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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 USPSTF guidelines for cholesterol screening in people with normal risks?
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

2. What tests are appropriate to order in an asymptomatic 57 yo male?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Forearm
4 mg/day
Total cholesterol - FOBT

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

4. What is the USPSTF guideline for chlamydial screening?
More than 15
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
During 2nd - 3rd trimester
In all W < 24 who are sexually active - In W > 24 with increased risk

5. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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)
Smoking - Alcoholism
> 2 yo and less than 40 lbs

6. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day
Femoral neck

7. How much calcium should adolescents (9 -18) take?
Exercise or physical therapy and vit D for patients > 65
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
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)

8. When can children sit in a booster seat?

9. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
4 mg/day
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

10. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
Start at 20 for all M and W regardless of RFs
Total cholesterol - FOBT
More than 15

11. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
During 2nd - 3rd trimester
Persons with no known risk factors

12. How much folate should all women of child bearing age take?
0.4 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
Breast CA - thromboembolic event - stroke and CAD
During 2nd - 3rd trimester

13. What type of illnesses does Hib vaccine prevent?
Femoral neck
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
Starts at 20 for both M and W

14. How often do asplenic patients receive pneumococcal vaccine?
NEVER
In all W < 24 who are sexually active - In W > 24 with increased risk
Every 5 years
1000 mg/day

15. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

16. If traveling to endemic areas - Why should one get a dose of live vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
To get IgA protection
Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

17. When should chest X-ray be used for screening?
More than 15
NEVER
Starts at 20 for both M and W
When they are > 40 lbs and still less then 5'

18. What are the guidelines for pap smear?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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 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)
During 2nd - 3rd trimester

19. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day
During 2nd - 3rd trimester
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

20. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day
800 IU/ day
Persons with no known risk factors

21. What is the schedule for rotavirus vaccine?
NEVER
In all W < 24 who are sexually active - In W > 24 with increased risk
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

22. What is the schedule for Gardasil?
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day

23. What can decrease fall in the elderly?
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
Exercise - Environmental hazard reduction - Close monitoring of medication

24. When is intensive individualized home-based intervention recommended?
When they are > 40 lbs and still less then 5'
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
In all W < 24 who are sexually active - In W > 24 with increased risk

25. Who should get shingles vaccine?
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Meningitis and Epiglottitis

26. What is the ADA guideline for DMT2 screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Femoral neck

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

28. What is HI law for booster seat?

29. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1200 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
HISTORY

30. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

31. What are some risk factors for CAD?
More than 15
HISTORY
2mo - 4mo - 6-18 mo and 4-6 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

32. What are the guidelines for visual screening?
1300 mg/day
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo

33. What is USPSTF guideline for abdominal aortic aneurysm screening?
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

34. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day

35. How much calcium should women > 50 take?
Persons with no known risk factors
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1200 mg/day

36. What are the USPSTF guidelines for mammogram?
During 2nd - 3rd trimester
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years
1000 IU/day

37. What is the schedule for varicella vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after

38. When should pregnant women get a flu shot?
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
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65
4 mg/day

39. When is area of induration > 10 mm considered TB positive?
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
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Forearm

40. Some contraindications for aspirin
Femoral neck
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

41. Who should get Tdap vaccine and how often?
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors
1300 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

42. Who are at increased risk for adverse effect catching a flu?
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...
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

43. How much vit D should adults > 50 take?
1200 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 IU/day

44. 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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

45. What are some RFs for DMT2?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60

46. What is the USPSTF guideline for fall prevention in the elderly?
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
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

47. When should tetanus immunoglobulin be given?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

48. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Forearm
12 - 23 mo - 2 doses are to be given 6 mo apart
To get IgA protection

49. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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
4 mg/day
Stroke and DVT

50. What is the schedule for DTap vaccine?
When they are > 40 lbs and still less then 5'
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 < 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