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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 rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
0.4 mg/day
800 IU/ day

2. What 3 things should always be done in an office visit?
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
BP - Height - Weight
Rear facing

3. How much folate should all women of child bearing age take?
Men 45 - 79 yo
0.4 mg/day
Total cholesterol - FOBT
Meningitis and Epiglottitis

4. Unopposed estrogen increases risks for what conditions?
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT
Rear facing

5. When is area of induration > 5mm considered TB positive?
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...
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

6. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication

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

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8. What kind of sunscreen SPF is recommended for sun protection?
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
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception

9. How much vit D should adults > 50 take?
HISTORY
Adults > 60
BP - Height - Weight
1000 IU/day

10. When should chest X-ray be used for screening?
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
NEVER
0.4 mg/day

11. Measurement of which anatomic structure is best predictor for hip fracture?
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
Femoral neck
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

12. What is the schedule for varicella vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after

13. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
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
Femoral neck

14. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism

15. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo
Femoral neck

16. What tests are appropriate to order in an asymptomatic 57 yo male?
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

17. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck

18. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

19. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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...

20. When should pregnant women get a flu shot?
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
Rear facing
Men 45 - 79 yo
During 2nd - 3rd trimester

21. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'

22. What is the schedule for MMR vaccine?
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT

23. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
When they are > 40 lbs and still less then 5'
Adults > 60
Children up to 7 yo and < 5' should be placed in a booster seat.

24. What is the NCEP III guideline for cholesterol screening?
65 (earlier if have increased risk factors)
More than 15
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

25. How much vit D should adults < 50 take?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 mg/day

26. What is the most important way to screen for CAD in an asymptomatic patients?
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...
HISTORY
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight

27. When should the meningococcal vaccine be given and to which group?
Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 20 for both M and W

28. What are the guidelines for pap smear?
Exercise or physical therapy and vit D for patients > 65
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 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

29. What type of illnesses does Hib vaccine prevent?
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo
NEVER
Meningitis and Epiglottitis

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

31. What are some RFs for DMT2?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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)
1200 mg/day
Meningitis and Epiglottitis

32. What is the schedule for Gardasil?
Start at 20 for all M and W regardless of RFs
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

33. At what age should women have DEXA scan?
Children up to 7 yo and < 5' should be placed in a booster seat.
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

34. When is intensive individualized home-based intervention recommended?
Starts at 50 (recommends against starting at 40) and every 2 years
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
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
800 IU/ day

35. How often do asplenic patients receive pneumococcal vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester
Every 5 years

36. Which children should use a semi-upright/forward facing carseat?
Forearm
> 2 yo and less than 40 lbs
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
12 - 23 mo - 2 doses are to be given 6 mo apart

37. Who should get shingles vaccine?
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES
Adults > 60
Men 45 - 79 yo

38. What are some risk factors for CAD?
Rear facing
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo

39. What is HI law for booster seat?

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40. When can children sit in a booster seat?

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41. 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
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

42. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
> 2 yo and less than 40 lbs

43. What is the USPSTF guideline for fall prevention in the elderly?
In adults with sustained BP > 135/80 mmHg
Start at 20 for all M and W regardless of RFs
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65

44. What is the schedule for polio vaccine?
Forearm
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4mo - 6-18 mo and 4-6 yrs
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

45. What is the schedule for Hib vaccine?
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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)
2mo - 4 mo - 6mo and 12-15 mo

46. What are 2 conditions that have been proven to be beneficial to screened for?
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
Meningitis and Epiglottitis

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

48. 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)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day

49. 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
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

50. What is the schedule for Hep A vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
12 - 23 mo - 2 doses are to be given 6 mo apart
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