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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. Who should get Tdap vaccine and how often?
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
One dose at 12-15 mod - Booster at least 4-weeks after
To get IgA protection
65 (earlier if have increased risk factors)

2. When should pregnant women get a flu shot?
Rear facing
During 2nd - 3rd trimester
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

3. When should chest X-ray be used for screening?
NEVER
In adults with sustained BP > 135/80 mmHg
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

4. What 3 things should always be done in an office visit?
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

5. When can children sit in a booster seat?

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

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7. How much calcium should adolescents (9 -18) take?
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1300 mg/day

8. What is the schedule for MMR vaccine?
1000 mg/day
65 (earlier if have increased risk factors)
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

9. What type of illnesses does Hib vaccine prevent?
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis

10. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
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
Persons with no known risk factors

11. Unopposed estrogen increases risks for what conditions?
> 2 yo and less than 40 lbs
Stroke and DVT
Breast CA - thromboembolic event - stroke and CAD
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

12. When is area of induration > 10 mm considered TB positive?
1000 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Persons with no known risk factors
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

13. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs

14. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
HISTORY
Starts at 20 for both M and W

15. 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
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
Total cholesterol - FOBT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

16. How much calcium should adults (19 - 50) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
1000 mg/day
Starts at 20 for both M and W

17. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
Starts at 20 for both M and W
4 mg/day

18. What are the risks of combination HRT?
During 2nd - 3rd trimester
Femoral neck
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD

19. What is the schedule for Hep B vaccine?
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

20. 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
Starts at 50 (recommends against starting at 40) and every 2 years
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

21. When should Gardasil be given and for what purposes?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
Femoral neck
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 are the guidelines for colon cancer screening?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.

23. What are some safety issues you should counsel parents with young children?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Smoking - Alcoholism
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

24. When should the meningococcal vaccine be given and to which group?
To get IgA protection
Exercise or physical therapy and vit D for patients > 65
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What is the schedule for Gardasil?
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 or physical therapy and vit D for patients > 65
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

26. How often do asplenic patients receive pneumococcal vaccine?
2mo - 4 mo - 6mo and 12-15 mo
More than 15
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

27. How much folate should all women of child bearing age take?
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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...

28. Some contraindications for aspirin
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

29. What is the most important way to screen for CAD in an asymptomatic patients?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
When they are > 40 lbs and still less then 5'
HISTORY

30. What kind of sunscreen SPF is recommended for sun protection?
Forearm
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15

31. What is the NCEP III guideline for cholesterol screening?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Start at 20 for all M and W regardless of RFs
More than 15

32. What is USPSTF guideline for abdominal aortic aneurysm screening?
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
Breast CA - thromboembolic event - stroke and CAD

33. What is the USPSTF guideline for chlamydial screening?
Persons with no known risk factors
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...
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk

34. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
HISTORY
4 mg/day
1300 mg/day

35. Who are at increased risk for adverse effect catching a flu?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Persons with no known risk factors

36. What kind of car seat should children < 2 yo be placed in?
Children up to 7 yo and < 5' should be placed in a booster seat.
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing

37. 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)
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
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs

38. What are the guidelines for pap smear?
800 IU/ day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

39. What is the schedule for polio vaccine?
Rear facing
Meningitis and Epiglottitis
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What tests are appropriate to order in an asymptomatic 57 yo male?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children up to 7 yo and < 5' should be placed in a booster seat.
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

41. How much vit D should adults > 50 take?
When they are > 40 lbs and still less then 5'
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
1000 IU/day

42. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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)
4 mg/day

43. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65

44. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis

45. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Forearm

46. What is the USPSTF guideline for DMT2 screening?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

47. What is the schedule for Hib vaccine?
> 2 yo and less than 40 lbs
0.4 mg/day
Women 55 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo

48. How much calcium should women > 50 take?
1200 mg/day
Men 45 - 79 yo
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years

49. Who should get shingles vaccine?
Adults > 60
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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)

50. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.