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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 HI law for booster seat?

2. What tests are appropriate to order in an asymptomatic 57 yo male?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY
More than 15
Total cholesterol - FOBT

3. How much calcium should adults (19 - 50) take?
BP - Height - Weight
1000 mg/day
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

4. When can children sit in a booster seat?

5. 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
1000 mg/day
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

6. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Rear facing
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

7. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
1200 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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

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

9. When should the meningococcal vaccine be given and to which group?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight
Men 45 - 79 yo

10. What is the USPSTF guideline for chlamydial screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

12. What is USPSTF guideline for abdominal aortic aneurysm screening?
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
Femoral neck

13. When is area of induration > 15 mm considered TB positive?
To get IgA protection
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)
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1300 mg/day
Men 45 - 79 yo
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk

15. How much folate and for How long should a woman take for planned pregnancy?
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 - 0.8 mg/day for 1 month prior to conception

16. How often do asplenic patients receive pneumococcal vaccine?
Rear facing
800 IU/ day
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

17. If traveling to endemic areas - Why should one get a dose of live vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
Women 55 - 79 yo
1200 mg/day

18. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
Men 45 - 79 yo
Women 55 - 79 yo
Every 5 years

19. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
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
One time abdominal X-ray for all MALES who ever SMOKES

20. When should tetanus immunoglobulin be given?
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

21. What is the schedule for polio vaccine?
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs

22. What are the guidelines for visual screening?
Men 45 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo

23. At what age should women have DEXA scan?
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise or physical therapy and vit D for patients > 65
65 (earlier if have increased risk factors)
4 mg/day

24. 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
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What are some safety issues you should counsel parents with young children?
During 2nd - 3rd trimester
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...
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT

26. When should chest X-ray be used for screening?
2mo - 4 mo - 6mo and 12-15 mo
NEVER
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)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo - 6mo and 12-15 mo

28. What is the schedule for varicella 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...
Femoral neck
Total cholesterol - FOBT

29. What is the most important way to screen for CAD in an asymptomatic 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
1300 mg/day
NEVER
HISTORY

30. How much vit D should adults < 50 take?
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 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

31. How much calcium should adolescents (9 -18) take?
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
1300 mg/day
Rear facing

32. What 3 things should always be done in an office visit?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
HISTORY
1200 mg/day
BP - Height - Weight

33. What is the NCEP III guideline for cholesterol screening?
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight
Start at 20 for all M and W regardless of RFs

34. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

35. How much calcium should women > 50 take?
1200 mg/day
Rear facing
1000 IU/day
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)

36. What is the USPSTF guideline for fall prevention in the elderly?
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise or physical therapy and vit D for patients > 65
1300 mg/day

37. In which group of patients should aspirin be given as primary prevention for MI?
Rear facing
Exercise or physical therapy and vit D for patients > 65
Persons with no known risk factors
Men 45 - 79 yo

38. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
Starts at 20 for both M and W
1000 IU/day

39. Who should get Tdap vaccine and how often?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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)
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

40. What are the risks of combination HRT?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
800 IU/ day

41. What is the schedule for rotavirus vaccine?
NEVER
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
Persons with no known risk factors
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

42. When is intensive individualized home-based intervention recommended?
When they are > 40 lbs and still less then 5'
NEVER
2mo - 4 mo - 6mo and 12-15 mo
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

43. What is the schedule for Gardasil?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12 - 23 mo - 2 doses are to be given 6 mo apart

44. Who are at increased risk for adverse effect catching a flu?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
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

45. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day
65 (earlier if have increased risk factors)

46. What is the schedule for Hep A vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
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

47. Who should get shingles vaccine?
Adults > 60
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

48. How much folate should all women of child bearing age take?
0.4 mg/day
1000 IU/day
In adults with sustained BP > 135/80 mmHg
NEVER

49. What is the schedule for Hib vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
Adults > 60
2mo - 4 mo - 6mo and 12-15 mo

50. When should Gardasil be given and for what purposes?
0.4 - 0.8 mg/day for 1 month prior to conception
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
1300 mg/day
In adults with sustained BP > 135/80 mmHg