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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 visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 mg/day
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

2. Which children should use a semi-upright/forward facing carseat?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs
Smoking - Alcoholism

3. What is USPSTF guideline for abdominal aortic aneurysm screening?
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism

4. What type of illnesses does Hib vaccine prevent?
Femoral neck
1000 IU/day
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication

5. What are the risks of combination HRT?
1300 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight

6. What are some RFs for DMT2?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1000 IU/day
Men 45 - 79 yo

7. What is the most important way to screen for CAD in an asymptomatic patients?
Breast CA - thromboembolic event - stroke and CAD
HISTORY
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. How much folate and for How long should a woman take for planned pregnancy?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise or physical therapy and vit D for patients > 65

9. What tests are appropriate to order in an asymptomatic 57 yo male?
1300 mg/day
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

10. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years
Rear facing

11. How much calcium should adolescents (9 -18) take?
800 IU/ day
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

12. What are some safety issues you should counsel parents with young children?
12 - 23 mo - 2 doses are to be given 6 mo apart
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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...
> 2 yo and less than 40 lbs

13. In which group of patients should aspirin be given as primary prevention for MI?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
Men 45 - 79 yo
More than 15

14. When is area of induration > 5mm considered TB positive?
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
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

15. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

16. What is the schedule for DTap vaccine?
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Rear facing
Forearm

17. What is the USPSTF guideline for chlamydial screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

18. What is the schedule for varicella vaccine?
In adults with sustained BP > 135/80 mmHg
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after

19. How much vit D should adults < 50 take?
Stroke and DVT
800 IU/ day
Children up to 7 yo and < 5' should be placed in a booster seat.
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

20. What is the schedule for polio vaccine?
Total cholesterol - FOBT
2mo - 4mo - 6-18 mo and 4-6 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY

21. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
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
One time abdominal X-ray for all MALES who ever SMOKES
800 IU/ day

22. How much folate should all women of child bearing age take?
0.4 mg/day
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

23. What is the ADA guideline for DMT2 screening?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One dose at 12-15 mod - Booster at least 4-weeks after

24. What kind of sunscreen SPF is recommended for sun 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
BP - Height - Weight
More than 15

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Meningitis and Epiglottitis
During 2nd - 3rd trimester
12 - 23 mo - 2 doses are to be given 6 mo apart

26. When is intensive individualized home-based intervention recommended?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
1200 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

27. Some contraindications for aspirin
Smoking - Alcoholism
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

28. What is the schedule for Hep A vaccine?
Men 45 - 79 yo
Smoking - Alcoholism
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart

29. Measurement of which anatomic structure is best predictor for hip fracture?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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...
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck

30. How often do asplenic patients receive pneumococcal vaccine?
Persons with no known risk factors
Total cholesterol - FOBT
Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

31. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 mg/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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. When should tetanus immunoglobulin be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise - Environmental hazard reduction - Close monitoring of medication
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

33. When should Gardasil be given and for what purposes?
Start at 20 for all M and W regardless of RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
> 2 yo and less than 40 lbs

34. What are the guidelines for colon cancer screening?
1000 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
65 (earlier if have increased risk factors)
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

35. Who should get shingles vaccine?
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Adults > 60

36. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
800 IU/ day
Women 55 - 79 yo

37. What is the USPSTF guideline for DMT2 screening?
4 mg/day
In adults with sustained BP > 135/80 mmHg
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
1000 IU/day

38. What is the USPSTF guideline for fall prevention in the elderly?
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight

39. What are the guidelines for pap smear?
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)
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
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

40. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs
Starts at 50 (recommends against starting at 40) and every 2 years

41. How much calcium should women > 50 take?
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs
1200 mg/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)

42. How much calcium should adults (19 - 50) take?
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 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

43. If traveling to endemic areas - Why should one get a dose of live vaccine?
Exercise or physical therapy and vit D for patients > 65
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

44. Unopposed estrogen increases risks for what conditions?
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

45. What kind of car seat should children < 2 yo be placed in?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
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)

46. What is the schedule for Hib vaccine?
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
To get IgA protection
2mo - 4 mo - 6mo and 12-15 mo

47. How much fluoride should military children in HI be given?
1000 mg/day
HISTORY
800 IU/ day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

48. 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
Starts at 20 for both M and W
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

49. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
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

50. What are 2 conditions that have been proven to be beneficial to screened for?
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
Total cholesterol - FOBT
Smoking - Alcoholism