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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. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Stroke and DVT
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
More than 15

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk

3. Who should get shingles vaccine?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
Adults > 60

4. What is the schedule for Hib vaccine?
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo - 6mo and 12-15 mo
12 - 23 mo - 2 doses are to be given 6 mo apart

5. 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
When they are > 40 lbs and still less then 5'
Exercise - Environmental hazard reduction - Close monitoring of medication
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

6. What type of illnesses does Hib vaccine prevent?
Every 5 years
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'
65 (earlier if have increased risk factors)

7. What is the NCEP III guideline for cholesterol screening?
2mo - 4 mo - 6mo and 12-15 mo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs
Persons with no known risk factors

8. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
65 (earlier if have increased risk factors)

9. 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
Starts at 50 (recommends against starting at 40) and every 2 years
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
Men 45 - 79 yo

10. What are the guidelines for visual screening?
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs

11. What is the ADA guideline for DMT2 screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
12 - 23 mo - 2 doses are to be given 6 mo apart

12. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 20 for both M and W
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
Starts at 50 (recommends against starting at 40) and every 2 years

13. What is HI law for booster seat?

14. When should chest X-ray be used for screening?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
> 2 yo and less than 40 lbs
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

15. What is the schedule for DTap vaccine?
0.4 mg/day
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What is the schedule for Hep A vaccine?
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm
Total cholesterol - FOBT

17. When is area of induration > 10 mm considered TB positive?
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
Adults > 60
BP - Height - Weight

18. Unopposed estrogen increases risks for what conditions?
65 (earlier if have increased risk factors)
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
Stroke and DVT
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...

19. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
Stroke and DVT
Women 55 - 79 yo
1200 mg/day

20. What are some risk factors for CAD?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Women 55 - 79 yo
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

21. Some contraindications for aspirin
2mo - 4mo - 6-18 mo and 4-6 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men 45 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

22. When is intensive individualized home-based intervention recommended?
More than 15
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
1300 mg/day
Women 55 - 79 yo

23. How much folate should all women of child bearing age take?
1000 IU/day
0.4 mg/day
65 (earlier if have increased risk factors)
Every 5 years

24. At what age should women have DEXA scan?
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)
Stroke and DVT

25. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 - 0.8 mg/day for 1 month prior to conception
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

26. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Starts at 20 for both M and W
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day

27. What kind of sunscreen SPF is recommended for sun protection?
Femoral neck
1200 mg/day
Men 45 - 79 yo
More than 15

28. Who should get Tdap vaccine and how often?
When they are > 40 lbs and still less then 5'
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
Femoral neck
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

29. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs

30. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 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
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

31. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
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...

32. What is the schedule for varicella vaccine?
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
Breast CA - thromboembolic event - stroke and CAD

33. What is the schedule for MMR 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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
12 - 23 mo - 2 doses are to be given 6 mo apart
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

34. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
When they are > 40 lbs and still less then 5'

35. How much vit D should adults < 50 take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
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

36. How much calcium should adults (19 - 50) take?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
BP - Height - Weight

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

38. When can children sit in a booster seat?

39. What are some RFs for DMT2?
1200 mg/day
Women 55 - 79 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)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

40. Measurement of which anatomic structure is best predictor for hip fracture?
> 2 yo and less than 40 lbs
1000 IU/day
Femoral neck
4 mg/day

41. When should Gardasil be given and for what purposes?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

42. What are some safety issues you should counsel parents with young children?
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...
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES

43. When should the meningococcal vaccine be given and to which group?
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs

44. What kind of polio vaccine is preferred?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo

45. How much fluoride should military children in HI be given?
One dose at 12-15 mod - Booster at least 4-weeks after
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 mg/day

46. How much calcium should adolescents (9 -18) take?
12 - 23 mo - 2 doses are to be given 6 mo apart
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
Total cholesterol - FOBT

47. What is the most important way to screen for CAD in an asymptomatic patients?
1000 IU/day
4 mg/day
HISTORY
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...

48. 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)
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
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

49. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1000 mg/day
Forearm
Start at 20 for all M and W regardless of RFs
Starts at 50 (recommends against starting at 40) and every 2 years

50. 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
Meningitis and Epiglottitis
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients