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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 vit D should adults < 50 take?
In adults with sustained BP > 135/80 mmHg
Adults > 60
Children up to 7 yo and < 5' should be placed in a booster seat.
800 IU/ day

2. At what age should women have DEXA scan?
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
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart
Adults > 60

3. What is the schedule for rotavirus vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

4. What type of illnesses does Hib vaccine prevent?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis

5. How much calcium should women > 50 take?
0.4 mg/day
1200 mg/day
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

6. What is the schedule for polio vaccine?
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
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
2mo - 4mo - 6-18 mo and 4-6 yrs

7. How much fluoride should military children in HI be given?
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

8. What is the NCEP III guideline for cholesterol screening?
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs

9. How much flouride should non military children in the state of HI be given?
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

10. How much calcium should adults (19 - 50) take?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
1000 mg/day
When they are > 40 lbs and still less then 5'

11. Unopposed estrogen increases risks for what conditions?
800 IU/ day
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

12. What are the USPSTF guidelines for mammogram?
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years
1300 mg/day

13. What is the most important way to screen for CAD in an asymptomatic patients?
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication
HISTORY

14. What are the risks of combination HRT?
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis
NEVER
Breast CA - thromboembolic event - stroke and CAD

15. In which group of patients should aspirin be given as primary prevention for MI?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 mg/day
Men 45 - 79 yo
Smoking - Alcoholism

16. What is the schedule for Gardasil?
HISTORY
In adults with sustained BP > 135/80 mmHg
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

17. When should Gardasil be given and for what purposes?
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
1300 mg/day

18. Who should get Tdap vaccine and how often?
When they are > 40 lbs and still less then 5'
Start at 20 for all M and W regardless of RFs
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

19. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs
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

20. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

21. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
During 2nd - 3rd trimester
In all W < 24 who are sexually active - In W > 24 with increased risk

22. Which children should use a semi-upright/forward facing carseat?
2mo - 4mo - 6-18 mo and 4-6 yrs
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
BP - Height - Weight

23. What 3 things should always be done in an office visit?
Breast CA - thromboembolic event - stroke and CAD
In all W < 24 who are sexually active - In W > 24 with increased risk
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
BP - Height - Weight

24. What are the guidelines for pap smear?
Persons with no known risk factors
0.4 mg/day
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)

25. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after

26. When is intensive individualized home-based intervention recommended?
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
Stroke and DVT
BP - Height - Weight
1000 IU/day

27. What kind of polio vaccine is preferred?
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)
During 2nd - 3rd trimester
1000 IU/day

28. Measurement of which anatomic structure is best predictor for hip fracture?
Meningitis and Epiglottitis
Women 55 - 79 yo
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

29. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
To get IgA protection
Rear facing
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

31. What are the guidelines for visual screening?
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. What kind of sunscreen SPF is recommended for sun protection?
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. If traveling to endemic areas - Why should one get a dose of live vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
To get IgA protection
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

34. How much calcium should adolescents (9 -18) take?
1300 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER

35. What is the ADA guideline for DMT2 screening?
0.4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15

36. When is area of induration > 5mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
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
NEVER
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

37. When should the meningococcal vaccine be given and to which group?
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
> 2 yo and less than 40 lbs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

38. When should chest X-ray be used for screening?
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo
NEVER

39. What is the schedule for Hep A vaccine?
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart

40. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

41. What are some risk factors for CAD?
1300 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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...
To get IgA protection

42. What are some RFs for DMT2?
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
0.4 - 0.8 mg/day for 1 month prior to conception
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
When they are > 40 lbs and still less then 5'

43. When is area of induration > 15 mm considered TB positive?
Men 45 - 79 yo
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day

44. How much vit D should adults > 50 take?
4 mg/day
HISTORY
1000 IU/day
Meningitis and Epiglottitis

45. What is the USPSTF guideline for fall prevention in the elderly?
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
In adults with sustained BP > 135/80 mmHg
Forearm

46. Who should get shingles vaccine?
Femoral neck
2mo - 4mo - 6-18 mo and 4-6 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60

47. How much folate should all women of child bearing age take?
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...
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 mg/day

48. When can children sit in a booster seat?

49. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

50. What is HI law for booster seat?