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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 3 things should always be done in an office visit?
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
Persons with no known risk factors
NEVER

2. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
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

3. What are 2 conditions that have been proven to be beneficial to screened for?
Total cholesterol - FOBT
1000 mg/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
Smoking - Alcoholism

4. What kind of car seat should children < 2 yo be placed in?
Rear facing
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis
Adults > 60

5. What is the schedule for rotavirus vaccine?
Start at 20 for all M and W regardless of RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years

6. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W
0.4 - 0.8 mg/day for 1 month prior to conception

7. At what age should women have DEXA scan?
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)

8. How much vit D should adults > 50 take?
4 mg/day
During 2nd - 3rd trimester
1000 IU/day
Stroke and DVT

9. What are the guidelines for visual screening?
One dose at 12-15 mod - Booster at least 4-weeks after
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day

10. How much calcium should adults (19 - 50) take?
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day

11. Measurement of which anatomic structure is best predictor for hip fracture?
During 2nd - 3rd trimester
Femoral neck
To get IgA protection
1300 mg/day

12. What is the schedule for varicella 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...
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 mg/day
Women 55 - 79 yo

13. Unopposed estrogen increases risks for what conditions?
1300 mg/day
Stroke and DVT
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight

14. 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
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT

15. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What kind of sunscreen SPF is recommended for sun protection?
More than 15
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

17. What are the guidelines for pap smear?
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
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)
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 take for planned pregnancy?
800 IU/ day
0.4 - 0.8 mg/day for 1 month prior to conception
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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. What are some risk factors for CAD?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

20. What are the guidelines for colon cancer screening?
1200 mg/day
Adults > 60
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
Starts at 50 (recommends against starting at 40) and every 2 years

21. What is the NCEP III guideline for cholesterol screening?
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
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

22. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Meningitis and Epiglottitis
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

23. When should chest X-ray be used for screening?
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60

24. When is intensive individualized home-based intervention recommended?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
1000 mg/day

25. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk

26. When is area of induration > 5mm considered TB positive?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

27. Who are at increased risk for adverse effect catching a flu?
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise - Environmental hazard reduction - Close monitoring of medication

28. What is the USPSTF guideline for fall prevention in the elderly?
Stroke and DVT
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise or physical therapy and vit D for patients > 65
NEVER

29. How much calcium should women > 50 take?
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs

30. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart

31. Who should get shingles vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day
Adults > 60
Meningitis and Epiglottitis

32. In which group of patients should aspirin be given as primary prevention for MI?
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
Exercise or physical therapy and vit D for patients > 65
In adults with sustained BP > 135/80 mmHg

33. What tests are appropriate to order in an asymptomatic 57 yo male?
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
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)
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

34. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

35. Who should get Tdap vaccine and how often?
When they are > 40 lbs and still less then 5'
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
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
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. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Total cholesterol - FOBT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

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

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38. How much flouride should non military children in the state of HI be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

39. What is USPSTF guideline for abdominal aortic aneurysm screening?
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES
0.4 - 0.8 mg/day for 1 month prior to conception

40. What is HI law for booster seat?

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41. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
4 mg/day
Rear facing
1300 mg/day

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...
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. Which children should use a semi-upright/forward facing carseat?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
> 2 yo and less than 40 lbs
BP - Height - Weight

44. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

45. When should Gardasil be given and for what purposes?
Stroke and DVT
Femoral neck
HISTORY
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

46. What is the schedule for Gardasil?
Start at 20 for all M and W regardless of RFs
800 IU/ day
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

47. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. What is the USPSTF guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Femoral neck

49. What are some RFs for DMT2?
Men 45 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

50. How much calcium should adolescents (9 -18) take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day
Stroke and DVT
To get IgA protection