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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 is the USPSTF guideline for chlamydial screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication

2. What 3 things should always be done in an office visit?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
1200 mg/day
BP - Height - Weight

3. When is intensive individualized home-based intervention recommended?
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
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
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
Exercise - Environmental hazard reduction - Close monitoring of medication

4. What is the USPSTF guideline for DMT2 screening?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In adults with sustained BP > 135/80 mmHg

5. What is the schedule for MMR vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

6. What are the USPSTF guidelines for mammogram?
> 2 yo and less than 40 lbs
NEVER
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years

7. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
In adults with sustained BP > 135/80 mmHg
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
4 mg/day

8. How much calcium should adults (19 - 50) take?
Exercise or physical therapy and vit D for patients > 65
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

9. What are the guidelines for visual screening?
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
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

10. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm

11. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4mo - 6-18 mo and 4-6 yrs

12. Who should get shingles vaccine?
Starts at 20 for both M and W
Stroke and DVT
Adults > 60
800 IU/ day

13. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
Stroke and DVT

14. What are the guidelines for pap smear?
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)
In adults with sustained BP > 135/80 mmHg
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo

15. How much flouride should non military children in the state of HI be given?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

16. What is the schedule for varicella vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis

17. How often do asplenic patients receive pneumococcal vaccine?
During 2nd - 3rd trimester
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

18. What is the USPSTF guideline for fall prevention in the elderly?
1300 mg/day
During 2nd - 3rd trimester
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

19. In which group of patients should aspirin be given as primary prevention for MI?
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
Rear facing
2mo - 4 mo - 6mo and 12-15 mo

20. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo

21. What are some RFs for DMT2?
In adults with sustained BP > 135/80 mmHg
Forearm
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

22. What is the schedule for polio vaccine?
1000 mg/day
Breast CA - thromboembolic event - stroke and CAD
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
2mo - 4mo - 6-18 mo and 4-6 yrs

23. 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 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)
Start at 20 for all M and W regardless of RFs
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...

24. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

25. Who are at increased risk for adverse effect catching a flu?
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In adults with sustained BP > 135/80 mmHg
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?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
To get IgA protection

27. What is HI law for booster seat?

28. What kind of car seat should children < 2 yo be placed in?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Every 5 years
Rear facing
Women 55 - 79 yo

29. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

30. When is area of induration > 15 mm considered TB positive?
> 2 yo and less than 40 lbs
Persons with no known risk factors
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk

31. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
4 mg/day
0.4 mg/day

32. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
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

33. Unopposed estrogen increases risks for what conditions?
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
Stroke and DVT
12 - 23 mo - 2 doses are to be given 6 mo apart

34. How much vit D should adults < 50 take?
800 IU/ day
Femoral neck
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

35. 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...
NEVER
Women 55 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. What kind of polio vaccine is preferred?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1200 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

37. What tests are appropriate to order in an asymptomatic 57 yo male?
65 (earlier if have increased risk factors)
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
Women 55 - 79 yo
Total cholesterol - FOBT

38. How much calcium should women > 50 take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1200 mg/day
BP - Height - Weight
NEVER

39. In which group of patients should aspirin be given as primary prevention for stroke?
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
To get IgA protection
Women 55 - 79 yo
Rear facing

40. When can children sit in a booster seat?

41. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
HISTORY
Starts at 20 for both M and W

42. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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
Adults > 60
Children up to 7 yo and < 5' should be placed in a booster seat.

43. How much fluoride should military children in HI be given?
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W
0.4 - 0.8 mg/day for 1 month prior to conception

46. When should chest X-ray be used for screening?
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
NEVER

47. What is the schedule for Hep A vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
12 - 23 mo - 2 doses are to be given 6 mo apart
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

48. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Rear facing

49. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
Forearm

50. What is the NCEP III guideline for cholesterol screening?
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
Start at 20 for all M and W regardless of RFs