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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 polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15

2. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 50 (recommends against starting at 40) and every 2 years
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
BP - Height - Weight

3. What 3 things should always be done in an office visit?
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
BP - Height - Weight
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

4. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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
Meningitis and Epiglottitis

5. What are the guidelines for visual screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
4 mg/day
Femoral neck
Preschool children : 3-4 yo - Elderly patients: > 65 yo

6. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
To get IgA protection

7. What is the schedule for DTap vaccine?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. When can children sit in a booster seat?

9. What type of illnesses does Hib vaccine prevent?
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
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis

10. What kind of car seat should children < 2 yo be placed in?
Rear facing
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

11. When is area of induration > 15 mm considered TB positive?
Stroke and DVT
2mo - 4mo - 6-18 mo and 4-6 yrs
More than 15
Persons with no known risk factors

12. What is the schedule for Hep B vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

13. At what age should women have DEXA scan?
Rear facing
65 (earlier if have increased risk factors)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day

14. 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
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart

15. Who should get Tdap vaccine and how often?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester

17. How often do asplenic patients receive pneumococcal vaccine?
1000 IU/day
Every 5 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm

18. What is the schedule for varicella vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

19. How much folate should all women of child bearing age 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
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 mg/day
Women 55 - 79 yo

20. What tests are appropriate to order in an asymptomatic 57 yo male?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
Men 45 - 79 yo
Total cholesterol - FOBT

21. What are some RFs for DMT2?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT
In adults with sustained BP > 135/80 mmHg
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

22. 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
Starts at 20 for both M and W
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection

23. What is the USPSTF guideline for chlamydial screening?
800 IU/ day
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...
In all W < 24 who are sexually active - In W > 24 with increased risk

24. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart

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

26. What kind of sunscreen SPF is recommended for sun protection?
1000 IU/day
More than 15
In adults with sustained BP > 135/80 mmHg
800 IU/ day

27. What is the schedule for Gardasil?
Children up to 7 yo and < 5' should be placed in a booster seat.
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

28. Measurement of which anatomic structure is best predictor for hip fracture?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Femoral neck
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

29. What is the USPSTF guideline for fall prevention in the elderly?
Forearm
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
Rear facing

30. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'
Adults > 60

31. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Adults > 60
When they are > 40 lbs and still less then 5'
1000 IU/day
Starts at 20 for both M and W

32. How much vit D should adults < 50 take?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck
Children up to 7 yo and < 5' should be placed in a booster seat.

33. Who are at increased risk for adverse effect catching a flu?
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
Starts at 20 for both M and W

34. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

35. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs

36. When should pregnant women get a flu shot?
65 (earlier if have increased risk factors)
During 2nd - 3rd trimester
Meningitis and Epiglottitis
800 IU/ day

37. What is the schedule for Hib 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
2mo - 4 mo - 6mo and 12-15 mo
12 - 23 mo - 2 doses are to be given 6 mo apart
One time abdominal X-ray for all MALES who ever SMOKES

38. What are the guidelines for colon cancer screening?
Meningitis and Epiglottitis
In adults with sustained BP > 135/80 mmHg
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

39. Which children should use a semi-upright/forward facing carseat?
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
HISTORY
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

40. When is area of induration > 10 mm considered TB positive?
Forearm
Every 5 years
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
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

41. What is the NCEP III guideline for cholesterol screening?
Meningitis and Epiglottitis
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day
Start at 20 for all M and W regardless of RFs

42. When is intensive individualized home-based intervention recommended?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
BP - Height - Weight

43. How much fluoride should military children in HI be given?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

44. What are the USPSTF guidelines for mammogram?
Femoral neck
65 (earlier if have increased risk factors)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 50 (recommends against starting at 40) and every 2 years

45. What kind of polio vaccine is preferred?
65 (earlier if have increased risk factors)
Women 55 - 79 yo
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

46. What are the guidelines for pap smear?
0.4 mg/day
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg
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)

47. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
Children up to 7 yo and < 5' should be placed in a booster seat.
In adults with sustained BP > 135/80 mmHg
0.4 - 0.8 mg/day for 1 month prior to conception

48. In which group of patients should aspirin be given as primary prevention for stroke?
More than 15
1000 IU/day
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

49. How much calcium should women > 50 take?
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
1200 mg/day
Meningitis and Epiglottitis
Forearm

50. How much calcium should adolescents (9 -18) take?
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose