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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 USPSTF guideline for fall prevention in the elderly?
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
> 2 yo and less than 40 lbs
Exercise or physical therapy and vit D for patients > 65
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

2. How often do asplenic patients receive pneumococcal vaccine?
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
Every 5 years
65 (earlier if have increased risk factors)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

3. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Stroke and DVT
Men 45 - 79 yo
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

4. When is intensive individualized home-based intervention recommended?
65 (earlier if have increased risk factors)
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
Forearm
Children up to 7 yo and < 5' should be placed in a booster seat.

5. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise or physical therapy and vit D for patients > 65
Adults > 60
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. Who should get shingles vaccine?
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
Exercise or physical therapy and vit D for patients > 65
Adults > 60

7. When is area of induration > 15 mm considered TB positive?
Forearm
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart

8. When is area of induration > 5mm considered TB positive?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Stroke and DVT

9. How much calcium should adults (19 - 50) take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day
Total cholesterol - FOBT

10. What is the ADA guideline for DMT2 screening?
Men 45 - 79 yo
Starts at 20 for both M and W
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester

11. What is the schedule for varicella vaccine?
Total cholesterol - FOBT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One dose at 12-15 mod - Booster at least 4-weeks after
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. Some contraindications for aspirin
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

13. What is HI law for booster seat?

14. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
4 mg/day

15. What is the USPSTF guideline for DMT2 screening?
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...
In adults with sustained BP > 135/80 mmHg
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

16. What are some safety issues you should counsel parents with young children?
Exercise or physical therapy and vit D for patients > 65
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 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

17. How much vit D should adults > 50 take?
Breast CA - thromboembolic event - stroke and CAD
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day

18. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Start at 20 for all M and W regardless of RFs
HISTORY
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

19. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES

20. What 3 things should always be done in an office visit?
BP - Height - Weight
During 2nd - 3rd trimester
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

21. Who should get Tdap vaccine and how often?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
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
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

22. What is USPSTF guideline for abdominal aortic aneurysm screening?
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD
0.4 - 0.8 mg/day for 1 month prior to conception

23. When should tetanus immunoglobulin be given?
0.4 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception

24. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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

25. 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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In adults with sustained BP > 135/80 mmHg

26. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Smoking - Alcoholism
In adults with sustained BP > 135/80 mmHg
Total cholesterol - FOBT

27. What is the schedule for polio vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart
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

28. What are 2 conditions that have been proven to be beneficial to screened for?
800 IU/ day
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. In which group of patients should aspirin be given as primary prevention for stroke?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
Women 55 - 79 yo

30. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

31. 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
Smoking - Alcoholism
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 - 23 mo - 2 doses are to be given 6 mo apart

32. How much flouride should non military children in the state of HI be given?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

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

34. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1300 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
2mo - 4mo - 6-18 mo and 4-6 yrs

35. What can decrease fall in the elderly?
When they are > 40 lbs and still less then 5'
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors
Forearm

36. What are the USPSTF guidelines for mammogram?
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years

37. What is the schedule for rotavirus vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

38. What are the guidelines for pap smear?
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
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
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)

39. How much folate should all women of child bearing age take?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
During 2nd - 3rd trimester

40. In which group of patients should aspirin be given as primary prevention for MI?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
During 2nd - 3rd trimester

41. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day

42. What are the risks of combination HRT?
Femoral neck
Breast CA - thromboembolic event - stroke and CAD
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Women 55 - 79 yo

43. What is the schedule for DTap vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

44. At what age should women have DEXA scan?
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
65 (earlier if have increased risk factors)

45. Who are at increased risk for adverse effect catching a flu?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

46. How much vit D should adults < 50 take?
65 (earlier if have increased risk factors)
Men 45 - 79 yo
Meningitis and Epiglottitis
800 IU/ day

47. What are some risk factors for CAD?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
When they are > 40 lbs and still less then 5'
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Smoking - Alcoholism

48. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Every 5 years
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
2mo - 4mo - 6-18 mo and 4-6 yrs

49. When should pregnant women get a flu shot?
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
During 2nd - 3rd trimester
1000 IU/day

50. When can children sit in a booster seat?