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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 rotavirus vaccine?
> 2 yo and less than 40 lbs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2mo - 4 mo - 6mo and 12-15 mo
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

2. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
One time abdominal X-ray for all MALES who ever SMOKES
4 mg/day
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

3. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day

4. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
Total cholesterol - FOBT
Adults > 60

5. What is the ADA guideline for DMT2 screening?
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 20 for both M and W
One time abdominal X-ray for all MALES who ever SMOKES
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

6. What are the guidelines for pap smear?
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

7. 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
Exercise or physical therapy and vit D for patients > 65
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
4 mg/day

8. What are some risk factors for CAD?
Adults > 60
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

9. When should chest X-ray be used for screening?
NEVER
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
Men 45 - 79 yo

10. What is the schedule for Hib vaccine?
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
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.

11. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck

12. What is the schedule for Hep A vaccine?
BP - Height - Weight
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck

13. At what age should women have DEXA scan?
HISTORY
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.
BP - Height - Weight
Forearm

15. How much fluoride should military children in HI be given?
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

16. How much calcium should adolescents (9 -18) take?
NEVER
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
Every 5 years

17. What is USPSTF guideline for abdominal aortic aneurysm screening?
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart

18. What can decrease fall in the elderly?
BP - Height - Weight
Starts at 50 (recommends against starting at 40) and every 2 years
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication

19. In which group of patients should aspirin be given as primary prevention for MI?
During 2nd - 3rd trimester
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

20. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One dose at 12-15 mod - Booster at least 4-weeks after
1000 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...

21. What are some RFs for DMT2?
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 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)
Exercise or physical therapy and vit D for patients > 65

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

23. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
0.4 mg/day
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk

24. Who should get shingles vaccine?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

25. What is the USPSTF guideline for DMT2 screening?
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
In adults with sustained BP > 135/80 mmHg

26. What is the schedule for Hep B vaccine?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after

27. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
1300 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

28. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

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

30. When is area of induration > 10 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis
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

31. When should Gardasil be given and for what purposes?
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
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
In all W < 24 who are sexually active - In W > 24 with increased risk

32. What is the schedule for Gardasil?
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)
Starts at 20 for both M and W
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

33. What 3 things should always be done in an office visit?
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

34. How much calcium should women > 50 take?
1200 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

35. Who are at increased risk for adverse effect catching a flu?
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
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception

36. What type of illnesses does Hib vaccine prevent?
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
1000 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis

37. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

38. What is the schedule for polio vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

39. How much vit D should adults > 50 take?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 IU/day

40. What are the guidelines for visual screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

41. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
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

42. What kind of polio vaccine is preferred?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism

43. When should pregnant women get a flu shot?
To get IgA protection
During 2nd - 3rd trimester
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Rear facing

44. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Breast CA - thromboembolic event - stroke and CAD
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65
To get IgA protection

45. When is intensive individualized home-based intervention recommended?
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day
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

46. What is the USPSTF guideline for chlamydial screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4mo - 6-18 mo and 4-6 yrs

47. Who should get Tdap vaccine and how often?
Forearm
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
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

48. What kind of car seat should children < 2 yo be placed in?
Rear facing
More than 15
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years

49. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Stroke and DVT
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
In adults with sustained BP > 135/80 mmHg

50. How much calcium should adults (19 - 50) take?
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...
1000 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
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