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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 USPSTF guideline for fall prevention in the elderly?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65

2. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
More than 15
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

3. When should Gardasil be given and for what purposes?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
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?
When they are > 40 lbs and still less then 5'
BP - Height - Weight
During 2nd - 3rd trimester
NEVER

5. What type of illnesses does Hib vaccine prevent?
Forearm
More than 15
Meningitis and Epiglottitis
Starts at 20 for both M and W

6. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

7. How much calcium should adolescents (9 -18) take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
HISTORY
1300 mg/day

8. Who are at increased risk for adverse effect catching a flu?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

9. 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)
Starts at 50 (recommends against starting at 40) and every 2 years
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception

10. If traveling to endemic areas - Why should one get a dose of live vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
More than 15
To get IgA protection
Breast CA - thromboembolic event - stroke and CAD

11. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
In adults with sustained BP > 135/80 mmHg
Forearm
1000 mg/day
4 mg/day

12. When is area of induration > 10 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
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

13. In which group of patients should aspirin be given as primary prevention for stroke?
Forearm
To get IgA protection
Women 55 - 79 yo
HISTORY

14. Some contraindications for aspirin
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)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Forearm
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

15. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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)
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 20 for both M and W

16. When should pregnant women get a flu shot?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
During 2nd - 3rd trimester

17. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
HISTORY
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
> 2 yo and less than 40 lbs

18. What are the USPSTF guidelines for mammogram?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD
Starts at 50 (recommends against starting at 40) and every 2 years

19. How much calcium should adults (19 - 50) take?
Exercise or physical therapy and vit D for patients > 65
1000 mg/day
1000 IU/day
BP - Height - Weight

20. What is the schedule for varicella vaccine?
0.4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

21. Unopposed estrogen increases risks for what conditions?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 20 for both M and W
4 mg/day
Stroke and DVT

22. When can children sit in a booster seat?

23. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day

24. What is the schedule for MMR vaccine?
HISTORY
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

25. What are the risks of combination HRT?
Persons with no known risk factors
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
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

26. What 3 things should always be done in an office visit?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

27. How much fluoride should military children in HI be given?
1000 mg/day
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

28. What are the guidelines for visual screening?
To get IgA protection
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 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

29. When should tetanus immunoglobulin be given?
Total cholesterol - FOBT
Persons with no known risk factors
Meningitis and Epiglottitis
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

30. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

31. How much calcium should women > 50 take?
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs
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)
1200 mg/day

32. What is the USPSTF guideline for chlamydial screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
2mo - 4 mo - 6mo and 12-15 mo

33. How much folate should all women of child bearing age take?
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
0.4 mg/day
2mo - 4 mo - 6mo and 12-15 mo

34. What is the schedule for rotavirus vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

35. What can decrease fall in the elderly?
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

36. What is the schedule for Hep B vaccine?
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...
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

37. What is the most important way to screen for CAD in an asymptomatic patients?
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
HISTORY
Stroke and DVT

38. How much flouride should non military children in the state of HI be given?
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...
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
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. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day
Starts at 20 for both M and W

40. What is the USPSTF guideline for DMT2 screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In adults with sustained BP > 135/80 mmHg
HISTORY

41. What is the schedule for polio vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
More than 15
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs

42. What is USPSTF guideline for abdominal aortic aneurysm screening?
In adults with sustained BP > 135/80 mmHg
Adults > 60
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk

43. What are some safety issues you should counsel parents with young children?
Meningitis and Epiglottitis
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
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

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

45. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Persons with no known risk factors

46. 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
HISTORY
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)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

47. 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
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
Children up to 7 yo and < 5' should be placed in a booster seat.

48. How much vit D should adults < 50 take?
0.4 - 0.8 mg/day for 1 month prior to conception
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
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

49. What is the schedule for DTap vaccine?
NEVER
Femoral neck
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

50. What kind of sunscreen SPF is recommended for sun protection?
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...
NEVER
0.4 mg/day
More than 15