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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. How much flouride should non military children in the state of HI be given?
Preschool children : 3-4 yo - Elderly patients: > 65 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
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

2. What 3 things should always be done in an office visit?
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
One time abdominal X-ray for all MALES who ever SMOKES
BP - Height - Weight
During 2nd - 3rd trimester

3. How much calcium should adults (19 - 50) take?
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.
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day

4. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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...
Children up to 7 yo and < 5' should be placed in a booster seat.
Persons with no known risk factors

5. How much calcium should women > 50 take?
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD

6. What kind of sunscreen SPF is recommended for sun protection?
Exercise or physical therapy and vit D for patients > 65
Every 5 years
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

7. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT
Men 45 - 79 yo

8. When is area of induration > 10 mm considered TB positive?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

9. When should chest X-ray be used for screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day
NEVER
Adults > 60

10. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60
Women 55 - 79 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

11. What can decrease fall in the elderly?
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Smoking - Alcoholism
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

12. 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
1000 IU/day
1200 mg/day
Total cholesterol - FOBT

13. Who should get shingles vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 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)

14. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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
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

15. When should Gardasil be given and for what purposes?
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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
12 - 23 mo - 2 doses are to be given 6 mo apart

16. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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 - 4 mo - 6mo and 12-15 mo
1300 mg/day

17. Which children should use a semi-upright/forward facing carseat?
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

18. What is the NCEP III guideline for cholesterol 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)
Femoral neck
Start at 20 for all M and W regardless of RFs
1300 mg/day

19. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 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

20. 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...
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

21. Who should get Tdap vaccine and how often?
0.4 mg/day
Rear facing
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
800 IU/ day

22. When can children sit in a booster seat?

23. What are the risks of combination HRT?
More than 15
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
When they are > 40 lbs and still less then 5'

24. How much folate and for How long should a woman take for planned pregnancy?
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)
0.4 - 0.8 mg/day for 1 month prior to conception
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...
HISTORY

25. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Every 5 years
Women 55 - 79 yo
65 (earlier if have increased risk factors)

26. 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
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Meningitis and Epiglottitis

27. What is the ADA guideline for DMT2 screening?
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

28. When is area of induration > 5mm considered TB positive?
Meningitis and Epiglottitis
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
Start at 20 for all M and W regardless of RFs
1000 mg/day

29. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo
Stroke and DVT

30. What is HI law for booster seat?

31. What kind of car seat should children < 2 yo be placed in?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing
Forearm

32. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT
To get IgA protection

33. Some contraindications for aspirin
Starts at 50 (recommends against starting at 40) and every 2 years
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

34. What are some RFs for DMT2?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
BP - Height - Weight

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

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

37. How much vit D should adults < 50 take?
800 IU/ day
Start at 20 for all M and W regardless of RFs
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

38. What is the schedule for DTap vaccine?
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
In adults with sustained BP > 135/80 mmHg

39. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Forearm
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

40. What is the schedule for Hib 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
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years

41. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
When they are > 40 lbs and still less then 5'
2mo - 4 mo - 6mo and 12-15 mo
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

42. What is the schedule for Hep A vaccine?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
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...
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

43. What is the schedule for polio vaccine?
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs

44. Measurement of which anatomic structure is best predictor for hip fracture?
Adults > 60
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

45. What is the schedule for rotavirus vaccine?
800 IU/ day
Persons with no known risk factors
During 2nd - 3rd trimester
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

46. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Forearm
4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
When they are > 40 lbs and still less then 5'

47. What is the USPSTF guideline for fall prevention in the elderly?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day

48. At what age should women have DEXA scan?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
65 (earlier if have increased risk factors)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

49. What is the schedule for Gardasil?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
HISTORY

50. In which group of patients should aspirin be given as primary prevention for MI?
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 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