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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 kind of sunscreen SPF is recommended for sun protection?
Total cholesterol - FOBT
More than 15
1000 IU/day
During 2nd - 3rd trimester

2. What can decrease fall in the elderly?
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo - 6mo and 12-15 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

3. 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
To get IgA protection

4. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Rear facing
During 2nd - 3rd trimester
Breast CA - thromboembolic event - stroke and CAD

5. What is the schedule for Hep A vaccine?
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. When is area of induration > 15 mm considered TB positive?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1200 mg/day
Total cholesterol - FOBT
Persons with no known risk factors

7. What is the schedule for polio vaccine?
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4mo - 6-18 mo and 4-6 yrs
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)

8. What are some RFs for DMT2?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Exercise or physical therapy and vit D for patients > 65
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children up to 7 yo and < 5' should be placed in a booster seat.

9. What is HI law for booster seat?

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

11. When should the meningococcal vaccine be given and to which group?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One dose at 12-15 mod - Booster at least 4-weeks after
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

12. When is area of induration > 5mm considered TB positive?
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)
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
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

13. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1200 mg/day
Persons with no known risk factors
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
4 mg/day

14. Which children should use a semi-upright/forward facing carseat?
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

15. 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
In adults with sustained BP > 135/80 mmHg
Stroke and DVT
To get IgA protection

16. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Start at 20 for all M and W regardless of RFs

17. How often do asplenic patients receive pneumococcal vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
800 IU/ day
Every 5 years
1000 IU/day

18. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
Rear facing
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

19. 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
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs
800 IU/ day

20. What is the most important way to screen for CAD in an asymptomatic patients?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Stroke and DVT
HISTORY
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

21. When is area of induration > 10 mm considered TB positive?
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo
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
Starts at 20 for both M and W

22. How much calcium should women > 50 take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day
During 2nd - 3rd trimester
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

23. When should pregnant women get a flu shot?
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis
During 2nd - 3rd trimester
In adults with sustained BP > 135/80 mmHg

24. What are the guidelines for pap smear?
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 dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
800 IU/ day
NEVER

25. Who should get shingles vaccine?
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day
Adults > 60
Every 5 years

26. How much flouride should non military children in the state of HI be given?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

27. In which group of patients should aspirin be given as primary prevention for MI?
4 mg/day
Men 45 - 79 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
During 2nd - 3rd trimester

28. What are some safety issues you should counsel parents with young children?
Rear facing
In adults with sustained BP > 135/80 mmHg
HISTORY
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...

29. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
65 (earlier if have increased risk factors)
Adults > 60
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)

30. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
800 IU/ day
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo - 6mo and 12-15 mo

31. What is the USPSTF guideline for fall prevention in the elderly?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Exercise or physical therapy and vit D for patients > 65
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

32. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Total cholesterol - FOBT
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

33. What is the NCEP III guideline for cholesterol screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
1000 mg/day

34. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
800 IU/ day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 - 0.8 mg/day for 1 month prior to conception

35. How much folate should all women of child bearing age take?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
0.4 mg/day
Forearm

36. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
Starts at 50 (recommends against starting at 40) and every 2 years
One dose at 12-15 mod - Booster at least 4-weeks after

37. What is the schedule for Gardasil?
Forearm
Persons with no known risk factors
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

38. When can children sit in a booster seat?

39. What tests are appropriate to order in an asymptomatic 57 yo male?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What are the guidelines for visual screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD

41. Measurement of which anatomic structure is best predictor for hip fracture?
1000 mg/day
Starts at 20 for both M and W
1000 IU/day
Femoral neck

42. Who are at increased risk for adverse effect catching a flu?
Persons with no known risk factors
65 (earlier if have increased risk factors)
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

43. When should chest X-ray be used for screening?
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT
Stroke and DVT

44. What is the schedule for rotavirus vaccine?
Stroke and DVT
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

45. What is the USPSTF guideline for chlamydial screening?
HISTORY
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER

46. How much vit D should adults < 50 take?
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after
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
800 IU/ day

47. What 3 things should always be done in an office visit?
1200 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD

48. What is the schedule for varicella vaccine?
Rear facing
One dose at 12-15 mod - Booster at least 4-weeks after
1300 mg/day
Start at 20 for all M and W regardless of RFs

49. When should tetanus immunoglobulin be given?
Total cholesterol - FOBT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

50. How much calcium should adolescents (9 -18) take?
1300 mg/day
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
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...