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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 DTap vaccine?
Exercise or physical therapy and vit D for patients > 65
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Rear facing
Total cholesterol - FOBT

2. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
800 IU/ day

3. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Women 55 - 79 yo
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...
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

4. What are the USPSTF guidelines for mammogram?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 50 (recommends against starting at 40) and every 2 years

5. How much vit D should adults > 50 take?
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day

6. What is HI law for booster seat?

7. When can children sit in a booster seat?

8. What type of illnesses does Hib vaccine prevent?
Every 5 years
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
HISTORY

9. When is area of induration > 10 mm considered TB positive?
Adults > 60
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk
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

10. What 3 things should always be done in an office visit?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Meningitis and Epiglottitis

11. If traveling to endemic areas - Why should one get a dose of live vaccine?
Every 5 years
0.4 mg/day
Femoral neck
To get IgA protection

12. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
When they are > 40 lbs and still less then 5'

13. What is the schedule for Hib vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo - 6mo and 12-15 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

14. What kind of sunscreen SPF is recommended for sun protection?
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
More than 15
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

15. What is the schedule for polio vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

16. How much calcium should women > 50 take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
800 IU/ day
1200 mg/day
1000 mg/day

17. How much calcium should adults (19 - 50) take?
1000 mg/day
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

18. At what age should women have DEXA scan?
Women 55 - 79 yo
65 (earlier if have increased 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...
1000 mg/day

19. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Total cholesterol - FOBT
4 mg/day
NEVER

20. When is area of induration > 5mm 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
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
Forearm
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 kind of polio vaccine is preferred?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day
1000 IU/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

22. In which group of patients should aspirin be given as primary prevention for MI?
65 (earlier if have increased risk factors)
During 2nd - 3rd trimester
Men 45 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs

23. Some contraindications for aspirin
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism

24. When should Gardasil be given and for what purposes?
> 2 yo and less than 40 lbs
HISTORY
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
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

25. What are the risks of combination HRT?
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER
Breast CA - thromboembolic event - stroke and CAD
Forearm

26. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
Smoking - Alcoholism

27. How much folate and for How long should a woman take for planned pregnancy?
During 2nd - 3rd trimester
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
0.4 - 0.8 mg/day for 1 month prior to conception

28. What can decrease fall in the elderly?
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

29. What is the USPSTF guideline for fall prevention in the elderly?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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 50 (recommends against starting at 40) and every 2 years
Exercise or physical therapy and vit D for patients > 65

30. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
> 2 yo and less than 40 lbs
Forearm
Meningitis and Epiglottitis
During 2nd - 3rd trimester

31. Which children should use a semi-upright/forward facing carseat?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing

32. What are the guidelines for visual screening?
0.4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. Who are at increased risk for adverse effect catching a flu?
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day
1200 mg/day

34. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
Starts at 20 for both M and W
> 2 yo and less than 40 lbs

35. What is the schedule for Gardasil?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

36. What kind of car seat should children < 2 yo be placed in?
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
Rear facing

37. In which group of patients should aspirin be given as primary prevention for stroke?
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
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

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

39. What are 2 conditions that have been proven to be beneficial to screened for?
Every 5 years
Stroke and DVT
Smoking - Alcoholism
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

40. How much calcium should adolescents (9 -18) take?
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
1300 mg/day
Smoking - Alcoholism

41. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
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

42. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

43. What are some safety issues you should counsel parents with young children?
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
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...
Women 55 - 79 yo

44. 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)
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception

45. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

46. Who should get Tdap vaccine and how often?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
Starts at 20 for both M and W
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

47. When should chest X-ray be used for screening?
NEVER
Persons with no known risk factors
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In adults with sustained BP > 135/80 mmHg

48. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
65 (earlier if have increased risk factors)
Starts at 20 for both M and W

49. What tests are appropriate to order in an asymptomatic 57 yo male?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W

50. When should the meningococcal vaccine be given and to which group?
During 2nd - 3rd trimester
Meningitis and Epiglottitis
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman