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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. If traveling to endemic areas - Why should one get a dose of live vaccine?
Femoral neck
1200 mg/day
To get IgA protection
Starts at 50 (recommends against starting at 40) and every 2 years

2. When should chest X-ray be used for screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

3. 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
0.4 mg/day
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD

4. Who are at increased risk for adverse effect catching a flu?
1200 mg/day
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
65 (earlier if have increased risk factors)

5. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
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
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

6. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
1200 mg/day
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 years

7. What is the USPSTF guideline for fall prevention in the elderly?
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
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)

8. What is the schedule for polio vaccine?
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 - 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
Women 55 - 79 yo

9. What is the most important way to screen for CAD in an asymptomatic patients?
12 - 23 mo - 2 doses are to be given 6 mo apart
To get IgA protection
HISTORY
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

10. How much vit D should adults < 50 take?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
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

11. 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
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

12. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
NEVER
800 IU/ day

13. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
To get IgA protection

14. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
800 IU/ day
Starts at 20 for both M and W
1300 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

15. What is the NCEP III guideline for cholesterol screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight
1300 mg/day
Start at 20 for all M and W regardless of RFs

16. What is the schedule for rotavirus vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - 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

17. When should tetanus immunoglobulin be given?
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)
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

18. How much calcium should adults (19 - 50) take?
Starts at 20 for both M and W
Stroke and DVT
In adults with sustained BP > 135/80 mmHg
1000 mg/day

19. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 mg/day
Stroke and DVT
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES

20. What is the schedule for varicella vaccine?
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after
Stroke and DVT
More than 15

21. In which group of patients should aspirin be given as primary prevention for stroke?
1000 IU/day
Women 55 - 79 yo
4 mg/day
Men 45 - 79 yo

22. What is the USPSTF guideline for chlamydial screening?
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)
In all W < 24 who are sexually active - In W > 24 with increased risk
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 50 (recommends against starting at 40) and every 2 years

23. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Adults > 60
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. How much vit D should adults > 50 take?
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo
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

25. What kind of sunscreen SPF is recommended for sun protection?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
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

26. What are 2 conditions that have been proven to be beneficial to screened for?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Smoking - Alcoholism
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester
1200 mg/day

28. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

29. What is the schedule for DTap vaccine?
Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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)
Start at 20 for all M and W regardless of RFs

30. Unopposed estrogen increases risks for what conditions?
Exercise - Environmental hazard reduction - Close monitoring of medication
One time abdominal X-ray for all MALES who ever SMOKES
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT

31. Who should get shingles vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

32. What are the guidelines for pap smear?
Starts at 20 for both M and W
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)
Persons with no known risk factors

33. When should pregnant women get a flu shot?
Femoral neck
During 2nd - 3rd trimester
1200 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

34. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 20 for both M and W
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk

35. What 3 things should always be done in an office visit?
Forearm
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight

36. How much folate should all women of child bearing age take?
Women 55 - 79 yo
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65
Children up to 7 yo and < 5' should be placed in a booster seat.

37. What are some safety issues you should counsel parents with young children?
Start at 20 for all M and W regardless of RFs
Adults > 60
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...

38. Some contraindications for aspirin
2mo - 4mo - 6-18 mo and 4-6 yrs
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

39. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Stroke and DVT
4 mg/day
BP - Height - Weight
Forearm

40. When is intensive individualized home-based intervention recommended?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

41. 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
1300 mg/day
During 2nd - 3rd trimester
Meningitis and Epiglottitis

42. When is area of induration > 15 mm considered TB positive?
> 2 yo and less than 40 lbs
To get IgA protection
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors

43. How often do asplenic patients receive pneumococcal vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
Every 5 years

44. What is HI law for booster seat?

45. What can decrease fall in the elderly?
Rear facing
NEVER
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT

46. What are some RFs for DMT2?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

47. What type of illnesses does Hib vaccine prevent?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo
Meningitis and Epiglottitis
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

48. What kind of car seat should children < 2 yo be placed in?
2mo - 4mo - 6-18 mo and 4-6 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
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

49. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

50. What is the schedule for Gardasil?
Men 45 - 79 yo
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs