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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 Hep A vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism
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

2. Some contraindications for aspirin
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One time abdominal X-ray for all MALES who ever SMOKES

3. Who should get Tdap vaccine and how often?
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day
65 (earlier if have increased risk factors)
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

4. What are 2 conditions that have been proven to be beneficial to screened for?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Smoking - Alcoholism
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

5. How much fluoride should military children in HI be given?
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
More than 15

6. What are the guidelines for visual screening?
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo

7. In which group of patients should aspirin be given as primary prevention for stroke?
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day
Women 55 - 79 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

8. 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
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise - Environmental hazard reduction - Close monitoring of medication

9. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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 50 (recommends against starting at 40) and every 2 years

10. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis
In adults with sustained BP > 135/80 mmHg
12 - 23 mo - 2 doses are to be given 6 mo apart

11. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 50 (recommends against starting at 40) and every 2 years
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)
Smoking - Alcoholism

12. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'

13. What 3 things should always be done in an office visit?
Rear facing
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

14. When should pregnant women get a flu shot?
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester

15. What are some RFs for DMT2?
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
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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

16. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Forearm
> 2 yo and less than 40 lbs

17. What kind of polio vaccine is preferred?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

18. At what age should women have DEXA scan?
1000 mg/day
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
More than 15

19. What are the risks of combination HRT?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD

20. Unopposed estrogen increases risks for what conditions?
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
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

21. 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
Femoral neck
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)

22. What is the schedule for MMR vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Stroke and DVT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors

23. What is USPSTF guideline for abdominal aortic aneurysm screening?
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES

24. What is the NCEP III guideline for cholesterol screening?
Femoral neck
Start at 20 for all M and W regardless of RFs
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
More than 15

25. When should the meningococcal vaccine be given and to which group?
1300 mg/day
Total cholesterol - FOBT
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)

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

27. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day
Persons with no known risk factors
Adults > 60

28. How much vit D should adults < 50 take?
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs
800 IU/ day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

29. What kind of car seat should children < 2 yo be placed in?
Rear facing
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Men 45 - 79 yo
65 (earlier if have increased risk factors)

30. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Men 45 - 79 yo
NEVER
Exercise or physical therapy and vit D for patients > 65

31. When is intensive individualized home-based intervention recommended?
Exercise - Environmental hazard reduction - Close monitoring of medication
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

32. When should chest X-ray be used for screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER
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

33. What are the guidelines for colon cancer screening?
1300 mg/day
Smoking - Alcoholism
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 - 4 mo - 6mo and 12-15 mo

34. When is area of induration > 15 mm considered TB positive?
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
Persons with no known risk factors
More than 15

35. Who should get shingles vaccine?
Exercise or physical therapy and vit D for patients > 65
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection

36. What are the USPSTF guidelines for mammogram?
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
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after

37. How much folate and for How long should a woman take for planned pregnancy?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 - 0.8 mg/day for 1 month prior to conception

38. What is the USPSTF guideline for fall prevention in the elderly?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck

39. Measurement of which anatomic structure is best predictor for hip fracture?
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo
Femoral neck
When they are > 40 lbs and still less then 5'

40. What are some safety issues you should counsel parents with young children?
Exercise or physical therapy and vit D for patients > 65
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 mg/day
Stroke and DVT

41. When can children sit in a booster seat?

42. What is the USPSTF guideline for chlamydial screening?
0.4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 IU/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
More than 15

44. What are the guidelines for pap smear?
Total cholesterol - FOBT
Starts at 20 for both M and W
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. How often do asplenic patients receive pneumococcal vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
1000 mg/day

46. How much folate should all women of child bearing age take?
Total cholesterol - FOBT
During 2nd - 3rd trimester
1000 mg/day
0.4 mg/day

47. How much calcium should women > 50 take?
800 IU/ day
1200 mg/day
NEVER
1000 mg/day

48. What kind of sunscreen SPF is recommended for sun protection?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
More than 15
Women 55 - 79 yo

49. How much calcium should adolescents (9 -18) take?
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
Forearm
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo

50. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
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
Stroke and DVT