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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 DMT2 screening?
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
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In adults with sustained BP > 135/80 mmHg

2. How much calcium should women > 50 take?
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
BP - Height - Weight
1200 mg/day

3. What are some risk factors for CAD?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

4. What is the schedule for Hep A vaccine?
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day

5. What tests are appropriate to order in an asymptomatic 57 yo male?
Rear facing
1000 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...
Total cholesterol - FOBT

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

7. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Forearm
2mo - 4 mo - 6mo and 12-15 mo

8. When is area of induration > 10 mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart

9. What are the guidelines for pap smear?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
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 overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

10. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children up to 7 yo and < 5' should be placed in a booster seat.

11. What are some RFs for DMT2?
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

12. What is the schedule for varicella 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
> 2 yo and less than 40 lbs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after

13. What is the most important way to screen for CAD in an asymptomatic patients?
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 - 0.8 mg/day for 1 month prior to conception
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
HISTORY

14. When should pregnant women get a flu shot?
4 mg/day
Total cholesterol - FOBT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
During 2nd - 3rd trimester

15. When should tetanus immunoglobulin be given?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
12 - 23 mo - 2 doses are to be given 6 mo apart
4 mg/day

16. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Children up to 7 yo and < 5' should be placed in a booster seat.
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

17. When can children sit in a booster seat?

18. How much calcium should adolescents (9 -18) take?
Total cholesterol - FOBT
1300 mg/day
During 2nd - 3rd trimester
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

19. Some contraindications for aspirin
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
Women 55 - 79 yo
1000 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. When is intensive individualized home-based intervention recommended?
Starts at 50 (recommends against starting at 40) and every 2 years
NEVER
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
Exercise - Environmental hazard reduction - Close monitoring of medication

21. What are the guidelines for colon cancer screening?
Persons with no known risk factors
1300 mg/day
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

22. What are some safety issues you should counsel parents with young children?
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)
1200 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...

23. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

24. If traveling to endemic areas - Why should one get a dose of live vaccine?
1000 IU/day
To get IgA protection
In adults with sustained BP > 135/80 mmHg
More than 15

25. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
More than 15
1000 IU/day
In adults with sustained BP > 135/80 mmHg

26. What is the USPSTF guideline for fall prevention in the elderly?
When they are > 40 lbs and still less then 5'
Forearm
In adults with sustained BP > 135/80 mmHg
Exercise or physical therapy and vit D for patients > 65

27. When is area of induration > 15 mm considered TB positive?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
Persons with no known risk factors
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)

28. How much folate should all women of child bearing age take?
Rear facing
0.4 mg/day
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

29. 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
Women 55 - 79 yo
1000 mg/day
0.4 mg/day

30. Measurement of which anatomic structure is best predictor for hip fracture?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER

31. Who should get shingles vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60

32. How much fluoride should military children in HI be given?
0.4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

33. What kind of car seat should children < 2 yo be placed in?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
When they are > 40 lbs and still less then 5'

34. How much flouride should non military children in the state of HI be given?
Exercise - Environmental hazard reduction - Close monitoring of medication
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

35. How much calcium should adults (19 - 50) take?
BP - Height - Weight
HISTORY
1300 mg/day
1000 mg/day

36. What are the USPSTF guidelines for mammogram?
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)
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
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years

37. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
Adults > 60
Meningitis and Epiglottitis

38. What 3 things should always be done in an office visit?
Forearm
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

39. How often do asplenic patients receive pneumococcal vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart
Every 5 years

40. What is the schedule for Hep B vaccine?
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
Exercise or physical therapy and vit D for patients > 65
1000 mg/day

41. What is the schedule for rotavirus vaccine?
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In adults with sustained BP > 135/80 mmHg

42. What is the schedule for polio 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...
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
1200 mg/day

43. What are the risks of combination HRT?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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

44. 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
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs
NEVER

45. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
1000 IU/day
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

46. Unopposed estrogen increases risks for what conditions?
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

47. What is the schedule for Gardasil?
800 IU/ day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
HISTORY

48. What is the ADA guideline for DMT2 screening?
One time abdominal X-ray for all MALES who ever SMOKES
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

49. Which children should use a semi-upright/forward facing carseat?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs
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
1300 mg/day

50. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
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
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