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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 are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Persons with no known risk factors
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

2. What type of illnesses does Hib vaccine prevent?
1300 mg/day
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES

3. What can decrease fall in the elderly?
BP - Height - Weight
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...
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT

4. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Children up to 7 yo and < 5' should be placed in a booster seat.
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY
800 IU/ day

5. When is intensive individualized home-based intervention recommended?
4 mg/day
Adults > 60
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
During 2nd - 3rd trimester

6. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W
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

7. Who should get Tdap vaccine and how often?
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 - 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

8. What is the schedule for Hep B vaccine?
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What kind of polio vaccine is preferred?
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

10. What kind of sunscreen SPF is recommended for sun protection?
Children up to 7 yo and < 5' should be placed in a booster seat.
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15
> 2 yo and less than 40 lbs

11. Who should get shingles vaccine?
Every 5 years
0.4 mg/day
Adults > 60
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

12. What is the USPSTF guideline for DMT2 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
Femoral neck
Persons with no known risk factors
In adults with sustained BP > 135/80 mmHg

13. What 3 things should always be done in an office visit?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors
BP - Height - Weight

14. What tests are appropriate to order in an asymptomatic 57 yo male?
12 - 23 mo - 2 doses are to be given 6 mo apart
Total cholesterol - FOBT
Men 45 - 79 yo
More than 15

15. How much calcium should women > 50 take?
1200 mg/day
Stroke and DVT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

16. 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)
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection
1200 mg/day

17. At what age should women have DEXA scan?
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection
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
65 (earlier if have increased risk factors)

18. What kind of car seat should children < 2 yo be placed in?
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing
Children up to 7 yo and < 5' should be placed in a booster seat.
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

19. How much vit D should adults < 50 take?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day
Every 5 years

20. What are some risk factors for CAD?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

21. Some contraindications for aspirin
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. What is the USPSTF guideline for chlamydial screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
In all W < 24 who are sexually active - In W > 24 with increased risk

23. What are some safety issues you should counsel parents with young children?
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...
Start at 20 for all M and W regardless of RFs
NEVER
Children up to 7 yo and < 5' should be placed in a booster seat.

24. 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
1200 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester

25. When should pregnant women get a flu shot?
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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester

26. What is the schedule for varicella vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
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
One dose at 12-15 mod - Booster at least 4-weeks after

27. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart

28. When is area of induration > 15 mm considered TB positive?
1000 IU/day
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
Persons with no known risk factors

29. What are the risks of combination HRT?
During 2nd - 3rd trimester
Rear facing
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day

30. What is the schedule for Hep A vaccine?
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...
12 - 23 mo - 2 doses are to be given 6 mo apart
Persons with no known risk factors

31. Which children should use a semi-upright/forward facing carseat?
Smoking - Alcoholism
1000 IU/day
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.

32. How much calcium should adolescents (9 -18) take?
One dose at 12-15 mod - Booster at least 4-weeks after
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER

33. In which group of patients should aspirin be given as primary prevention for MI?
During 2nd - 3rd trimester
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...
Men 45 - 79 yo

34. What are 2 conditions that have been proven to be beneficial to screened for?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1200 mg/day

35. How much fluoride should military children in HI be given?
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after
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

36. What is USPSTF guideline for abdominal aortic aneurysm screening?
1300 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
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

37. What are the guidelines for pap smear?
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
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 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)
One time abdominal X-ray for all MALES who ever SMOKES

38. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 - 0.8 mg/day for 1 month prior to conception
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day

39. What is the schedule for polio vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
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

40. What is the USPSTF guideline for fall prevention in the elderly?
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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise or physical therapy and vit D for patients > 65

41. What is the schedule for Gardasil?
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs

42. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day
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

43. Measurement of which anatomic structure is best predictor for hip fracture?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One dose at 12-15 mod - Booster at least 4-weeks after

44. How much folate should all women of child bearing age take?
0.4 mg/day
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Smoking - Alcoholism

45. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
One dose at 12-15 mod - Booster at least 4-weeks after
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT

46. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
BP - Height - Weight
1000 IU/day
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

47. How much flouride should non military children in the state of HI be given?
One time abdominal X-ray for all MALES who ever SMOKES
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
> 2 yo and less than 40 lbs

48. When can children sit in a booster seat?

49. When is area of induration > 10 mm considered TB positive?
Total cholesterol - FOBT
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
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

50. 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
Men 45 - 79 yo
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 mg/day