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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 guidelines for pap smear?
Children up to 7 yo and < 5' should be placed in a booster seat.
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)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1300 mg/day

2. When is area of induration > 10 mm considered TB positive?
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
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
Meningitis and Epiglottitis

3. At what age should women have DEXA scan?
In adults with sustained BP > 135/80 mmHg
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65

4. What can decrease fall in the elderly?
Persons with no known risk factors
Exercise - Environmental hazard reduction - Close monitoring of medication
In all W < 24 who are sexually active - In W > 24 with increased risk
Men 45 - 79 yo

5. What is the schedule for Hep B vaccine?
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo - 6mo and 12-15 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

6. What 3 things should always be done in an office visit?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD

7. 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
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...
In adults with sustained BP > 135/80 mmHg
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

8. What are some risk factors for CAD?
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
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)

9. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
1300 mg/day
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

10. How often do asplenic patients receive pneumococcal vaccine?
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
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
Every 5 years

11. How much calcium should adults (19 - 50) take?
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day
Forearm

12. What is the schedule for Hib vaccine?
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
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo

13. Which children should use a semi-upright/forward facing carseat?
1000 IU/day
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
Femoral neck

14. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

15. When should the meningococcal vaccine be given and to which group?
Men 45 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60

16. What are some RFs for DMT2?
Rear facing
More than 15
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

17. How much flouride should non military children in the state of HI be given?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm
1000 mg/day

18. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Exercise - Environmental hazard reduction - Close monitoring of medication

19. What are the guidelines for colon cancer screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Meningitis and Epiglottitis
1200 mg/day

20. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
Women 55 - 79 yo
Total cholesterol - FOBT
1300 mg/day

21. Who should get Tdap vaccine and how often?
Adults > 60
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
> 2 yo and less than 40 lbs
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. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day
Smoking - Alcoholism
1300 mg/day

23. What is the schedule for MMR vaccine?
NEVER
> 2 yo and less than 40 lbs
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

24. What is HI law for booster seat?

25. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Start at 20 for all M and W regardless of RFs
1200 mg/day
Every 5 years

26. What is the schedule for polio vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight

27. What is the schedule for rotavirus vaccine?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

28. Who are at increased risk for adverse effect catching a flu?
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

29. What is the schedule for DTap vaccine?
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES
Men 45 - 79 yo

30. 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)
1000 mg/day
Rear facing

31. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15

32. What is the schedule for Gardasil?
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)
2mo - 4mo - 6-18 mo and 4-6 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

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

34. When should chest X-ray be used for screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
NEVER
Total cholesterol - FOBT
Starts at 20 for both M and W

35. When should tetanus immunoglobulin be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

36. What kind of polio vaccine is preferred?
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
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

37. 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)
1000 IU/day
Every 5 years
Men 45 - 79 yo

38. What kind of car seat should children < 2 yo be placed in?
Rear facing
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

39. How much folate and for How long should a woman take for planned pregnancy?
To get IgA protection
65 (earlier if have increased risk factors)
HISTORY
0.4 - 0.8 mg/day for 1 month prior to conception

40. 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
When they are > 40 lbs and still less then 5'
To get IgA protection
0.4 - 0.8 mg/day for 1 month prior to conception

41. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

42. When is area of induration > 15 mm considered TB positive?
2mo - 4mo - 6-18 mo and 4-6 yrs
Persons with no known risk factors
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 all W < 24 who are sexually active - In W > 24 with increased risk

43. How much fluoride should military children in HI be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 20 for both M and W

44. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD
NEVER

45. What tests are appropriate to order in an asymptomatic 57 yo male?
During 2nd - 3rd trimester
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT

46. What kind of sunscreen SPF is recommended for sun protection?
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...
Breast CA - thromboembolic event - stroke and CAD
Rear facing
More than 15

47. What are the USPSTF guidelines for mammogram?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Forearm
Starts at 50 (recommends against starting at 40) and every 2 years

48. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

49. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
To get IgA protection
Women 55 - 79 yo
Forearm

50. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
HISTORY