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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 is area of induration > 5mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
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
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

2. What is the USPSTF guideline for chlamydial screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication

3. What 3 things should always be done in an office visit?
NEVER
1000 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
BP - Height - Weight

4. What are the guidelines for colon cancer screening?
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...
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
To get IgA protection

5. What are the USPSTF guidelines for mammogram?
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
Women 55 - 79 yo
Adults > 60

6. 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
1300 mg/day
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

7. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
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...
To get IgA protection

8. When is area of induration > 10 mm considered TB positive?
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
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg

9. Who should get Tdap vaccine and how often?
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
Meningitis and Epiglottitis
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

10. How much vit D should adults > 50 take?
4 mg/day
Exercise or physical therapy and vit D for patients > 65
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES

11. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
To get IgA protection
4 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
Men 45 - 79 yo

12. How much folate should all women of child bearing age take?
0.4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm

13. How much flouride should non military children in the state of HI be given?
Stroke and DVT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1200 mg/day
NEVER

14. What can decrease fall in the elderly?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years

15. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 mg/day

16. What are some risk factors for CAD?
1200 mg/day
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

17. What is the most important way to screen for CAD in an asymptomatic 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
HISTORY
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

18. What is the schedule for DTap vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
When they are > 40 lbs and still less then 5'
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

19. Some contraindications for aspirin
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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism

20. What is the schedule for Hib vaccine?
Men 45 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis

21. How much calcium should adults (19 - 50) take?
2mo - 4 mo - 6mo and 12-15 mo
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
1000 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

22. What is the USPSTF guideline for fall prevention in the elderly?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
HISTORY

23. Which children should use a semi-upright/forward facing carseat?
NEVER
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk

24. What is the schedule for Gardasil?
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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

25. Who are at increased risk for adverse effect catching a flu?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Women 55 - 79 yo

26. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
65 (earlier if have increased risk factors)
2mo - 4mo - 6-18 mo and 4-6 yrs

27. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs

28. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo - 6mo and 12-15 mo
To get IgA protection

29. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
In adults with sustained BP > 135/80 mmHg
Starts at 20 for both M and W

30. When should pregnant women get a flu shot?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 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
During 2nd - 3rd trimester

31. What are some RFs for DMT2?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo

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

33. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors
One dose at 12-15 mod - Booster at least 4-weeks after

34. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs

35. How much fluoride should military children in HI be given?
One time abdominal X-ray for all MALES who ever SMOKES
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In adults with sustained BP > 135/80 mmHg

36. How much calcium should adolescents (9 -18) take?
> 2 yo and less than 40 lbs
1300 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)
Total cholesterol - FOBT

37. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

38. When can children sit in a booster seat?

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39. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

40. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
In adults with sustained BP > 135/80 mmHg
Exercise or physical therapy and vit D for patients > 65

41. How much calcium should women > 50 take?
Exercise - Environmental hazard reduction - Close monitoring of medication
Femoral neck
1200 mg/day
Total cholesterol - FOBT

42. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors

43. What kind of sunscreen SPF is recommended for sun protection?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing

44. What are the guidelines for pap smear?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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)
Total cholesterol - FOBT

45. When is area of induration > 15 mm considered TB positive?
Total cholesterol - FOBT
Persons with no known risk factors
1300 mg/day
HISTORY

46. What is HI law for booster seat?

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47. At what age should women have DEXA scan?
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
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. What is the schedule for Hep A vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
12 - 23 mo - 2 doses are to be given 6 mo apart
Adults > 60
BP - Height - Weight

49. What kind of car seat should children < 2 yo be placed in?
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
During 2nd - 3rd trimester
Rear facing

50. What is the schedule for rotavirus vaccine?
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 - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age