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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 calcium should adults (19 - 50) take?
1000 IU/day
HISTORY
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day

2. How much folate should all women of child bearing age take?
0.4 mg/day
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk

3. Who should get shingles vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
Adults > 60

4. What kind of car seat should children < 2 yo be placed in?
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight

5. When should Gardasil be given and for what purposes?
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
Starts at 20 for both M and W
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
Rear facing

6. How much vit D should adults > 50 take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 IU/day

7. What is the USPSTF guideline for chlamydial screening?
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT

8. What is HI law for booster seat?

9. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
BP - Height - Weight
Start at 20 for all M and W regardless of RFs
1200 mg/day

10. In which group of patients should aspirin be given as primary prevention for stroke?
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs
2mo - 4mo - 6-18 mo and 4-6 yrs
Women 55 - 79 yo

11. What is the schedule for Gardasil?
800 IU/ day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
In all W < 24 who are sexually active - In W > 24 with increased risk

13. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
HISTORY
Children up to 7 yo and < 5' should be placed in a booster seat.
In adults with sustained BP > 135/80 mmHg

14. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

15. What is the USPSTF guideline for fall prevention in the elderly?
More than 15
Women 55 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise or physical therapy and vit D for patients > 65

16. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

17. How often do asplenic patients receive pneumococcal vaccine?
Meningitis and Epiglottitis
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

18. When should tetanus immunoglobulin be given?
Men 45 - 79 yo
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
One dose at 12-15 mod - Booster at least 4-weeks after

19. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors
> 2 yo and less than 40 lbs
4 mg/day

20. How much vit D should adults < 50 take?
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)
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
800 IU/ day

21. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. When can children sit in a booster seat?

23. 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
1300 mg/day
Men 45 - 79 yo
Stroke and DVT

24. What is the schedule for Hep A vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

25. What is the NCEP III guideline for cholesterol screening?
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
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

26. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
800 IU/ day
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

27. What kind of polio vaccine is preferred?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

28. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs

29. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
BP - Height - Weight
Stroke and DVT
Rear facing

30. 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
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

31. 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
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

32. What are the guidelines for colon cancer screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
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

33. What tests are appropriate to order in an asymptomatic 57 yo male?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
HISTORY
Total cholesterol - FOBT

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

35. In which group of patients should aspirin be given as primary prevention for MI?
800 IU/ day
Exercise or physical therapy and vit D for patients > 65
Starts at 20 for both M and W
Men 45 - 79 yo

36. When is area of induration > 15 mm considered TB positive?
Forearm
Persons with no known risk factors
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

37. When is area of induration > 5mm considered TB positive?
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
4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

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

39. How much calcium should women > 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15

40. What is USPSTF guideline for abdominal aortic aneurysm screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Forearm
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES

41. What are some safety issues you should counsel parents with young children?
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
Rear facing
Starts at 20 for both M and W
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...

42. If traveling to endemic areas - Why should one get a dose of live vaccine?
> 2 yo and less than 40 lbs
To get IgA protection
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo

43. What is the schedule for varicella vaccine?
Forearm
12 - 23 mo - 2 doses are to be given 6 mo apart
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
One dose at 12-15 mod - Booster at least 4-weeks after

44. How much folate and for How long should a woman take for planned pregnancy?
One dose at 12-15 mod - Booster at least 4-weeks after
When they are > 40 lbs and still less then 5'
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception

45. When should chest X-ray be used for screening?
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 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

46. What is the schedule for Hep B 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

47. Unopposed estrogen increases risks for what conditions?
Forearm
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors

49. When should the meningococcal vaccine be given and to which group?
Persons with no known risk factors
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
When they are > 40 lbs and still less then 5'
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

50. How much calcium should adolescents (9 -18) take?
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD
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