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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. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

2. How often do asplenic patients receive pneumococcal vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years
Smoking - Alcoholism

3. What is the USPSTF guideline for chlamydial screening?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs

4. How much fluoride should military children in HI be given?
During 2nd - 3rd trimester
1300 mg/day
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

5. What is the schedule for Hep B vaccine?
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 - 0.8 mg/day for 1 month prior to conception
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

6. Measurement of which anatomic structure is best predictor for hip fracture?
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck
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)
Breast CA - thromboembolic event - stroke and CAD

7. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
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
Rear facing
Forearm

8. What kind of car seat should children < 2 yo be placed in?
Rear facing
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication
Preschool children : 3-4 yo - Elderly patients: > 65 yo

9. When can children sit in a booster seat?

10. What is the schedule for rotavirus vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 mg/day
1000 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

11. What kind of polio vaccine is preferred?
800 IU/ day
1000 IU/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. Which children should use a semi-upright/forward facing carseat?
NEVER
0.4 mg/day
> 2 yo and less than 40 lbs
To get IgA protection

13. If traveling to endemic areas - Why should one get a dose of live vaccine?
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
To get IgA protection

14. Who should get Tdap vaccine and how often?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs
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
Total cholesterol - FOBT

15. How much folate and for How long should a woman take for planned pregnancy?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
In all W < 24 who are sexually active - In W > 24 with increased risk

16. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT

17. What are the guidelines for colon cancer screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

18. Who should get shingles vaccine?
800 IU/ day
Adults > 60
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...
1300 mg/day

19. What is HI law for booster seat?

20. When should chest X-ray be used for screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
> 2 yo and less than 40 lbs
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)

21. How much vit D should adults < 50 take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
800 IU/ day
One dose at 12-15 mod - Booster at least 4-weeks after
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

22. What is the NCEP III guideline for cholesterol screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo
Start at 20 for all M and W regardless of RFs

23. How much calcium should women > 50 take?
Persons with no known risk factors
1200 mg/day
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

24. How much calcium should adolescents (9 -18) take?
1300 mg/day
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Meningitis and Epiglottitis
Adults > 60

26. What are some RFs for DMT2?
To get IgA protection
During 2nd - 3rd trimester
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

27. What is USPSTF guideline for abdominal aortic aneurysm screening?
Women 55 - 79 yo
1200 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Femoral neck

28. How much calcium should adults (19 - 50) take?
12 - 23 mo - 2 doses are to be given 6 mo apart
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day

29. When is area of induration > 5mm considered TB positive?
Starts at 50 (recommends against starting at 40) and every 2 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
> 2 yo and less than 40 lbs
Adults > 60

30. How much vit D should adults > 50 take?
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

31. 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
Children up to 7 yo and < 5' should be placed in a booster seat.
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart

32. At what age should women have DEXA scan?
Exercise or physical therapy and vit D for patients > 65
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
65 (earlier if have increased risk factors)

33. What are the guidelines for pap smear?
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
More than 15
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)
When they are > 40 lbs and still less then 5'

34. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo

35. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart

36. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 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)
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
Adults > 60

37. What is the schedule for varicella vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One dose at 12-15 mod - Booster at least 4-weeks after
Women 55 - 79 yo
4 mg/day

38. When is area of induration > 15 mm considered TB positive?
When they are > 40 lbs and still less then 5'
Persons with no known risk factors
Women 55 - 79 yo
1300 mg/day

39. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Rear facing
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

40. What is the schedule for Hep A vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

41. How much folate should all women of child bearing age take?
0.4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism

42. What are the USPSTF guidelines for mammogram?
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...
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart

43. 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
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...
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD

44. 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
BP - Height - Weight
12 - 23 mo - 2 doses are to be given 6 mo apart

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

46. What are 2 conditions that have been proven to be beneficial to screened for?
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
Total cholesterol - FOBT
Smoking - Alcoholism

47. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. What is the schedule for polio vaccine?
> 2 yo and less than 40 lbs
2mo - 4mo - 6-18 mo and 4-6 yrs
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
In adults with sustained BP > 135/80 mmHg

49. When should pregnant women get a flu shot?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
In all W < 24 who are sexually active - In W > 24 with increased risk

50. When is intensive individualized home-based intervention recommended?
65 (earlier if have increased risk factors)
Adults > 60
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 - 23 mo - 2 doses are to be given 6 mo apart