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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. Some contraindications for aspirin
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One time abdominal X-ray for all MALES who ever SMOKES
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

2. When is intensive individualized home-based intervention recommended?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
During 2nd - 3rd trimester
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

3. What are the guidelines for colon cancer 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
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

4. When can children sit in a booster seat?

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5. What type of illnesses does Hib vaccine prevent?
In adults with sustained BP > 135/80 mmHg
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis
Rear facing

6. Who are at increased risk for adverse effect catching a flu?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

7. In which group of patients should aspirin be given as primary prevention for stroke?
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
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
Women 55 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

8. What are 2 conditions that have been proven to be beneficial to screened for?
Women 55 - 79 yo
To get IgA protection
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
Smoking - Alcoholism

9. What are the risks of combination HRT?
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
1000 IU/day
During 2nd - 3rd trimester

10. What are some risk factors for CAD?
One time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
Total cholesterol - FOBT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

11. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
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)
Stroke and DVT

12. What is the schedule for Gardasil?
In adults with sustained BP > 135/80 mmHg
Total cholesterol - FOBT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT

13. What are some RFs for DMT2?
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
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)

14. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 20 for both M and W
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

15. What is the NCEP III guideline for cholesterol screening?
One time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs
65 (earlier if have increased risk factors)
When they are > 40 lbs and still less then 5'

16. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
One time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs
Rear facing

17. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12 - 23 mo - 2 doses are to be given 6 mo apart
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

18. Measurement of which anatomic structure is best predictor for hip fracture?
To get IgA protection
Men 45 - 79 yo
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

19. How much fluoride should military children in HI be given?
Breast CA - thromboembolic event - stroke and CAD
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism

20. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
Exercise - Environmental hazard reduction - Close monitoring of medication

21. What 3 things should always be done in an office visit?
BP - Height - Weight
Stroke and DVT
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)
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

22. What are the guidelines for visual screening?
800 IU/ 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

23. What is USPSTF guideline for abdominal aortic aneurysm screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One time abdominal X-ray for all MALES who ever SMOKES

24. How often do asplenic patients receive pneumococcal vaccine?
NEVER
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

25. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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)
4 mg/day
Smoking - Alcoholism
800 IU/ day

26. What is the ADA guideline for DMT2 screening?
When they are > 40 lbs and still less then 5'
HISTORY
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

27. When is area of induration > 5mm considered TB positive?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Persons with no known risk factors
1300 mg/day

28. When is area of induration > 10 mm considered TB positive?
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
Women 55 - 79 yo
65 (earlier if have increased risk factors)

29. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT

30. What can decrease fall in the elderly?
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after
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 guidelines for pap smear?
Starts at 50 (recommends against starting at 40) and every 2 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)
Women 55 - 79 yo
Forearm

32. What is the most important way to screen for CAD in an asymptomatic patients?
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
HISTORY
Stroke and DVT

33. What are some safety issues you should counsel parents with young children?
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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

34. 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
Total cholesterol - FOBT
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1300 mg/day
Forearm
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
0.4 - 0.8 mg/day for 1 month prior to conception

36. What is the schedule for Hib 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
Smoking - Alcoholism
2mo - 4 mo - 6mo and 12-15 mo

37. How much calcium should adolescents (9 -18) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
Start at 20 for all M and W regardless of RFs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

38. What is the USPSTF guideline for DMT2 screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In adults with sustained BP > 135/80 mmHg

39. What kind of sunscreen SPF is recommended for sun protection?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

40. What is the schedule for MMR 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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years

41. How much folate should all women of child bearing age take?
0.4 mg/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
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

42. Which children should use a semi-upright/forward facing carseat?
More than 15
To get IgA protection
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

43. When should tetanus immunoglobulin be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo - 6mo and 12-15 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

44. What is the schedule for polio vaccine?
Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

45. How much vit D should adults < 50 take?
Start at 20 for all M and W regardless of RFs
800 IU/ day
One dose at 12-15 mod - Booster at least 4-weeks after
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...

46. What is the USPSTF guideline for chlamydial screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
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

47. What is HI law for booster seat?

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48. What tests are appropriate to order in an asymptomatic 57 yo male?
1200 mg/day
Total cholesterol - FOBT
Meningitis and Epiglottitis
To get IgA protection

49. How much flouride should non military children in the state of HI be given?
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
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

50. How much calcium should women > 50 take?
Men 45 - 79 yo
1200 mg/day
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo