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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. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Total cholesterol - FOBT
Smoking - Alcoholism
BP - Height - Weight

2. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Every 5 years
1300 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

3. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Every 5 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

4. What is USPSTF guideline for abdominal aortic aneurysm screening?
Rear facing
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...
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES

5. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
> 2 yo and less than 40 lbs
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)

6. How much vit D should adults > 50 take?
When they are > 40 lbs and still less then 5'
1000 IU/day
Forearm
During 2nd - 3rd trimester

7. What are the USPSTF guidelines for mammogram?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day

8. Who should get Tdap vaccine and how often?
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

9. 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
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
1300 mg/day
Starts at 20 for both M and W

10. What is the schedule for varicella vaccine?
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
One dose at 12-15 mod - Booster at least 4-weeks after

11. When is area of induration > 15 mm considered TB positive?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

12. How much folate and for How long should a woman take for planned pregnancy?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception

13. What is the USPSTF guideline for chlamydial 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

14. In which group of patients should aspirin be given as primary prevention for MI?
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men 45 - 79 yo

15. When is intensive individualized home-based intervention recommended?
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day
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

16. When should chest X-ray be used for screening?
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
1200 mg/day
When they are > 40 lbs and still less then 5'

17. In which group of patients should aspirin be given as primary prevention for stroke?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo

18. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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
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

19. What is the USPSTF guideline for DMT2 screening?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
NEVER
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

20. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
2mo - 4mo - 6-18 mo and 4-6 yrs
NEVER
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

21. When should Gardasil be given and for what purposes?
Smoking - Alcoholism
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

22. How much flouride should non military children in the state of HI be given?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

23. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Total cholesterol - FOBT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo

24. How much vit D should adults < 50 take?
Persons with no known risk factors
Men 45 - 79 yo
Exercise or physical therapy and vit D for patients > 65
800 IU/ day

25. What kind of car seat should children < 2 yo be placed in?
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing
1000 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)

26. What is the most important way to screen for CAD in an asymptomatic patients?
Femoral neck
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
HISTORY

27. What can decrease fall in the elderly?
1000 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors

28. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
Women 55 - 79 yo
4 mg/day
1300 mg/day

30. What type of illnesses does Hib vaccine prevent?
To get IgA protection
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

31. How often do asplenic patients receive pneumococcal vaccine?
Femoral neck
Every 5 years
NEVER
4 mg/day

32. What is the USPSTF guideline for fall prevention in the elderly?
Breast CA - thromboembolic event - stroke and CAD
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

33. What are 2 conditions that have been proven to be beneficial to screened for?
Women 55 - 79 yo
Smoking - Alcoholism
When they are > 40 lbs and still less then 5'
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)

34. What are the guidelines for colon cancer screening?
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
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. What is the ADA guideline for DMT2 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. How much calcium should adolescents (9 -18) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
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)
To get IgA protection
1300 mg/day

37. 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W
One time abdominal X-ray for all MALES who ever SMOKES

38. When is area of induration > 10 mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Breast CA - thromboembolic event - stroke and CAD
Starts at 20 for both M and W
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

39. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Forearm
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

40. Which children should use a semi-upright/forward facing carseat?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Breast CA - thromboembolic event - stroke and CAD

41. How much folate should all women of child bearing age take?
In adults with sustained BP > 135/80 mmHg
When they are > 40 lbs and still less then 5'
More than 15
0.4 mg/day

42. What is the schedule for rotavirus vaccine?
Men 45 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

43. How much fluoride should military children in HI be given?
Breast CA - thromboembolic event - stroke and CAD
Stroke and DVT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

44. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)
Every 5 years

45. What is the schedule for polio vaccine?
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
2mo - 4mo - 6-18 mo and 4-6 yrs
NEVER
Smoking - Alcoholism

46. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight
Smoking - Alcoholism

47. Unopposed estrogen increases risks for what conditions?
Starts at 20 for both M and W
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD
Stroke and DVT

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

49. What are the risks of combination HRT?
0.4 mg/day
800 IU/ day
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD

50. What is the schedule for DTap vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Rear facing
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