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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 can decrease fall in the elderly?
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years

2. When can children sit in a booster seat?

3. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
1000 IU/day
0.4 mg/day
Starts at 20 for both M and W
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

4. When should chest X-ray be used for screening?
Exercise or physical therapy and vit D for patients > 65
NEVER
To get IgA protection
4 mg/day

5. What is the schedule for Gardasil?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

6. What is the schedule for Hep A vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

7. What are the guidelines for visual screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

8. What is USPSTF guideline for abdominal aortic aneurysm screening?
1000 IU/day
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES

9. How much fluoride should military children in HI be given?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

10. What kind of sunscreen SPF is recommended for sun protection?
Rear facing
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
During 2nd - 3rd trimester
More than 15

11. How much calcium should women > 50 take?
1200 mg/day
BP - Height - Weight
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. What is the USPSTF guideline for chlamydial screening?
HISTORY
In all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 - 0.8 mg/day for 1 month prior to conception

13. 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)
1000 IU/day
800 IU/ day
Start at 20 for all M and W regardless of RFs

14. What is the schedule for Hep B vaccine?
When they are > 40 lbs and still less then 5'
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Femoral neck
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

15. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

16. In which group of patients should aspirin be given as primary prevention for MI?
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

17. What is HI law for booster seat?

18. What is the NCEP III guideline for cholesterol screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
BP - Height - Weight

19. When should Gardasil be given and for what purposes?
Breast CA - thromboembolic event - stroke and CAD
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
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

20. What is the USPSTF guideline for DMT2 screening?
NEVER
More than 15
In adults with sustained BP > 135/80 mmHg
Adults > 60

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

22. Unopposed estrogen increases risks for what conditions?
> 2 yo and less than 40 lbs
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT

23. When is area of induration > 15 mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors

24. Who are at increased risk for adverse effect catching a flu?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

25. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
One time abdominal X-ray for all MALES who ever SMOKES
Men 45 - 79 yo
To get IgA protection

26. What type of illnesses does Hib vaccine prevent?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Men 45 - 79 yo
Meningitis and Epiglottitis

27. Measurement of which anatomic structure is best predictor for hip fracture?
4 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
Femoral neck
Smoking - Alcoholism

28. Some contraindications for aspirin
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Breast CA - thromboembolic event - stroke and CAD

29. How much folate should all women of child bearing age take?
0.4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY
Adults > 60

30. When is area of induration > 5mm considered TB positive?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day

31. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES

32. How much vit D should adults > 50 take?
1000 IU/day
HISTORY
Exercise - Environmental hazard reduction - Close monitoring of medication
Adults > 60

33. What is the schedule for MMR vaccine?
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
To get IgA protection
Stroke and DVT

34. What are the USPSTF guidelines for mammogram?
Persons with no known risk factors
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

35. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
800 IU/ day

36. How much calcium should adolescents (9 -18) take?
Rear facing
1300 mg/day
1200 mg/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

37. What is the schedule for rotavirus vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT

38. When should tetanus immunoglobulin be given?
More than 15
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm

39. In which group of patients should aspirin be given as primary prevention for stroke?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
Women 55 - 79 yo

40. 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
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 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

41. What 3 things should always be done in an office visit?
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg

42. What is the ADA guideline for DMT2 screening?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Total cholesterol - FOBT

43. What are some safety issues you should counsel parents with young children?
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo
1200 mg/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...

44. What kind of car seat should children < 2 yo be placed in?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES

45. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
NEVER

46. What are the guidelines for pap smear?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Every 5 years
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)

47. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Every 5 years
> 2 yo and less than 40 lbs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

48. 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
Stroke and DVT
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after

49. How much folate and for How long should a woman take for planned pregnancy?
BP - Height - Weight
HISTORY
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

50. Which children should use a semi-upright/forward facing carseat?
To get IgA protection
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs
1000 mg/day