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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 NCEP III guideline for cholesterol screening?
1200 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
Start at 20 for all M and W regardless of RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

2. What is the USPSTF guideline for fall prevention in the elderly?
1000 IU/day
To get IgA protection
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

3. How often do asplenic patients receive pneumococcal vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years

4. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
When they are > 40 lbs and still less then 5'

5. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
During 2nd - 3rd trimester

6. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT

7. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

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

9. What are some safety issues you should counsel parents with young children?
Persons with no known risk factors
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)
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

10. What is the schedule for polio vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. When should Gardasil be given and for what purposes?
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...
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
1300 mg/day
In adults with sustained BP > 135/80 mmHg

12. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
800 IU/ day
Exercise or physical therapy and vit D for patients > 65
Every 5 years

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

14. Some contraindications for aspirin
800 IU/ day
Men 45 - 79 yo
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

15. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Total cholesterol - FOBT

16. When can children sit in a booster seat?

17. What are the guidelines for colon cancer screening?
> 2 yo and less than 40 lbs
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
Every 5 years
Starts at 20 for both M and W

18. When should chest X-ray be used for screening?
Every 5 years
During 2nd - 3rd trimester
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs

19. When is intensive individualized home-based intervention recommended?
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
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
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

20. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 20 for both M and W
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 up to 7 yo and < 5' should be placed in a booster seat.

21. What type of illnesses does Hib vaccine prevent?
HISTORY
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis

22. If traveling to endemic areas - Why should one get a dose of live vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

23. What is the USPSTF guideline for DMT2 screening?
Persons with no known risk factors
One dose at 12-15 mod - Booster at least 4-weeks after
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

24. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo

25. How much flouride should non military children in the state of HI be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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 is the schedule for varicella vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
1000 IU/day
One dose at 12-15 mod - Booster at least 4-weeks after

27. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

28. When is area of induration > 10 mm considered TB positive?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs
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
1000 IU/day

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Rear facing
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
Starts at 50 (recommends against starting at 40) and every 2 years

30. What are 2 conditions that have been proven to be beneficial to screened for?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart

31. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
BP - Height - Weight

32. Measurement of which anatomic structure is best predictor for fractures elsewhere beside 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
HISTORY
Forearm
BP - Height - Weight

33. How much fluoride should military children in HI be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT
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...

34. What are the guidelines for visual 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
800 IU/ day
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

35. What kind of car seat should children < 2 yo be placed in?
One dose at 12-15 mod - Booster at least 4-weeks after
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
Rear facing

36. 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
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
HISTORY

37. What kind of sunscreen SPF is recommended for sun protection?
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
More than 15
Persons with no known risk factors

38. How much calcium should adolescents (9 -18) 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)
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
1300 mg/day
1200 mg/day

39. 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
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

40. How much folate should all women of child bearing age take?
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD
Women 55 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. What is the schedule for Hib 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
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors

42. What is HI law for booster seat?

43. 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck
65 (earlier if have increased risk factors)

44. What is the schedule for Gardasil?
Stroke and DVT
Meningitis and Epiglottitis
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES

45. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

46. Who should get Tdap vaccine and how often?
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
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

47. Who should get shingles vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
0.4 mg/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...

48. What is the schedule for MMR vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day
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

49. How much calcium should women > 50 take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1200 mg/day
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

50. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Smoking - Alcoholism
> 2 yo and less than 40 lbs
Starts at 50 (recommends against starting at 40) and every 2 years