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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. 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
Every 5 years
NEVER

2. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
Forearm
When they are > 40 lbs and still less then 5'

3. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg
NEVER

4. When is area of induration > 15 mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

5. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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
Meningitis and Epiglottitis
1300 mg/day

6. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
1000 IU/day

7. Who should get shingles vaccine?
800 IU/ day
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60

8. Measurement of which anatomic structure is best predictor for hip fracture?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
BP - Height - Weight
Femoral neck

9. When should the meningococcal vaccine be given and to which group?
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

10. In which group of patients should aspirin be given as primary prevention for MI?
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...
Men 45 - 79 yo
Smoking - Alcoholism

11. What are some risk factors for CAD?
During 2nd - 3rd trimester
Persons with no known risk factors
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Forearm
Adults > 60
Every 5 years

13. What is the schedule for Hep A 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)
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
12 - 23 mo - 2 doses are to be given 6 mo apart

14. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Adults > 60
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
1000 mg/day

15. When should Gardasil be given and for what purposes?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
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
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...

16. How much calcium should adolescents (9 -18) take?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 mg/day

17. 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
1000 IU/day
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart

18. When should tetanus immunoglobulin be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
Total cholesterol - FOBT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 20 for both M and W

19. How much folate and for How long should a woman take for planned pregnancy?
Starts at 20 for both M and W
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
When they are > 40 lbs and still less then 5'

20. What can decrease fall in the elderly?
In adults with sustained BP > 135/80 mmHg
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
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

21. Some contraindications for aspirin
Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

22. What is the schedule for MMR vaccine?
65 (earlier if have increased risk factors)
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

23. What are some safety issues you should counsel parents with young children?
Rear facing
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...
Exercise - Environmental hazard reduction - Close monitoring of medication

24. What are the guidelines for pap smear?
Every 5 years
During 2nd - 3rd trimester
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)

25. Which children should use a semi-upright/forward facing carseat?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
> 2 yo and less than 40 lbs
NEVER

26. What is the NCEP III guideline for cholesterol screening?
One dose at 12-15 mod - Booster at least 4-weeks after
Start at 20 for all M and W regardless of RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. What kind of polio vaccine is preferred?
4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis

28. What is the ADA guideline for DMT2 screening?
Femoral neck
1200 mg/day
Women 55 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

29. What is the schedule for polio vaccine?
Meningitis and Epiglottitis
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs

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

31. 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)
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm

32. What is the schedule for varicella vaccine?
Persons with no known risk factors
One dose at 12-15 mod - Booster at least 4-weeks after
Start at 20 for all M and W regardless of RFs
BP - Height - Weight

33. What is the schedule for Gardasil?
In all W < 24 who are sexually active - In W > 24 with increased risk
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

34. What is the USPSTF guideline for DMT2 screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Forearm
In adults with sustained BP > 135/80 mmHg

35. In which group of patients should aspirin be given as primary prevention for stroke?
Stroke and DVT
Women 55 - 79 yo
> 2 yo and less than 40 lbs
More than 15

36. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

37. What tests are appropriate to order in an asymptomatic 57 yo male?
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
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
Total cholesterol - FOBT

38. What are the USPSTF guidelines for mammogram?
Starts at 20 for both M and W
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years

39. What type of illnesses does Hib vaccine prevent?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis

40. When should pregnant women get a flu shot?
NEVER
One dose at 12-15 mod - Booster at least 4-weeks after
During 2nd - 3rd trimester
1200 mg/day

41. What is HI law for booster seat?

42. What kind of sunscreen SPF is recommended for sun protection?
Start at 20 for all M and W regardless of RFs
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
Stroke and DVT
More than 15

43. How much vit D should adults > 50 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
1300 mg/day

44. When is area of induration > 10 mm considered TB positive?
Total cholesterol - FOBT
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
Adults > 60
> 2 yo and less than 40 lbs

45. Unopposed estrogen increases risks for what conditions?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
800 IU/ day

46. 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
> 2 yo and less than 40 lbs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise or physical therapy and vit D for patients > 65

47. What is the most important way to screen for CAD in an asymptomatic patients?
Forearm
BP - Height - Weight
Adults > 60
HISTORY

48. What is the schedule for DTap vaccine?
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
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

49. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 IU/day
800 IU/ day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

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