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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 schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Stroke and DVT

2. Who should get Tdap vaccine and how often?
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
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...

3. When is area of induration > 15 mm considered TB positive?
BP - Height - Weight
Persons with no known risk factors
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

4. In which group of patients should aspirin be given as primary prevention for stroke?
Forearm
Women 55 - 79 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
BP - Height - Weight

5. What is the ADA guideline for DMT2 screening?
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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60
1200 mg/day

6. What is USPSTF guideline for abdominal aortic aneurysm screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One time abdominal X-ray for all MALES who ever SMOKES
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

7. What is the schedule for Hep B vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

8. How much vit D should adults < 50 take?
800 IU/ day
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

9. What are some safety issues you should counsel parents with young children?
Persons with no known risk factors
2mo - 4 mo - 6mo and 12-15 mo
> 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...

10. What is the schedule for Hib vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
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
4 mg/day

11. When is area of induration > 10 mm considered TB positive?
NEVER
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 mg/day
1000 mg/day

12. When is intensive individualized home-based intervention recommended?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

13. 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
When they are > 40 lbs and still less then 5'
1300 mg/day
Exercise or physical therapy and vit D for patients > 65

14. Which children should use a semi-upright/forward facing carseat?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs

15. 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)
In adults with sustained BP > 135/80 mmHg
Femoral neck
> 2 yo and less than 40 lbs

16. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Women 55 - 79 yo
4 mg/day
800 IU/ day

17. What is the schedule for polio vaccine?
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
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

18. Unopposed estrogen increases risks for what conditions?
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
HISTORY
Stroke and DVT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

19. What is the schedule for rotavirus vaccine?
Persons with no known 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
Starts at 20 for both M and W
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

20. When can children sit in a booster seat?

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

22. What is HI law for booster seat?

23. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
0.4 mg/day
Women 55 - 79 yo
Starts at 20 for both M and W
800 IU/ day

24. What kind of car seat should children < 2 yo be placed in?
Adults > 60
Start at 20 for all M and W regardless of RFs
1300 mg/day
Rear facing

25. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs

26. What 3 things should always be done in an office visit?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis

27. What are the guidelines for visual screening?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4mo - 6-18 mo and 4-6 yrs

28. When should chest X-ray be used for screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Women 55 - 79 yo
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs

29. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day
When they are > 40 lbs and still less then 5'
One dose at 12-15 mod - Booster at least 4-weeks after

30. What are 2 conditions that have been proven to be beneficial to screened for?
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
Smoking - Alcoholism
Rear facing

31. When should tetanus immunoglobulin be given?
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day

32. Who are at increased risk for adverse effect catching a flu?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

33. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs
Femoral neck

34. What are the risks of combination HRT?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
During 2nd - 3rd trimester
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

35. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
In adults with sustained BP > 135/80 mmHg
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

36. What is the schedule for varicella vaccine?
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
Stroke and DVT
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

37. How much fluoride should military children in HI be given?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
Smoking - Alcoholism

38. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
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
Femoral neck

39. In which group of patients should aspirin be given as primary prevention for MI?
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day
During 2nd - 3rd trimester
Men 45 - 79 yo

40. Who should get shingles vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. How much calcium should adults (19 - 50) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 mg/day

42. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise - Environmental hazard reduction - Close monitoring of medication

43. How much calcium should women > 50 take?
Starts at 20 for both M and W
1200 mg/day
HISTORY
In adults with sustained BP > 135/80 mmHg

44. What are some risk factors for CAD?
Femoral neck
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

45. What kind of sunscreen SPF is recommended for sun protection?
Meningitis and Epiglottitis
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

46. 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
Forearm
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

47. How much vit D should adults > 50 take?
1000 IU/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs
Exercise - Environmental hazard reduction - Close monitoring of medication

48. What is the schedule for Gardasil?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo

49. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

50. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
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