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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 kind of car seat should children < 2 yo be placed in?
One time abdominal X-ray for all MALES who ever SMOKES
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight
Rear facing

2. When is area of induration > 5mm considered TB positive?
BP - Height - Weight
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In adults with sustained BP > 135/80 mmHg

3. 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

4. What is the schedule for Gardasil?
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Total cholesterol - FOBT

5. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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...
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.

6. When should Gardasil be given and for what purposes?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
To get IgA protection
Exercise or physical therapy and vit D for patients > 65
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

7. At what age should women have DEXA scan?
Women 55 - 79 yo
65 (earlier if have increased risk factors)
Femoral neck
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

8. How much calcium should adolescents (9 -18) take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

9. Who should get shingles vaccine?
To get IgA protection
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

10. 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
Forearm
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 - 0.8 mg/day for 1 month prior to conception

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

12. What is the schedule for DTap vaccine?
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
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester

13. How much folate should all women of child bearing age take?
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...
Breast CA - thromboembolic event - stroke and CAD
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

14. What is the schedule for varicella vaccine?
Total cholesterol - FOBT
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One dose at 12-15 mod - Booster at least 4-weeks after

15. When can children sit in a booster seat?

16. 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

17. What is the USPSTF guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
During 2nd - 3rd trimester
Starts at 20 for both M and W

18. When should chest X-ray be used for screening?
1000 mg/day
NEVER
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
HISTORY

19. What kind of polio vaccine is preferred?
Starts at 20 for both M and W
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years

20. What are some risk factors for CAD?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

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

22. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more 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)

23. What are the risks of combination HRT?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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 dose at 12-15 mod - Booster at least 4-weeks after
Breast CA - thromboembolic event - stroke and CAD

24. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
0.4 mg/day
65 (earlier if have increased risk factors)
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
Forearm

25. When should tetanus immunoglobulin be given?
Starts at 20 for both M and W
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'
Forearm

26. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
4 mg/day
Starts at 20 for both M and W
Women 55 - 79 yo

27. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
Stroke and DVT
Every 5 years

28. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

30. What are the guidelines for pap smear?
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
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 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)

31. What are some RFs for DMT2?
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

32. What type of illnesses does Hib vaccine prevent?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Meningitis and Epiglottitis
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

33. When should pregnant women get a flu shot?
4 mg/day
Adults > 60
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester

34. When should the meningococcal vaccine be given and to which group?
1000 IU/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

35. What is the schedule for polio vaccine?
Start at 20 for all M and W regardless of RFs
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Breast CA - thromboembolic event - stroke and CAD

36. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)

37. How much vit D should adults > 50 take?
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day

38. How much vit D should adults < 50 take?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

39. What are some safety issues you should counsel parents with young children?
Children up to 7 yo and < 5' should be placed in a booster seat.
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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...

40. What is the schedule for Hep B vaccine?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

42. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
> 2 yo and less than 40 lbs
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
Every 5 years

43. What kind of sunscreen SPF is recommended for sun protection?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15
800 IU/ day
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

44. What can decrease fall in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

45. In which group of patients should aspirin be given as primary prevention for MI?
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ day

46. Who should get Tdap vaccine and how often?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
Children up to 7 yo and < 5' should be placed in a booster seat.
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

48. What are the USPSTF guidelines for mammogram?
4 mg/day
65 (earlier if have increased risk factors)
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

49. Measurement of which anatomic structure is best predictor for hip fracture?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 mg/day
Femoral neck

50. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD
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
1000 IU/day