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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 is the USPSTF guideline for chlamydial screening?
When they are > 40 lbs and still less then 5'
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors

2. What is the schedule for Gardasil?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
When they are > 40 lbs and still less then 5'

3. What is the schedule for MMR vaccine?
Stroke and DVT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 IU/day
Adults > 60

4. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
When they are > 40 lbs and still less then 5'
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 IU/day

5. What is the schedule for varicella vaccine?
Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
One dose at 12-15 mod - Booster at least 4-weeks after

6. 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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

7. What is the schedule for polio vaccine?
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...
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs
Women 55 - 79 yo

8. When can children sit in a booster seat?

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9. What tests are appropriate to order in an asymptomatic 57 yo male?
Femoral neck
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

10. How much vit D should adults > 50 take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
Rear facing
1000 IU/day

11. What 3 things should always be done in an office visit?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
BP - Height - Weight
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

12. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg

13. How much folate should all women of child bearing age take?
0.4 mg/day
65 (earlier if have increased risk factors)
To get IgA protection
800 IU/ day

14. What are the guidelines for visual screening?
Women 55 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

15. What are some RFs for DMT2?
BP - Height - Weight
When they are > 40 lbs and still less then 5'
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

16. What can decrease fall in the elderly?
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
Total cholesterol - FOBT

17. What are the risks of combination HRT?
Exercise or physical therapy and vit D for patients > 65
Breast CA - thromboembolic event - stroke and CAD
More than 15
During 2nd - 3rd trimester

18. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis

19. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Men 45 - 79 yo
Women 55 - 79 yo
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

21. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
0.4 mg/day
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 USPSTF guideline for abdominal aortic aneurysm screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
Persons with no known risk factors
65 (earlier if have increased risk factors)

23. Which children should use a semi-upright/forward facing carseat?
Adults > 60
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
> 2 yo and less than 40 lbs

24. When should tetanus immunoglobulin be given?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

25. How much calcium should women > 50 take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1200 mg/day
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

26. What is the schedule for Hep B vaccine?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
65 (earlier if have increased risk factors)

27. At what age should women have DEXA scan?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)

28. What are some safety issues you should counsel parents with young children?
When they are > 40 lbs and still less then 5'
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...

29. When should chest X-ray be used for screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
NEVER

30. What kind of sunscreen SPF is recommended for sun protection?
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
More than 15
800 IU/ day

31. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

32. In which group of patients should aspirin be given as primary prevention for MI?
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
BP - Height - Weight
Men 45 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs

33. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

34. What are some risk factors for CAD?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Start at 20 for all M and W regardless of RFs
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. How much calcium should adolescents (9 -18) take?
1300 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
In all W < 24 who are sexually active - In W > 24 with increased risk
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

36. 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
When they are > 40 lbs and still less then 5'
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

37. What is the schedule for Hib vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo - 6mo and 12-15 mo

38. What is the USPSTF guideline for DMT2 screening?
NEVER
In adults with sustained BP > 135/80 mmHg
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

39. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 20 for both M and W

40. How much vit D should adults < 50 take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day
0.4 - 0.8 mg/day for 1 month prior to conception

41. What is the NCEP III guideline for cholesterol screening?
Women 55 - 79 yo
1300 mg/day
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs

42. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
To get IgA protection
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

43. Who are at increased risk for adverse effect catching a flu?
When they are > 40 lbs and still less then 5'
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

44. What is the schedule for Hep A vaccine?
1000 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12 - 23 mo - 2 doses are to be given 6 mo apart

45. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism

46. What kind of car seat should children < 2 yo be placed in?
Rear facing
HISTORY
Start at 20 for all M and W regardless of RFs
1000 mg/day

47. If traveling to endemic areas - Why should one get a dose of live vaccine?
Total cholesterol - FOBT
To get IgA protection
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65

48. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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...
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
Men 45 - 79 yo
4 mg/day

49. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15
Breast CA - thromboembolic event - stroke and CAD

50. What is the schedule for DTap vaccine?
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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy