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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 varicella vaccine?
800 IU/ 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
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after

2. When should Gardasil be given and for what purposes?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

3. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Start at 20 for all M and W regardless of RFs
To get IgA protection
Every 5 years

4. What is the schedule for MMR vaccine?
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...
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised 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

5. What are 2 conditions that have been proven to be beneficial to screened for?
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
More than 15

6. 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
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

7. What is the NCEP III guideline for cholesterol screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo

8. What is the USPSTF guideline for fall prevention in the elderly?
Rear facing
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65

9. What is the ADA guideline for DMT2 screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

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

11. What is the schedule for DTap vaccine?
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
1000 IU/day
4 mg/day

12. What 3 things should always be done in an office visit?
Women 55 - 79 yo
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...
BP - Height - Weight
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

13. What is the schedule for polio vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4mo - 6-18 mo and 4-6 yrs
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
One time abdominal X-ray for all MALES who ever SMOKES

14. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day
Stroke and DVT

15. How much calcium should women > 50 take?
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

16. When is area of induration > 10 mm considered TB positive?
During 2nd - 3rd trimester
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
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

17. How much vit D should adults < 50 take?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day

18. What is the schedule for Hep A 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...
Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

19. What is the USPSTF guideline for DMT2 screening?
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
65 (earlier if have increased risk factors)

20. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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
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

21. What kind of sunscreen SPF is recommended for sun protection?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)

22. How much calcium should adolescents (9 -18) take?
2mo - 4 mo - 6mo and 12-15 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
NEVER

23. Some contraindications for aspirin
NEVER
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck
BP - Height - Weight

24. What is HI law for booster seat?

25. 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
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
65 (earlier if have increased risk factors)

26. When is intensive individualized home-based intervention recommended?
One dose at 12-15 mod - Booster at least 4-weeks after
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

27. 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)
4 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
Femoral neck

28. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
To get IgA protection
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

29. How much calcium should adults (19 - 50) take?
NEVER
1000 mg/day
Start at 20 for all M and W regardless of RFs
Rear facing

30. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Every 5 years
65 (earlier if have increased risk factors)
Total cholesterol - FOBT

31. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
Starts at 20 for both M and W
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

33. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Breast CA - thromboembolic event - stroke and CAD
HISTORY
1200 mg/day
Forearm

34. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT
Adults > 60
HISTORY

35. How much vit D should adults > 50 take?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
When they are > 40 lbs and still less then 5'
1000 IU/day

36. What is the schedule for rotavirus vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
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

37. Who are at increased risk for adverse effect catching a flu?
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise or physical therapy and vit D for patients > 65

38. Who should get Tdap vaccine and how often?
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
Starts at 20 for both M and W
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. What are the USPSTF guidelines for mammogram?
To get IgA protection
BP - Height - Weight
1300 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

40. What kind of car seat should children < 2 yo be placed in?
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
Men 45 - 79 yo
BP - Height - Weight
Rear facing

41. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after
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 adults with sustained BP > 135/80 mmHg

42. What are some safety issues you should counsel parents with young children?
Persons with no known risk factors
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. When is area of induration > 5mm considered TB positive?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)

44. When should pregnant women get a flu shot?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years
During 2nd - 3rd trimester

45. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
In adults with sustained BP > 135/80 mmHg
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
Women 55 - 79 yo

46. How much folate should all women of child bearing age take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

47. When is area of induration > 15 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Persons with no known risk factors
1000 IU/day
Men 45 - 79 yo

48. At what age should women have DEXA scan?
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
65 (earlier if have increased risk factors)

49. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after

50. 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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk