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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 kind of sunscreen SPF is recommended for sun protection?
More than 15
Total cholesterol - FOBT
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk

2. What are the risks of combination HRT?
When they are > 40 lbs and still less then 5'
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
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection

3. When can children sit in a booster seat?

4. What are some RFs for DMT2?
Every 5 years
Men 45 - 79 yo
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

5. Unopposed estrogen increases risks for what conditions?
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

6. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Starts at 20 for both M and W

7. What is the schedule for DTap vaccine?
Men 45 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

9. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY
Femoral neck

10. How much calcium should adolescents (9 -18) take?
During 2nd - 3rd trimester
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
More than 15
1300 mg/day

11. What type of illnesses does Hib vaccine prevent?
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis
NEVER
1000 IU/day

12. How much calcium should women > 50 take?
1300 mg/day
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)
1200 mg/day

13. What is the schedule for Hep B vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

14. What 3 things should always be done in an office visit?
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD
Rear facing

15. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
NEVER
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

16. What is the ADA guideline for DMT2 screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
NEVER

17. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
NEVER
Rear facing
In adults with sustained BP > 135/80 mmHg

18. What kind of car seat should children < 2 yo be placed in?
Rear facing
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and 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

19. Who should get Tdap vaccine and how often?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
2mo - 4 mo - 6mo and 12-15 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

20. What is the schedule for varicella vaccine?
Stroke and DVT
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk

21. How much flouride should non military children in the state of HI be given?
Persons with no known risk factors
0.4 mg/day
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

22. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Children up to 7 yo and < 5' should be placed in a booster seat.
Every 5 years
4 mg/day
Exercise or physical therapy and vit D for patients > 65

23. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

24. What are the guidelines for visual screening?
800 IU/ day
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
Femoral neck

25. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Children up to 7 yo and < 5' should be placed in a booster seat.
Stroke and DVT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Forearm

26. What is the schedule for rotavirus vaccine?
0.4 mg/day
During 2nd - 3rd trimester
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

27. How much folate should all women of child bearing age take?
To get IgA protection
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
4 mg/day

28. What is the USPSTF guideline for chlamydial screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In adults with sustained BP > 135/80 mmHg
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day

29. What is USPSTF guideline for abdominal aortic aneurysm 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)
Rear facing
0.4 - 0.8 mg/day for 1 month prior to conception
One time abdominal X-ray for all MALES who ever SMOKES

30. How much vit D should adults < 50 take?
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
800 IU/ day
Femoral neck
Exercise or physical therapy and vit D for patients > 65

31. What is the schedule for polio vaccine?
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)
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65

32. When is area of induration > 15 mm considered TB positive?
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
Starts at 20 for both M and W
Women 55 - 79 yo

33. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
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

34. What kind of polio vaccine is preferred?
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)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

35. When is area of induration > 10 mm considered TB positive?
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. At what age should women have DEXA scan?
NEVER
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day

37. What can decrease fall in the elderly?
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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 - Environmental hazard reduction - Close monitoring of medication

38. Measurement of which anatomic structure is best predictor for hip fracture?
800 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
Femoral neck
0.4 mg/day

39. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Persons with no known risk factors
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication

40. What are the USPSTF guidelines for mammogram?
To get IgA protection
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

41. When should pregnant women get a flu shot?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years

42. What is the most important way to screen for CAD in an asymptomatic patients?
During 2nd - 3rd trimester
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
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

43. What is the schedule for Gardasil?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

44. How much folate and for How long should a woman take for planned pregnancy?
NEVER
1000 IU/day
800 IU/ day
0.4 - 0.8 mg/day for 1 month prior to conception

45. What is HI law for booster seat?

46. Who are at increased risk for adverse effect catching a flu?
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
In adults with sustained BP > 135/80 mmHg
HISTORY

47. 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
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 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

48. What is the schedule for MMR vaccine?
1300 mg/day
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
Adults > 60

49. How much calcium should adults (19 - 50) take?
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 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

50. What are some risk factors for CAD?
0.4 mg/day
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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