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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 3 things should always be done in an office visit?
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

2. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
800 IU/ day
4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

3. What can decrease fall in the elderly?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Femoral neck
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication

4. How much folate should all women of child bearing age take?
0.4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
NEVER

5. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Adults > 60
Stroke and DVT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 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

6. What kind of polio vaccine is preferred?
One time abdominal X-ray for all MALES who ever SMOKES
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Forearm

7. What are the guidelines for visual screening?
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...
Persons with no known risk factors
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

8. What is the NCEP III guideline for cholesterol screening?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Start at 20 for all M and W regardless of RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What are the guidelines for pap smear?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 IU/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)
Every 5 years

10. At what age should women have DEXA scan?
1300 mg/day
65 (earlier if have increased risk factors)
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

11. How much calcium should women > 50 take?
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication

12. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

13. What are the risks of combination HRT?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
12 - 23 mo - 2 doses are to be given 6 mo apart
Breast CA - thromboembolic event - stroke and CAD
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

14. What tests are appropriate to order in an asymptomatic 57 yo male?
One time abdominal X-ray for all MALES who ever SMOKES
Total cholesterol - FOBT
BP - Height - Weight
During 2nd - 3rd trimester

15. What are the guidelines for colon cancer screening?
800 IU/ day
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
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

16. 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
1000 mg/day
Start at 20 for all M and W regardless of RFs
Adults > 60

17. What is the USPSTF guideline for chlamydial screening?
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
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

18. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

19. How much calcium should adolescents (9 -18) take?
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 mg/day

20. How much vit D should adults > 50 take?
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day
To get IgA protection
65 (earlier if have increased risk factors)

21. When is area of induration > 10 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
To get IgA protection
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

22. What are some RFs for DMT2?
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Starts at 20 for both M and W

23. What type of illnesses does Hib vaccine prevent?
Men 45 - 79 yo
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

24. When should tetanus immunoglobulin be given?
Rear facing
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo - 6mo and 12-15 mo
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

26. In which group of patients should aspirin be given as primary prevention for stroke?
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
To get IgA protection
Women 55 - 79 yo

27. How much calcium should adults (19 - 50) take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 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
Total cholesterol - FOBT
1000 mg/day

28. What is the schedule for DTap vaccine?
HISTORY
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
1200 mg/day

29. What is the schedule for polio vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day
When they are > 40 lbs and still less then 5'

30. In which group of patients should aspirin be given as primary prevention for MI?
NEVER
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo
1000 IU/day

31. What is the schedule for Hep A vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart

32. Unopposed estrogen increases risks for what conditions?
Smoking - Alcoholism
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
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

33. When can children sit in a booster seat?

34. What is the schedule for Hep B vaccine?
Every 5 years
Start at 20 for all M and W regardless of RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

35. Some contraindications for aspirin
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
0.4 mg/day
1200 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

36. What is the schedule for MMR vaccine?
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
Persons with no known risk factors

37. When is area of induration > 5mm considered TB positive?
0.4 mg/day
1300 mg/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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

38. How much flouride should non military children in the state of HI be given?
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
4 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

39. If traveling to endemic areas - Why should one get a dose of live vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
Exercise or physical therapy and vit D for patients > 65
Forearm
To get IgA protection

40. What is USPSTF guideline for abdominal aortic aneurysm screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors
One time abdominal X-ray for all MALES who ever SMOKES

41. What is the ADA guideline for DMT2 screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Rear facing

42. What is the schedule for varicella vaccine?
Stroke and DVT
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
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)

43. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
12 - 23 mo - 2 doses are to be given 6 mo apart
In adults with sustained BP > 135/80 mmHg
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

44. What are some risk factors for CAD?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

45. When should chest X-ray be used for screening?
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
NEVER
Persons with no known risk factors

46. What is the USPSTF guideline for fall prevention in the elderly?
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
NEVER
One dose at 12-15 mod - Booster at least 4-weeks after

47. What are the USPSTF guidelines for mammogram?
> 2 yo and less than 40 lbs
Starts at 50 (recommends against starting at 40) and every 2 years
NEVER
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. Who should get shingles vaccine?
0.4 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
HISTORY
Adults > 60

49. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60
Rear facing

50. Who are at increased risk for adverse effect catching a flu?
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks