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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 are the USPSTF guidelines for mammogram?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 50 (recommends against starting at 40) and every 2 years
1000 IU/day

2. When can children sit in a booster seat?

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3. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
In adults with sustained BP > 135/80 mmHg
More than 15
NEVER
4 mg/day

4. What can decrease fall in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise - Environmental hazard reduction - Close monitoring of medication

5. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
NEVER
Every 5 years

6. What is the schedule for DTap vaccine?
Rear facing
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
4 mg/day

7. 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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

8. What tests are appropriate to order in an asymptomatic 57 yo male?
0.4 mg/day
4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Total cholesterol - FOBT

9. When should chest X-ray be used for screening?
Exercise or physical therapy and vit D for patients > 65
NEVER
Persons with no known risk factors
Stroke and DVT

10. Which children should use a semi-upright/forward facing carseat?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
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

11. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Start at 20 for all M and W regardless of RFs
Femoral neck
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

12. Unopposed estrogen increases risks for what conditions?
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
> 2 yo and less than 40 lbs
Persons with no known risk factors

13. How much folate and for How long should a woman take for planned pregnancy?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 years
More than 15

14. How much calcium should adolescents (9 -18) take?
NEVER
HISTORY
1300 mg/day
Stroke and DVT

15. How often do asplenic patients receive pneumococcal vaccine?
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
Every 5 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

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

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

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18. 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
Forearm
Men 45 - 79 yo

19. What are some safety issues you should counsel parents with young children?
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
1000 IU/day
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...

20. When is area of induration > 10 mm considered TB positive?
One dose at 12-15 mod - Booster at least 4-weeks after
Children up to 7 yo and < 5' should be placed in a booster seat.
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
65 (earlier if have increased risk factors)

21. What are the guidelines for pap smear?
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 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)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

22. When should pregnant women get a flu shot?
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...
During 2nd - 3rd trimester
More than 15

23. Measurement of which anatomic structure is best predictor for hip fracture?
Total cholesterol - FOBT
1000 IU/day
Men 45 - 79 yo
Femoral neck

24. When is area of induration > 15 mm considered TB positive?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Smoking - Alcoholism
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs

25. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo
During 2nd - 3rd trimester
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. How much vit D should adults > 50 take?
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo

27. 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
More than 15
> 2 yo and less than 40 lbs
1200 mg/day

28. 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
HISTORY
Rear facing
1000 mg/day

29. What is the schedule for MMR vaccine?
Persons with no known risk factors
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
To get IgA protection

30. How much vit D should adults < 50 take?
Smoking - Alcoholism
800 IU/ day
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck

31. What kind of polio vaccine is preferred?
Starts at 50 (recommends against starting at 40) and every 2 years
During 2nd - 3rd trimester
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)

32. What is the USPSTF guideline for fall prevention in the elderly?
Men 45 - 79 yo
> 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

33. Some contraindications for aspirin
To get IgA protection
Rear facing
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12 - 23 mo - 2 doses are to be given 6 mo apart

34. What is USPSTF guideline for abdominal aortic aneurysm screening?
4 mg/day
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

35. What 3 things should always be done in an office visit?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
BP - Height - Weight
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

36. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Forearm
Adults > 60
During 2nd - 3rd trimester

37. What is the most important way to screen for CAD in an asymptomatic patients?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
HISTORY

38. What are the guidelines for colon cancer screening?
Stroke and DVT
One dose at 12-15 mod - Booster at least 4-weeks after
1000 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

39. Who are at increased risk for adverse effect catching a flu?
Children up to 7 yo and < 5' should be placed in a booster seat.
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

40. How much flouride should non military children in the state of HI be given?
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Start at 20 for all M and W regardless of RFs

41. Who should get Tdap vaccine and how often?
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day
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
NEVER

42. How much folate should all women of child bearing age take?
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Smoking - Alcoholism

43. What is HI law for booster seat?

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44. What is the USPSTF guideline for chlamydial screening?
To get IgA protection
800 IU/ day
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

45. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Forearm

46. What are the risks of combination HRT?
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
Stroke and DVT

47. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Meningitis and Epiglottitis

48. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Total cholesterol - FOBT
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

49. What is the schedule for Hep A vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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)
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day

50. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Start at 20 for all M and W regardless of RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day