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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 risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day
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

2. What kind of sunscreen SPF is recommended for sun protection?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
More than 15
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

3. What is the schedule for Hep A vaccine?
Start at 20 for all M and W regardless of RFs
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
12 - 23 mo - 2 doses are to be given 6 mo apart

4. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
4 mg/day
NEVER
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

5. What 3 things should always be done in an office visit?
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

6. Who should get Tdap vaccine and how often?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/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
Starts at 20 for both M and W

7. What tests are appropriate to order in an asymptomatic 57 yo male?
1200 mg/day
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60

8. How much vit D should adults > 50 take?
1000 IU/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
BP - Height - Weight
Femoral neck

9. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 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

10. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 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)

11. What are some risk factors for 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
Total cholesterol - FOBT
1000 IU/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. When should tetanus immunoglobulin be given?
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children up to 7 yo and < 5' should be placed in a booster seat.

13. What is the USPSTF guideline for fall prevention in the elderly?
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
Total cholesterol - FOBT
Exercise or physical therapy and vit D for patients > 65

14. How much fluoride should military children in HI be given?
Femoral neck
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)
> 2 yo and less than 40 lbs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

15. When is area of induration > 10 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
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
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

16. Who are at increased risk for adverse effect catching a flu?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Rear facing
Femoral neck

17. What is the most important way to screen for CAD in an asymptomatic patients?
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 mg/day

18. What is the schedule for varicella vaccine?
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

19. What is the schedule for Gardasil?
In adults with sustained BP > 135/80 mmHg
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

20. What type of illnesses does Hib vaccine prevent?
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism
Women 55 - 79 yo
Meningitis and Epiglottitis

21. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Meningitis and Epiglottitis
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...
800 IU/ day
Starts at 20 for both M and W

22. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
4 mg/day

23. How much vit D should adults < 50 take?
800 IU/ day
Rear facing
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Smoking - Alcoholism

24. 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
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 mg/day

25. What is HI law for booster seat?

26. What can decrease fall in the elderly?
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)
Exercise - Environmental hazard reduction - Close monitoring of medication

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

28. What is the schedule for DTap vaccine?
When they are > 40 lbs and still less then 5'
1000 mg/day
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

29. What is the ADA guideline for DMT2 screening?
1000 mg/day
Rear facing
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

30. At what age should women have DEXA scan?
Women 55 - 79 yo
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

31. When is intensive individualized home-based intervention recommended?
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
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
BP - Height - Weight

32. How much folate should all women of child bearing age take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
Women 55 - 79 yo

33. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
65 (earlier if have increased risk factors)
Persons with no known risk factors

34. Who should get shingles vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Adults > 60

35. When should chest X-ray be used for screening?
During 2nd - 3rd trimester
Starts at 20 for both M and W
NEVER
Every 5 years

36. If traveling to endemic areas - Why should one get a dose of live vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
To get IgA protection
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

37. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 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
During 2nd - 3rd trimester
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

38. How often do asplenic patients receive pneumococcal vaccine?
Exercise or physical therapy and vit D for patients > 65
More than 15
1000 IU/day
Every 5 years

39. What is the schedule for Hep B vaccine?
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
Rear facing

40. 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
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)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children up to 7 yo and < 5' should be placed in a booster seat.

41. When should the meningococcal vaccine be given and to which group?
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day

42. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Every 5 years
Forearm
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)
Starts at 20 for both M and W

43. Which children should use a semi-upright/forward facing carseat?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years
> 2 yo and less than 40 lbs

44. How much calcium should adults (19 - 50) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day
1200 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

45. What are the guidelines for visual screening?
HISTORY
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.
Preschool children : 3-4 yo - Elderly patients: > 65 yo

46. When should pregnant women get a flu shot?
When they are > 40 lbs and still less then 5'
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo - 6mo and 12-15 mo
During 2nd - 3rd trimester

47. What is the NCEP III guideline for cholesterol screening?
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
Start at 20 for all M and W regardless of RFs
NEVER

48. What are the guidelines for colon cancer screening?
Femoral neck
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
Forearm
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...

49. When should Gardasil be given and for what purposes?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck
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

50. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65