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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 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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm
Start at 20 for all M and W regardless of RFs

2. What is HI law for booster seat?

3. Unopposed estrogen increases risks for what conditions?
Meningitis and Epiglottitis
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

4. When can children sit in a booster seat?

5. When is area of induration > 15 mm considered TB positive?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Persons with no known risk factors
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

6. How often do asplenic patients receive pneumococcal vaccine?
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
Men 45 - 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...

7. In which group of patients should aspirin be given as primary prevention for MI?
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)
1300 mg/day
Men 45 - 79 yo

8. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
1200 mg/day

9. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Rear facing

10. How much flouride should non military children in the state of HI be given?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after

11. What are the USPSTF guidelines for mammogram?
0.4 - 0.8 mg/day for 1 month prior to conception
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 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

12. 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
Children up to 7 yo and < 5' should be placed in a booster seat.
During 2nd - 3rd trimester
Stroke and DVT

13. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
Stroke and DVT
> 2 yo and less than 40 lbs

14. When should Gardasil be given and for what purposes?
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
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

15. In which group of patients should aspirin be given as primary prevention for stroke?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
Women 55 - 79 yo

16. Who should get shingles vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise or physical therapy and vit D for patients > 65
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

17. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
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 > 60

18. 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
More than 15
Breast CA - thromboembolic event - stroke and CAD
NEVER

19. Which children should use a semi-upright/forward facing carseat?
One time abdominal X-ray for all MALES who ever SMOKES
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
> 2 yo and less than 40 lbs

20. What are the risks of combination HRT?
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
Breast CA - thromboembolic event - stroke and CAD
4 mg/day
Exercise or physical therapy and vit D for patients > 65

21. When is area of induration > 5mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

22. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

23. 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
Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years

24. What kind of car seat should children < 2 yo be placed in?
65 (earlier if have increased risk factors)
Rear facing
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

25. What is the schedule for Gardasil?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
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

26. When is area of induration > 10 mm considered TB positive?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
65 (earlier if have increased risk factors)
1200 mg/day

27. How much calcium should adults (19 - 50) take?
0.4 mg/day
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day

28. How much vit D should adults < 50 take?
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
1300 mg/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

29. Who are at increased risk for adverse effect catching a flu?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Adults > 60

30. What is the ADA guideline for DMT2 screening?
1200 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

31. What tests are appropriate to order in an asymptomatic 57 yo male?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after

32. What is the schedule for Hep B vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years

33. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
More than 15

34. What is the schedule for Hib vaccine?
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo - 6mo and 12-15 mo
Adults > 60

35. What type of illnesses does Hib vaccine prevent?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Meningitis and Epiglottitis

36. What are 2 conditions that have been proven to be beneficial to screened for?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

37. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

38. 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
BP - Height - Weight
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

39. How much calcium should adolescents (9 -18) take?
1300 mg/day
Stroke and DVT
Preschool children : 3-4 yo - Elderly patients: > 65 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

40. What are the guidelines for visual screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Meningitis and Epiglottitis

41. How much vit D should adults > 50 take?
BP - Height - Weight
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
4 mg/day

42. What is the schedule for DTap vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise or physical therapy and vit D for patients > 65
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

43. When is intensive individualized home-based intervention recommended?
1300 mg/day
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
Every 5 years
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

44. Measurement of which anatomic structure is best predictor for hip fracture?
Meningitis and Epiglottitis
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

45. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Femoral neck
NEVER
Stroke and DVT

46. If traveling to endemic areas - Why should one get a dose of live vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm
To get IgA protection
800 IU/ day

47. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
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)
0.4 mg/day
Forearm

48. When should pregnant women get a flu shot?
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester
HISTORY
NEVER

49. 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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)
HISTORY

50. How much folate and for How long should a woman take for planned pregnancy?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years