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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 ADA guideline for DMT2 screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more 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
0.4 mg/day

2. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
Total cholesterol - FOBT
NEVER

3. When is area of induration > 10 mm considered TB positive?
Meningitis and Epiglottitis
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
Starts at 50 (recommends against starting at 40) and every 2 years
1300 mg/day

4. How often do asplenic patients receive pneumococcal vaccine?
Every 5 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
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

5. When should tetanus immunoglobulin be given?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...
Total cholesterol - FOBT

6. How much calcium should adults (19 - 50) take?
1000 mg/day
To get IgA protection
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

7. What are some RFs for DMT2?
During 2nd - 3rd trimester
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Forearm
4 mg/day

8. Who are at increased risk for adverse effect catching a flu?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Persons with no known risk factors

9. What can decrease fall in the elderly?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo
When they are > 40 lbs and still less then 5'

10. What is the schedule for varicella vaccine?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo

11. When can children sit in a booster seat?

12. What is the schedule for MMR vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise or physical therapy and vit D for patients > 65
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

13. Who should get shingles vaccine?
More than 15
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Adults > 60
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)

14. What are some safety issues you should counsel parents with young children?
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
Breast CA - thromboembolic event - stroke and CAD
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...
Start at 20 for all M and W regardless of RFs

15. What is the USPSTF guideline for chlamydial screening?
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 - 0.8 mg/day for 1 month prior to conception
Total cholesterol - FOBT

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

17. How much folate and for How long should a woman take for planned pregnancy?
800 IU/ day
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise - Environmental hazard reduction - Close monitoring of medication

18. Measurement of which anatomic structure is best predictor for hip fracture?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
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...
Femoral neck

19. What is the schedule for Hep B vaccine?
> 2 yo and less than 40 lbs
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...
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

20. Unopposed estrogen increases risks for what conditions?
Total cholesterol - FOBT
Stroke and DVT
Starts at 20 for both M and W
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

21. Some contraindications for aspirin
1000 mg/day
Men 45 - 79 yo
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

22. How much calcium should adolescents (9 -18) take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

23. What is the NCEP III guideline for cholesterol screening?
One dose at 12-15 mod - Booster at least 4-weeks after
Start at 20 for all M and W regardless of RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

24. What are the guidelines for colon cancer screening?
65 (earlier if have increased risk factors)
Rear facing
Starts at 50 (recommends against starting at 40) and every 2 years
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

25. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
> 2 yo and less than 40 lbs

26. 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
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
1200 mg/day

27. What are the guidelines for pap smear?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day
Smoking - Alcoholism
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)

28. Who should get Tdap vaccine and how often?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Stroke and DVT
Preschool children : 3-4 yo - Elderly patients: > 65 yo

29. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
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)

30. What is the USPSTF guideline for DMT2 screening?
Forearm
Children up to 7 yo and < 5' should be placed in a booster seat.
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg

31. When should chest X-ray be used for screening?
BP - Height - Weight
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)
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years

32. What is HI law for booster seat?

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

34. What is the schedule for DTap vaccine?
> 2 yo and less than 40 lbs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo

35. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

36. What kind of sunscreen SPF is recommended for sun protection?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

37. What is the schedule for Hep A vaccine?
Adults > 60
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
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. What tests are appropriate to order in an asymptomatic 57 yo male?
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.

39. What are 2 conditions that have been proven to be beneficial to screened for?
Femoral neck
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD
Forearm

40. What are the guidelines for visual screening?
1000 IU/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...
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

41. At what age should women have DEXA scan?
2mo - 4 mo - 6mo and 12-15 mo
More than 15
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
65 (earlier if have increased risk factors)

42. What is the schedule for rotavirus vaccine?
> 2 yo and less than 40 lbs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day
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

43. How much flouride should non military children in the state of HI be given?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 mg/day
Smoking - Alcoholism
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

44. 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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

45. How much vit D should adults < 50 take?
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
800 IU/ day
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

46. What kind of car seat should children < 2 yo be placed in?
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In adults with sustained BP > 135/80 mmHg
More than 15

47. In which group of patients should aspirin be given as primary prevention for stroke?
1300 mg/day
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

48. How much calcium should women > 50 take?
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
1200 mg/day
NEVER

49. What are the risks of combination HRT?
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD
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

50. How much fluoride should military children in HI be given?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Meningitis and Epiglottitis