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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 are some safety issues you should counsel parents with young children?
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...
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

2. When is area of induration > 5mm considered TB positive?
One time abdominal X-ray for all MALES who ever SMOKES
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
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
Smoking - Alcoholism

3. What is the schedule for rotavirus vaccine?
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...
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

4. What is the schedule for Hib vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
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...
65 (earlier if have increased risk factors)
2mo - 4 mo - 6mo and 12-15 mo

5. When should tetanus immunoglobulin be given?
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)
Stroke and DVT
Children up to 7 yo and < 5' should be placed in a booster seat.

6. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

7. What kind of car seat should children < 2 yo be placed in?
Exercise or physical therapy and vit D for patients > 65
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
Rear facing

8. When should the meningococcal vaccine be given and to which group?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Femoral neck
Smoking - Alcoholism

9. At what age should women have DEXA scan?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
NEVER
More than 15

10. What is USPSTF guideline for abdominal aortic aneurysm screening?
1000 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
One time abdominal X-ray for all MALES who ever SMOKES
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)

11. What is the USPSTF guideline for chlamydial screening?
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm

12. In which group of patients should aspirin be given as primary prevention for stroke?
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
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
Women 55 - 79 yo
HISTORY

13. When is intensive individualized home-based intervention recommended?
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
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
NEVER
> 2 yo and less than 40 lbs

14. What is the schedule for Hep A vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
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

15. What is the ADA guideline for DMT2 screening?
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

16. What can decrease fall in the elderly?
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication

17. How much vit D should adults < 50 take?
Exercise or physical therapy and vit D for patients > 65
800 IU/ day
Stroke and DVT
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...

18. What kind of sunscreen SPF is recommended for sun protection?
Meningitis and Epiglottitis
More than 15
4 mg/day
NEVER

19. What is HI law for booster seat?

20. What is the NCEP III guideline for cholesterol screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Start at 20 for all M and W regardless of RFs
Exercise - Environmental hazard reduction - Close monitoring of medication

21. How much calcium should adolescents (9 -18) take?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
BP - Height - Weight

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

23. What is the schedule for Hep B vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
Every 5 years

24. 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
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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

25. How much vit D should adults > 50 take?
Rear facing
NEVER
2mo - 4 mo - 6mo and 12-15 mo
1000 IU/day

26. How much folate should all women of child bearing age take?
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)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

27. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...
Meningitis and Epiglottitis
Every 5 years

28. Who are at increased risk for adverse effect catching a flu?
One dose at 12-15 mod - Booster at least 4-weeks after
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

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

30. 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
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT

31. How much folate and for How long should a woman take for planned pregnancy?
0.4 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER

32. If traveling to endemic areas - Why should one get a dose of live vaccine?
Start at 20 for all M and W regardless of RFs
Every 5 years
In adults with sustained BP > 135/80 mmHg
To get IgA protection

33. What 3 things should always be done in an office visit?
Men 45 - 79 yo
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
BP - Height - Weight

34. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk

35. Unopposed estrogen increases risks for what conditions?
Starts at 50 (recommends against starting at 40) and every 2 years
NEVER
Stroke and DVT
2mo - 4mo - 6-18 mo and 4-6 yrs

36. What tests are appropriate to order in an asymptomatic 57 yo male?
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Every 5 years
Total cholesterol - FOBT

37. What is the schedule for varicella vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

38. How much calcium should women > 50 take?
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1200 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

39. What are the USPSTF guidelines for cholesterol screening in 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)
Stroke and DVT
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 20 for both M and W

40. What is the schedule for polio vaccine?
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after

41. What are the guidelines for pap smear?
One time abdominal X-ray for all MALES who ever SMOKES
During 2nd - 3rd trimester
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)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

42. 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
Meningitis and Epiglottitis
Femoral neck
800 IU/ day

43. 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
Starts at 50 (recommends against starting at 40) and every 2 years
Femoral neck
In adults with sustained BP > 135/80 mmHg

44. Some contraindications for aspirin
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs

45. How much flouride should non military children in the state of HI be given?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

46. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

47. What are the guidelines for colon cancer screening?
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
Rear facing
Breast CA - thromboembolic event - stroke and CAD

48. Measurement of which anatomic structure is best predictor for hip fracture?
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo
Smoking - Alcoholism
Femoral neck

49. What type of illnesses does Hib vaccine prevent?
Persons with no known risk factors
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
1000 mg/day
Meningitis and Epiglottitis

50. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism