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Family Medicine Health Maintenance

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 20 minutes. 2 minutes extra for reading the instructions.
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 car seat should children < 2 yo be placed in?
Rear facing
Persons with no known risk factors
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

2. What are the guidelines for pap smear?
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)
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES
Stroke and DVT

3. What are the risks of combination HRT?
Stroke and DVT
Starts at 20 for both M and W
Rear facing
Breast CA - thromboembolic event - stroke and CAD

4. When should Gardasil be given and for what purposes?
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
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
BP - Height - Weight

5. Who should get shingles vaccine?
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
Adults > 60
1200 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

6. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
65 (earlier if have increased risk factors)
When they are > 40 lbs and still less then 5'

7. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

8. What is USPSTF guideline for abdominal aortic aneurysm screening?
Stroke and DVT
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

9. What are the guidelines for colon cancer screening?
Meningitis and Epiglottitis
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

10. What are some risk factors for CAD?
Persons with no known risk factors
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
NEVER
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

11. When can children sit in a booster seat?

12. What is the schedule for polio vaccine?
> 2 yo and less than 40 lbs
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

13. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Exercise - Environmental hazard reduction - Close monitoring of medication
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...
Forearm
1200 mg/day

14. How much folate should all women of child bearing age take?
Start at 20 for all M and W regardless of RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day

15. When should pregnant women get a flu shot?
Total cholesterol - FOBT
During 2nd - 3rd trimester
Stroke and DVT
When they are > 40 lbs and still less then 5'

16. When is area of induration > 10 mm considered TB positive?
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
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
HISTORY

17. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

18. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

19. What is the USPSTF guideline for fall prevention in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65
1000 IU/day
In adults with sustained BP > 135/80 mmHg

20. How much vit D should adults > 50 take?
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication
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

21. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

22. What is the ADA guideline for DMT2 screening?
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

23. When should tetanus immunoglobulin be given?
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
In adults with sustained BP > 135/80 mmHg
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

24. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Women 55 - 79 yo
To get IgA protection
Femoral neck

25. How much calcium should women > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1200 mg/day
0.4 mg/day
800 IU/ day

26. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Breast CA - thromboembolic event - stroke and CAD
4 mg/day
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

28. What is the schedule for Hib vaccine?
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In adults with sustained BP > 135/80 mmHg

29. What is the schedule for Hep B vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

30. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years

31. In which group of patients should aspirin be given as primary prevention for MI?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day

32. When should the meningococcal vaccine be given and to which group?
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism

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

34. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day
During 2nd - 3rd trimester

35. When is intensive individualized home-based intervention recommended?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
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

36. Unopposed estrogen increases risks for what conditions?
When they are > 40 lbs and still less then 5'
Every 5 years
During 2nd - 3rd trimester
Stroke and DVT

37. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Children up to 7 yo and < 5' should be placed in a booster seat.
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W

38. At what age should women have DEXA scan?
One dose at 12-15 mod - Booster at least 4-weeks after
800 IU/ day
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
65 (earlier if have increased risk factors)

39. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

40. What can decrease fall in the elderly?
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication

41. How much vit D should adults < 50 take?
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
800 IU/ day
Starts at 20 for both M and W

42. What are the USPSTF guidelines for mammogram?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

43. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception
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

44. How often do asplenic patients receive pneumococcal vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Adults > 60
Every 5 years

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
Total cholesterol - FOBT

46. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Every 5 years

47. What kind of sunscreen SPF is recommended for sun protection?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
More than 15

48. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years

49. What tests are appropriate to order in an asymptomatic 57 yo male?
Exercise - Environmental hazard reduction - Close monitoring of medication
Total cholesterol - FOBT
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

50. Who are at increased risk for adverse effect catching a flu?
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
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
800 IU/ day