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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 women > 50 take?
1200 mg/day
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
Start at 20 for all M and W regardless of RFs

2. When should pregnant women get a flu shot?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
During 2nd - 3rd trimester
HISTORY

3. What are the USPSTF guidelines for mammogram?
Start at 20 for all M and W regardless of RFs
To get IgA protection
Women 55 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years

4. What is the schedule for varicella vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Persons with no known risk factors
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after

5. What is the schedule for rotavirus vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
BP - Height - Weight
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

6. When should chest X-ray be used for screening?
> 2 yo and less than 40 lbs
NEVER
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

7. How much fluoride should military children in HI be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. What is the schedule for Hep A vaccine?
In adults with sustained BP > 135/80 mmHg
1000 IU/day
BP - Height - Weight
12 - 23 mo - 2 doses are to be given 6 mo apart

9. When should tetanus immunoglobulin be given?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER

10. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Children up to 7 yo and < 5' should be placed in a booster seat.
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise or physical therapy and vit D for patients > 65

11. How much calcium should adults (19 - 50) take?
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
1000 mg/day
Meningitis and Epiglottitis

12. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years
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

13. When is intensive individualized home-based intervention recommended?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
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

14. What are the guidelines for colon cancer screening?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
> 2 yo and less than 40 lbs

15. Which children should use a semi-upright/forward facing carseat?
Stroke and DVT
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day

16. In which group of patients should aspirin be given as primary prevention for MI?
Femoral neck
During 2nd - 3rd trimester
Men 45 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception

17. If traveling to endemic areas - Why should one get a dose of live vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
To get IgA protection
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

18. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors
Total cholesterol - FOBT

19. Some contraindications for aspirin
More than 15
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...
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg

20. At what age should women have DEXA scan?
1200 mg/day
65 (earlier if have increased risk factors)
Every 5 years
More than 15

21. What is HI law for booster seat?

22. When can children sit in a booster seat?

23. 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
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo

24. Who should get shingles vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4mo - 6-18 mo and 4-6 yrs
Adults > 60

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
65 (earlier if have increased risk factors)
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
Starts at 20 for both M and W
Breast CA - thromboembolic event - stroke and CAD

26. What is the ADA guideline for DMT2 screening?
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
HISTORY
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

27. What are the risks of combination HRT?
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
Femoral neck
One dose at 12-15 mod - Booster at least 4-weeks after
Breast CA - thromboembolic event - stroke and CAD

28. What are some RFs for DMT2?
To get IgA protection
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

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

30. What is the NCEP III guideline for cholesterol screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo

31. What are the guidelines for visual screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. What is the schedule for DTap vaccine?
Men 45 - 79 yo
HISTORY
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

33. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Total cholesterol - FOBT
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day
1300 mg/day

34. How much folate and for How long should a woman take for planned pregnancy?
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception

35. What can decrease fall in the elderly?
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...
Stroke and DVT
Men 45 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication

36. 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism
Persons with no known risk factors

37. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Women 55 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

38. How often do asplenic patients receive pneumococcal vaccine?
To get IgA protection
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise or physical therapy and vit D for patients > 65
Every 5 years

39. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Femoral neck
Women 55 - 79 yo

40. What is USPSTF guideline for abdominal aortic aneurysm screening?
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

41. Who are at increased risk for adverse effect catching a flu?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism

42. What is the schedule for Gardasil?
0.4 mg/day
800 IU/ day
Femoral neck
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

43. What are 2 conditions that have been proven to be beneficial to screened for?
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

44. What are the guidelines for pap smear?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
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)

45. How much vit D should adults < 50 take?
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
800 IU/ 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)

46. What is the schedule for Hep B vaccine?
Persons with no known risk factors
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Smoking - Alcoholism
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 the schedule for Hib 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
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo

48. When should the meningococcal vaccine be given and to which group?
0.4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

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

50. What are some risk factors for CAD?
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In all W < 24 who are sexually active - In W > 24 with increased risk
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