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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 USPSTF guideline for abdominal aortic aneurysm screening?
Starts at 20 for both M and W
One time abdominal X-ray for all MALES who ever SMOKES
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

2. How much vit D should adults > 50 take?
1000 IU/day
1300 mg/day
Start at 20 for all M and W regardless of RFs
Exercise - Environmental hazard reduction - Close monitoring of medication

3. What is HI law for booster seat?

4. When can children sit in a booster seat?

5. When is area of induration > 5mm considered TB positive?
Meningitis and Epiglottitis
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.
In adults with sustained BP > 135/80 mmHg

6. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Forearm
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...
Starts at 50 (recommends against starting at 40) and every 2 years

7. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
1300 mg/day
During 2nd - 3rd trimester
Rear facing

8. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
Forearm
4 mg/day
1000 mg/day

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

10. What are the guidelines for visual screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
0.4 mg/day
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
When they are > 40 lbs and still less then 5'

12. When should Gardasil be given and for what purposes?
Meningitis and Epiglottitis
1300 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

13. What are the guidelines for colon cancer screening?
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
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
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

14. How much flouride should non military children in the state of HI be given?
When they are > 40 lbs and still less then 5'
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

15. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
Femoral neck
1000 mg/day
To get IgA protection

16. What are the USPSTF guidelines for mammogram?
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

17. Who should get Tdap vaccine and how often?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
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

18. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One time abdominal X-ray for all MALES who ever SMOKES
Forearm

19. What are the risks of combination HRT?
Total cholesterol - FOBT
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)
Stroke and DVT
Breast CA - thromboembolic event - stroke and CAD

20. What is the schedule for polio vaccine?
Femoral neck
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

21. What is the schedule for Gardasil?
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Total cholesterol - FOBT
HISTORY

22. How much fluoride should military children in HI be given?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W
4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

23. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children up to 7 yo and < 5' should be placed in a booster seat.
Start at 20 for all M and W regardless of RFs

24. 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
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

25. What are some safety issues you should counsel parents with young children?
Every 5 years
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...
Breast CA - thromboembolic event - stroke and CAD

26. What tests are appropriate to order in an asymptomatic 57 yo male?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart

27. Measurement of which anatomic structure is best predictor for hip fracture?
BP - Height - Weight
Femoral neck
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

28. When is intensive individualized home-based intervention recommended?
Women 55 - 79 yo
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
To get IgA protection
One time abdominal X-ray for all MALES who ever SMOKES

29. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 20 for both M and W
Men 45 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

30. What is the ADA guideline for DMT2 screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In adults with sustained BP > 135/80 mmHg
During 2nd - 3rd trimester

31. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
1000 IU/day

32. How much calcium should adults (19 - 50) take?
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day

33. How much calcium should women > 50 take?
1200 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)
Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

34. When is area of induration > 10 mm considered TB positive?
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
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 mg/day
Smoking - Alcoholism

35. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Rear facing
> 2 yo and less than 40 lbs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

36. What are 2 conditions that have been proven to be beneficial to screened for?
Total cholesterol - FOBT
Smoking - Alcoholism
One time abdominal X-ray for all MALES who ever SMOKES
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

37. At what age should women have DEXA scan?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs

38. How much folate should all women of child bearing age take?
0.4 mg/day
Starts at 20 for both M and W
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT

40. Which children should use a semi-upright/forward facing carseat?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
> 2 yo and less than 40 lbs
To get IgA protection
NEVER

41. What is the schedule for rotavirus vaccine?
Meningitis and Epiglottitis
1300 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

42. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
Forearm

43. Some contraindications for aspirin
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

44. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Femoral neck
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 years

45. What is the schedule for Hib vaccine?
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

46. When should the meningococcal vaccine be given and to which group?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
When they are > 40 lbs and still less then 5'
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

47. What is the schedule for varicella vaccine?
Starts at 20 for both M and W
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after

48. What is the most important way to screen for CAD in an asymptomatic patients?
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
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
HISTORY

49. What is the schedule for DTap vaccine?
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

50. What kind of car seat should children < 2 yo be placed in?
Rear facing
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity