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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 folate should all women of child bearing age take?
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
To get IgA protection
Starts at 50 (recommends against starting at 40) and every 2 years

2. Who should get Tdap vaccine and how often?
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

3. What are the risks of combination HRT?
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)
Breast CA - thromboembolic event - stroke and CAD
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

4. What is the schedule for Hep B vaccine?
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Women 55 - 79 yo

5. What kind of polio vaccine is preferred?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

6. What are some risk factors for CAD?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

7. When can children sit in a booster seat?

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8. What is the schedule for DTap vaccine?
Starts at 20 for both M and W
Starts at 50 (recommends against starting at 40) and every 2 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

9. 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
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
NEVER

10. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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...
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

11. If traveling to endemic areas - Why should one get a dose of live vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
To get IgA protection
1000 IU/day

12. What is the ADA guideline for DMT2 screening?
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
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo

13. What is the schedule for varicella vaccine?
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after
NEVER
When they are > 40 lbs and still less then 5'

14. What is the schedule for rotavirus 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
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
Men 45 - 79 yo

15. What type of illnesses does Hib vaccine prevent?
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
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
Meningitis and Epiglottitis

16. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
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
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
65 (earlier if have increased risk factors)

17. What 3 things should always be done in an office visit?
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
800 IU/ day
BP - Height - Weight
1200 mg/day

18. When is area of induration > 15 mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
Persons with no known risk factors
Stroke and DVT

19. At what age should women have DEXA scan?
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
65 (earlier if have increased risk factors)

20. How often do asplenic patients receive pneumococcal vaccine?
Men 45 - 79 yo
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
Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

21. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication

22. Who are at increased risk for adverse effect catching a flu?
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
Starts at 50 (recommends against starting at 40) and every 2 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication

23. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - 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
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

24. What are the guidelines for colon cancer screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
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

25. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
Adults > 60

26. What is USPSTF guideline for abdominal aortic aneurysm screening?
Rear facing
Exercise or physical therapy and vit D for patients > 65
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

27. How much calcium should adults (19 - 50) take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

28. How much calcium should adolescents (9 -18) take?
Meningitis and Epiglottitis
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise or physical therapy and vit D for patients > 65
1300 mg/day

29. When should tetanus immunoglobulin be given?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER

30. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

31. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo - 6mo and 12-15 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Stroke and DVT

32. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Adults > 60
1300 mg/day

33. 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
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W

34. When should Gardasil be given and for what purposes?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
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

35. What is the USPSTF guideline for DMT2 screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In adults with sustained BP > 135/80 mmHg
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
Persons with no known risk factors

36. What are some safety issues you should counsel parents with young children?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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...
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

37. What are 2 conditions that have been proven to be beneficial to screened for?
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
More than 15
Breast CA - thromboembolic event - stroke and CAD

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

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39. How much vit D should adults > 50 take?
1000 IU/day
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
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

40. What is the schedule for Hib vaccine?
1000 mg/day
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
Children up to 7 yo and < 5' should be placed in a booster seat.

41. When is area of induration > 5mm considered TB positive?
One dose at 12-15 mod - Booster at least 4-weeks after
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
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

42. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
800 IU/ day
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

43. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
To get IgA protection
Adults > 60
Rear facing

44. What is the most important way to screen for CAD in an asymptomatic patients?
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo
Femoral neck
HISTORY

45. Which children should use a semi-upright/forward facing carseat?
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs

46. What is the schedule for Hep A vaccine?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
HISTORY

47. How much folate and for How long should a woman take for planned pregnancy?
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
Total cholesterol - FOBT

48. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
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...
Starts at 20 for both M and W

49. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

50. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12 - 23 mo - 2 doses are to be given 6 mo apart
1300 mg/day