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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 NCEP III guideline for cholesterol screening?
1200 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
When they are > 40 lbs and still less then 5'
Start at 20 for all M and W regardless of RFs

2. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
4 mg/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...
65 (earlier if have increased risk factors)

3. How much calcium should adults (19 - 50) take?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

4. Who should get shingles vaccine?
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
Women 55 - 79 yo

5. Some contraindications for aspirin
Persons with no known risk factors
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester
In all W < 24 who are sexually active - In W > 24 with increased risk

6. What is the USPSTF guideline for chlamydial screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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...

7. 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.

8. What kind of polio vaccine is preferred?
Adults > 60
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

10. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
800 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...
Forearm
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

11. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
Adults > 60
To get IgA protection
1300 mg/day

12. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

13. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
More than 15
Women 55 - 79 yo
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?
800 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...
To get IgA protection
Children up to 7 yo and < 5' should be placed in a booster seat.

15. What is the schedule for polio vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs
One time abdominal X-ray for all MALES who ever SMOKES

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

17. Which children should use a semi-upright/forward facing carseat?
Breast CA - thromboembolic event - stroke and CAD
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
> 2 yo and less than 40 lbs
65 (earlier if have increased risk factors)

18. What is the most important way to screen for CAD in an asymptomatic patients?
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
HISTORY
BP - Height - Weight

19. What is HI law for booster seat?

20. When should Gardasil be given and for what purposes?
4 mg/day
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
In all W < 24 who are sexually active - In W > 24 with increased risk

21. What are the guidelines for pap smear?
Smoking - Alcoholism
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
To get IgA protection
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)

22. When is intensive individualized home-based intervention recommended?
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
One dose at 12-15 mod - Booster at least 4-weeks after
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

23. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

24. What is USPSTF guideline for abdominal aortic aneurysm screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One time abdominal X-ray for all MALES who ever SMOKES

25. What are some RFs for DMT2?
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

26. 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
One time abdominal X-ray for all MALES who ever SMOKES
Exercise - Environmental hazard reduction - Close monitoring of medication
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

27. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs

28. How much calcium should women > 50 take?
NEVER
1200 mg/day
800 IU/ day
Forearm

29. What can decrease fall in the elderly?
Every 5 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
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

30. How much folate should all women of child bearing age take?
0.4 mg/day
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm

31. What is the schedule for varicella vaccine?
In adults with sustained BP > 135/80 mmHg
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

32. 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
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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

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

34. What is the schedule for Hib vaccine?
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
Forearm
Rear facing

35. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Women 55 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

36. What is the schedule for Hep A vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
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

37. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

38. What is the USPSTF guideline for fall prevention in the elderly?
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Every 5 years
Exercise or physical therapy and vit D for patients > 65

39. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60

40. What kind of sunscreen SPF is recommended for sun protection?
Femoral neck
BP - Height - Weight
More than 15
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)

41. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg

42. 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
To get IgA protection
BP - Height - Weight
Starts at 50 (recommends against starting at 40) and every 2 years

43. When is area of induration > 5mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
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
> 2 yo and less than 40 lbs

44. What 3 things should always be done in an office visit?
Starts at 20 for both M and W
Forearm
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
BP - Height - Weight

45. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

46. What are the risks of combination HRT?
Exercise or physical therapy and vit D for patients > 65
Breast CA - thromboembolic event - stroke and CAD
Rear facing
1000 mg/day

47. Measurement of which anatomic structure is best predictor for hip fracture?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Femoral neck
Stroke and DVT
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)

48. What are some risk factors for CAD?
Women 55 - 79 yo
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
Starts at 20 for both M and W

49. When can children sit in a booster seat?

50. When is area of induration > 10 mm considered TB positive?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 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