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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 are the USPSTF guidelines for cholesterol screening in people with normal risks?
One time abdominal X-ray for all MALES who ever SMOKES
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...
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors

2. How much folate and for How long should a woman take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
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 - 0.8 mg/day for 1 month prior to conception
Persons with no known risk factors

3. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Rear facing
When they are > 40 lbs and still less then 5'
NEVER

4. What kind of sunscreen SPF is recommended for sun protection?
More than 15
NEVER
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk

5. How much calcium should adults (19 - 50) take?
1000 mg/day
1300 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1200 mg/day

6. How often do asplenic patients receive pneumococcal vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Every 5 years
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
Starts at 50 (recommends against starting at 40) and every 2 years

7. What is the schedule for Gardasil?
4 mg/day
65 (earlier if have increased risk factors)
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

8. 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...
1300 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
Persons with no known risk factors

9. In which group of patients should aspirin be given as primary prevention for stroke?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
Adults > 60
Breast CA - thromboembolic event - stroke and CAD

10. How much vit D should adults < 50 take?
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
800 IU/ day
Men 45 - 79 yo

11. What is the NCEP III guideline for cholesterol screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Start at 20 for all M and W regardless of RFs
Rear facing
BP - Height - Weight

12. What is the most important way to screen for CAD in an asymptomatic patients?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
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
One dose at 12-15 mod - Booster at least 4-weeks after

13. What is the USPSTF guideline for chlamydial screening?
Meningitis and Epiglottitis
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

14. 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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

15. What is the schedule for Hep A vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart
During 2nd - 3rd trimester
Adults > 60

16. 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
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo

17. How much calcium should women > 50 take?
1200 mg/day
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

18. Who should get shingles vaccine?
Adults > 60
1000 IU/day
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

19. What is the schedule for Hib vaccine?
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4 mo - 6mo and 12-15 mo

20. When is area of induration > 5mm considered TB positive?
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 > 60
During 2nd - 3rd trimester

21. What is the schedule for MMR vaccine?
800 IU/ 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
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

22. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
1200 mg/day
Every 5 years

23. What is the USPSTF guideline for DMT2 screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In adults with sustained BP > 135/80 mmHg
4 mg/day

24. Unopposed estrogen increases risks for what conditions?
NEVER
Stroke and DVT
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

25. What 3 things should always be done in an office visit?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES

26. What is the USPSTF guideline for fall prevention in the elderly?
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
1000 IU/day
Exercise or physical therapy and vit D for patients > 65

27. In which group of patients should aspirin be given as primary prevention for MI?
Rear facing
0.4 mg/day
1200 mg/day
Men 45 - 79 yo

28. What are the risks of combination HRT?
65 (earlier if have increased risk factors)
2mo - 4mo - 6-18 mo and 4-6 yrs
When they are > 40 lbs and still less then 5'
Breast CA - thromboembolic event - stroke and CAD

29. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
Forearm
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 can decrease fall in the elderly?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

31. Measurement of which anatomic structure is best predictor for hip fracture?
Meningitis and Epiglottitis
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

32. When is area of induration > 10 mm considered TB positive?
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs
NEVER
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

33. 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication

34. Some contraindications for aspirin
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Rear facing
1000 IU/day

35. What is the schedule for DTap vaccine?
Start at 20 for all M and W regardless of 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In adults with sustained BP > 135/80 mmHg

36. 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
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD

37. When is area of induration > 15 mm considered TB positive?
65 (earlier if have increased risk factors)
Persons with no known risk factors
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo

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

39. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1300 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
Forearm

40. When should chest X-ray be used for screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60
NEVER
1000 mg/day

41. What kind of car seat should children < 2 yo be placed in?
0.4 mg/day
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing

42. How much calcium should adolescents (9 -18) take?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
1300 mg/day
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)

43. What are the USPSTF guidelines for mammogram?
Start at 20 for all M and W regardless of RFs
Forearm
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

44. When should pregnant women get a flu shot?
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
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

45. How much folate should all women of child bearing age take?
Femoral neck
Meningitis and Epiglottitis
0.4 mg/day
Forearm

46. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1300 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

47. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
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...
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'

48. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
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

49. What are the guidelines for colon cancer screening?
Men 45 - 79 yo
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

50. What are the guidelines for visual 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
Men 45 - 79 yo
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo