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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. How much vit D should adults > 50 take?
Stroke and DVT
1000 IU/day
Femoral neck
Meningitis and Epiglottitis

2. How much flouride should non military children in the state of HI be given?
Femoral neck
1300 mg/day
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

3. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
When they are > 40 lbs and still less then 5'
To get IgA protection
65 (earlier if have increased risk factors)

4. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
0.4 mg/day
4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
To get IgA protection

5. What is the ADA guideline for DMT2 screening?
Start at 20 for all M and W regardless of RFs
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

6. When can children sit in a booster seat?

7. What is the schedule for Hep B vaccine?
NEVER
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

8. Unopposed estrogen increases risks for what conditions?
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
Stroke and DVT
1300 mg/day

9. In which group of patients should aspirin be given as primary prevention for stroke?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart

10. What are the risks of combination HRT?
2mo - 4mo - 6-18 mo and 4-6 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection

11. What is the schedule for Gardasil?
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 mg/day
Femoral neck

12. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

13. What is the most important way to screen for CAD in an asymptomatic patients?
Exercise - Environmental hazard reduction - Close monitoring of medication
Breast CA - thromboembolic event - stroke and CAD
Start at 20 for all M and W regardless of RFs
HISTORY

14. What is HI law for booster seat?

15. How much calcium should adults (19 - 50) take?
Women 55 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
4 mg/day
1000 mg/day

16. When should chest X-ray be used for screening?
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/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

17. Who should get shingles vaccine?
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
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs
Adults > 60

18. What 3 things should always be done in an office visit?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years
BP - Height - Weight

19. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1200 mg/day
Forearm
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES

20. How much folate and for How long should a woman take for planned pregnancy?
Total cholesterol - FOBT
0.4 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day

21. Who should get Tdap vaccine and how often?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of 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)
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
Femoral neck

22. What can decrease fall in the elderly?
More than 15
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck
Exercise - Environmental hazard reduction - Close monitoring of medication

23. 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
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

24. What kind of polio vaccine is preferred?
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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Rear facing

25. When is area of induration > 5mm considered TB positive?
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
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

26. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
One time abdominal X-ray for all MALES who ever SMOKES
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)

27. What are the guidelines for pap smear?
Forearm
65 (earlier if have increased risk factors)
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)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

28. What kind of car seat should children < 2 yo be placed in?
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
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
To get IgA protection

29. What is the schedule for rotavirus vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
When they are > 40 lbs and still less then 5'

30. How much calcium should adolescents (9 -18) take?
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 mg/day
During 2nd - 3rd trimester
1300 mg/day

31. What tests are appropriate to order in an asymptomatic 57 yo male?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Total cholesterol - FOBT

32. How much vit D should adults < 50 take?
800 IU/ day
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing

33. How much folate should all women of child bearing age take?
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

34. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
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...
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
To get IgA protection

35. 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
Starts at 50 (recommends against starting at 40) and every 2 years
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)

36. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

37. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

38. What are 2 conditions that have been proven to be beneficial to screened for?
BP - Height - Weight
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism
HISTORY

39. What are some safety issues you should counsel parents with young children?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...

40. What is the schedule for Hib vaccine?
HISTORY
Persons with no known risk factors
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo

41. What is the schedule for DTap vaccine?
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

42. What kind of sunscreen SPF is recommended for sun protection?
More than 15
HISTORY
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs

43. What is the schedule for MMR vaccine?
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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
During 2nd - 3rd trimester
Rear facing

44. In which group of patients should aspirin be given as primary prevention for MI?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs
Men 45 - 79 yo

45. Which children should use a semi-upright/forward facing carseat?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

46. What is the USPSTF guideline for DMT2 screening?
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 - 4mo - 6-18 mo and 4-6 yrs
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

47. What is the schedule for polio vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

48. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4mo - 6-18 mo and 4-6 yrs

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

50. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Forearm
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy