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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 ADA guideline for DMT2 screening?
1200 mg/day
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

2. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years

3. How much vit D should adults > 50 take?
1000 IU/day
Persons with no known risk factors
800 IU/ 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

4. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 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...

5. Some contraindications for aspirin
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

6. When should pregnant women get a flu shot?
Meningitis and Epiglottitis
Women 55 - 79 yo
During 2nd - 3rd trimester
1000 IU/day

7. What are the guidelines for colon cancer screening?
Starts at 50 (recommends against starting at 40) and every 2 years
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
Rear facing
One dose at 12-15 mod - Booster at least 4-weeks after

8. Who are at increased risk for adverse effect catching a flu?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

9. 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
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
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

10. What are some safety issues you should counsel parents with young children?
Exercise - Environmental hazard reduction - Close monitoring of medication
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...
When they are > 40 lbs and still less then 5'

11. What are the guidelines for pap smear?
Starts at 50 (recommends against starting at 40) and every 2 years
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)
2mo - 4 mo - 6mo and 12-15 mo

12. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk
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

13. What is the schedule for Hep A vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Forearm
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD

15. When should Gardasil be given and for what purposes?
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
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...

16. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo
Starts at 20 for both M and W
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)

17. If traveling to endemic areas - Why should one get a dose of live vaccine?
Exercise or physical therapy and vit D for patients > 65
To get IgA protection
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

18. Who should get shingles 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
Adults > 60
> 2 yo and less than 40 lbs
Women 55 - 79 yo

19. When is area of induration > 10 mm considered TB positive?
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
Smoking - Alcoholism
During 2nd - 3rd trimester

20. When is area of induration > 5mm considered TB positive?
Starts at 20 for both M and W
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

21. How much calcium should adults (19 - 50) take?
Smoking - Alcoholism
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day

22. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 20 for both M and W
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Exercise or physical therapy and vit D for patients > 65

23. Measurement of which anatomic structure is best predictor for hip fracture?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
Exercise - Environmental hazard reduction - Close monitoring of medication

24. What is the schedule for rotavirus vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Femoral neck
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...

25. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
800 IU/ 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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

26. When is area of induration > 15 mm considered TB positive?
> 2 yo and less than 40 lbs
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...
4 mg/day
Persons with no known risk factors

27. What kind of car seat should children < 2 yo be placed in?
Rear facing
Total cholesterol - FOBT
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
Persons with no known risk factors

28. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
800 IU/ day
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.

29. Unopposed estrogen increases risks for what conditions?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Stroke and DVT
In all W < 24 who are sexually active - In W > 24 with increased risk

30. What is the schedule for Gardasil?
800 IU/ day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Smoking - Alcoholism
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

31. What are the guidelines for visual screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. How much vit D should adults < 50 take?
4 mg/day
Start at 20 for all M and W regardless of RFs
Meningitis and Epiglottitis
800 IU/ day

33. How often do asplenic patients receive pneumococcal vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In adults with sustained BP > 135/80 mmHg
Every 5 years
0.4 mg/day

34. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
HISTORY
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
Start at 20 for all M and W regardless of RFs

35. What 3 things should always be done in an office visit?
During 2nd - 3rd trimester
BP - Height - Weight
Starts at 20 for both M and W
> 2 yo and less than 40 lbs

36. How much folate should all women of child bearing age take?
BP - Height - Weight
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
To get IgA protection

37. What kind of sunscreen SPF is recommended for sun protection?
NEVER
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15

38. When should chest X-ray be used for screening?
65 (earlier if have increased risk factors)
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years

39. What kind of polio vaccine is preferred?
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 IU/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
HISTORY

40. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. What are some RFs for DMT2?
4 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

42. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Smoking - Alcoholism

43. Which children should use a semi-upright/forward facing carseat?
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years
> 2 yo and less than 40 lbs
Men 45 - 79 yo

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

45. How much calcium should adolescents (9 -18) take?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

46. Who should get Tdap vaccine and how often?
1000 mg/day
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis
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

47. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
4 mg/day

48. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight
NEVER
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

49. What are 2 conditions that have been proven to be beneficial to screened for?
To get IgA protection
2mo - 4 mo - 6mo and 12-15 mo
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart

50. How much fluoride should military children in HI be given?
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
1200 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day