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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. At what age should women have DEXA scan?
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
65 (earlier if have increased risk factors)
1200 mg/day

2. In which group of patients should aspirin be given as primary prevention for stroke?
Starts at 50 (recommends against starting at 40) and every 2 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
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo

3. What are the guidelines for visual screening?
Persons with no known risk factors
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Meningitis and Epiglottitis

4. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs

5. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Total cholesterol - FOBT
During 2nd - 3rd trimester
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

6. Who should get shingles vaccine?
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 - 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
Women 55 - 79 yo

7. How often do asplenic patients receive pneumococcal 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)
Starts at 50 (recommends against starting at 40) and every 2 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Every 5 years

8. How much fluoride should military children in HI be given?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise or physical therapy and vit D for patients > 65
During 2nd - 3rd trimester

9. What is the ADA guideline for DMT2 screening?
Stroke and DVT
Children up to 7 yo and < 5' should be placed in a booster seat.
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise or physical therapy and vit D for patients > 65

10. What are the guidelines for pap smear?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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)
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs

11. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT
To get IgA protection
Start at 20 for all M and W regardless of RFs

12. What is USPSTF guideline for abdominal aortic aneurysm screening?
Every 5 years
When they are > 40 lbs and still less then 5'
Starts at 20 for both M and W
One time abdominal X-ray for all MALES who ever SMOKES

13. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Children up to 7 yo and < 5' should be placed in a booster seat.

14. When is intensive individualized home-based intervention recommended?
0.4 - 0.8 mg/day for 1 month prior to conception
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
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

15. What type of illnesses does Hib vaccine prevent?
1300 mg/day
Meningitis and Epiglottitis
Exercise or physical therapy and vit D for patients > 65
1000 IU/day

16. What are some RFs for DMT2?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Stroke and DVT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

17. What are the risks of combination HRT?
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
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

18. How much folate and for How long should a woman take for planned pregnancy?
Rear facing
4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception

19. What kind of polio vaccine is preferred?
NEVER
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Adults > 60

20. What are 2 conditions that have been proven to be beneficial to screened for?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
BP - Height - Weight
Smoking - Alcoholism
In adults with sustained BP > 135/80 mmHg

21. What is the schedule for Hep B vaccine?
In adults with sustained BP > 135/80 mmHg
NEVER
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

22. When should pregnant women get a flu shot?
Exercise or physical therapy and vit D for patients > 65
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 and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester

23. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
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...
Smoking - Alcoholism

24. How much vit D should adults > 50 take?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
1000 IU/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

25. What is the schedule for Hep A vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart

26. What is the schedule for Hib 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
1300 mg/day
To get IgA protection

27. Who should get Tdap vaccine and how often?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)
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

28. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Women 55 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W

29. When is area of induration > 10 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

30. What is the schedule for varicella vaccine?
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after
When they are > 40 lbs and still less then 5'
1000 mg/day

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

32. What is the NCEP III guideline for cholesterol screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
Start at 20 for all M and W regardless of RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Rear facing

33. When can children sit in a booster seat?

34. What is the USPSTF guideline for chlamydial screening?
800 IU/ day
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm

35. What is the USPSTF guideline for DMT2 screening?
0.4 mg/day
In adults with sustained BP > 135/80 mmHg
800 IU/ day
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

36. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
800 IU/ day
In adults with sustained BP > 135/80 mmHg
4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

37. How much calcium should adolescents (9 -18) take?
1300 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors

38. Some contraindications for aspirin
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester
Starts at 20 for both M and W

39. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

40. What are the guidelines for colon cancer screening?
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
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

41. How much vit D should adults < 50 take?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day
More than 15
BP - Height - Weight

42. What kind of car seat should children < 2 yo be placed in?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Rear facing
Breast CA - thromboembolic event - stroke and CAD
65 (earlier if have increased risk factors)

43. What is HI law for booster seat?

44. What kind of sunscreen SPF is recommended for sun protection?
Meningitis and Epiglottitis
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
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
More than 15

45. When should chest X-ray be used for screening?
Forearm
Stroke and DVT
NEVER
Exercise - Environmental hazard reduction - Close monitoring of medication

46. What tests are appropriate to order in an asymptomatic 57 yo male?
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
65 (earlier if have increased risk factors)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

47. How much calcium should women > 50 take?
1200 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

48. What is the USPSTF guideline for fall prevention in the elderly?
Persons with no known risk factors
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight

49. How much calcium should adults (19 - 50) take?
1000 mg/day
1200 mg/day
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65

50. 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
Women 55 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
NEVER