
1300 mg/day

3. Measurement of which anatomic structure is best predictor for hip fracture?
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck
Start at 20 for all M and W regardless of RFs

4. What is the schedule for DTap vaccine?
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

6. 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
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
To get IgA protection

7. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm

8. When should the meningococcal vaccine be given and to which group?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men 45 - 79 yo
Women 55 - 79 yo

9. In which group of patients should aspirin be given as primary prevention for MI?
BP - Height - Weight
Femoral neck
HISTORY
Men 45 - 79 yo

10. When is area of induration > 10 mm considered TB positive?
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
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
Start at 20 for all M and W regardless of RFs

11. What are the risks of combination HRT?
0.4 mg/day
To get IgA protection
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day

12. How often do asplenic patients receive pneumococcal vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Every 5 years
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)

13. How much folate and for How long should a woman take for planned pregnancy?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
1000 IU/day

14. How much calcium should women > 50 take?
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
1200 mg/day
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES

15. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
More than 15

16. What kind of polio vaccine is preferred?
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...
One time abdominal X-ray for all MALES who ever SMOKES
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years

17. What is the NCEP III guideline for cholesterol screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

18. How much fluoride should military children in HI be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

19. 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...
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day

20. What is the schedule for varicella vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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)
Start at 20 for all M and W regardless of RFs

21. What 3 things should always be done in an office visit?
BP - Height - Weight
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
65 (earlier if have increased risk factors)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

22. What is the schedule for Gardasil?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs

23. What kind of sunscreen SPF is recommended for sun protection?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
More than 15

24. When is area of induration > 15 mm considered TB positive?
Starts at 50 (recommends against starting at 40) and every 2 years
Persons with no known risk factors
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

25. What is the USPSTF guideline for chlamydial screening?
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Adults > 60

26. At what age should women have DEXA scan?
1300 mg/day
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart
Total cholesterol - FOBT

27. What is the schedule for Hib vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
NEVER

28. What are the USPSTF guidelines for mammogram?
Start at 20 for all M and W regardless of RFs
1300 mg/day
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years

29. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.

30. How much vit D should adults < 50 take?
Adults > 60
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Forearm
800 IU/ day

31. What can decrease fall in the elderly?
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day

32. Who should get shingles vaccine?
Adults > 60
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

33. What tests are appropriate to order in an asymptomatic 57 yo male?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
Breast CA - thromboembolic event - stroke and CAD
Total cholesterol - FOBT

34. What is the USPSTF guideline for DMT2 screening?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In adults with sustained BP > 135/80 mmHg

35. When should Gardasil be given and for what purposes?
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
Persons with no known risk factors
4 mg/day
Forearm

36. What is the schedule for rotavirus vaccine?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
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

37. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One time abdominal X-ray for all MALES who ever SMOKES

38. What type of illnesses does Hib vaccine prevent?
Stroke and DVT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Meningitis and Epiglottitis

39. How much folate should all women of child bearing age take?
0.4 mg/day
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester

40. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
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
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

41. When should pregnant women get a flu shot?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
During 2nd - 3rd trimester
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

42. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
Rear facing
Women 55 - 79 yo

43. When can children sit in a booster seat?

44. Who should get Tdap vaccine and how often?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

45. What are 2 conditions that have been proven to be beneficial to screened for?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise or physical therapy and vit D for patients > 65
Smoking - Alcoholism

46. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 20 for both M and W
Every 5 years

47. When is area of induration > 5mm considered TB positive?
One dose at 12-15 mod - Booster at least 4-weeks after
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
0.4 - 0.8 mg/day for 1 month prior to conception
In adults with sustained BP > 135/80 mmHg

48. What is the most important way to screen for CAD in an asymptomatic patients?
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
Exercise - Environmental hazard reduction - Close monitoring of medication

49. When should chest X-ray be used for screening?
Starts at 20 for both M and W
Forearm
NEVER
Start at 20 for all M and W regardless of RFs

50. What is the USPSTF guideline for fall prevention in the elderly?
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
Exercise or physical therapy and vit D for patients > 65
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