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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 kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Start at 20 for all M and W regardless of RFs
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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

2. What are some RFs for DMT2?
Forearm
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
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

3. When is area of induration > 10 mm considered TB positive?
Men 45 - 79 yo
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 IU/day

4. What is the schedule for Gardasil?
Children up to 7 yo and < 5' should be placed in a booster seat.
HISTORY
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT

5. 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
Meningitis and Epiglottitis
Rear facing
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

6. How much flouride should non military children in the state of HI be given?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

7. How much fluoride should military children in HI be given?
1200 mg/day
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

8. How often do asplenic patients receive pneumococcal vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
65 (earlier if have increased risk factors)

9. What is the schedule for MMR vaccine?
When they are > 40 lbs and still less then 5'
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...
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

10. What are the guidelines for colon cancer 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
Femoral neck
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
NEVER

11. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
BP - Height - Weight
Forearm

12. How much folate should all women of child bearing age take?
0.4 mg/day
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
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...

13. Who should get Tdap vaccine and how often?
Men 45 - 79 yo
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
1000 mg/day
Stroke and DVT

14. What are the USPSTF guidelines for mammogram?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years

15. What is the NCEP III guideline for cholesterol screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 mg/day
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg

16. In which group of patients should aspirin be given as primary prevention for MI?
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
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Femoral neck

17. What is the schedule for Hep A vaccine?
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
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...
4 mg/day

18. What are the guidelines for pap smear?
More than 15
HISTORY
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 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

19. Measurement of which anatomic structure is best predictor for hip fracture?
Exercise or physical therapy and vit D for patients > 65
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
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

20. What is USPSTF guideline for abdominal aortic aneurysm screening?
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

21. What is the schedule for Hep B vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
65 (earlier if have increased risk factors)
NEVER
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. What are some safety issues you should counsel parents with young children?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...

23. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

24. At what age should women have DEXA scan?
Breast CA - thromboembolic event - stroke and CAD
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
Men 45 - 79 yo

25. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
One time abdominal X-ray for all MALES who ever SMOKES
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. What is the schedule for varicella vaccine?
Women 55 - 79 yo
Stroke and DVT
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years

27. How much calcium should adults (19 - 50) take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
Every 5 years
4 mg/day

28. How much folate and for How long should a woman take for planned pregnancy?
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo
0.4 - 0.8 mg/day for 1 month prior to conception
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

29. What are the risks of combination HRT?
1200 mg/day
Persons with no known risk factors
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD

30. When should chest X-ray be used for screening?
More than 15
During 2nd - 3rd trimester
Breast CA - thromboembolic event - stroke and CAD
NEVER

31. How much calcium should adolescents (9 -18) take?
1300 mg/day
1000 IU/day
To get IgA protection
65 (earlier if have increased risk factors)

32. How much vit D should adults > 50 take?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo

33. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

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

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

36. Unopposed estrogen increases risks for what conditions?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65

37. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Persons with no known risk factors
4 mg/day
1000 mg/day
Femoral neck

38. What 3 things should always be done in an office visit?
Persons with no known risk factors
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
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

39. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

40. How much calcium should women > 50 take?
1200 mg/day
Every 5 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Rear facing

41. What is the most important way to screen for CAD in an asymptomatic patients?
Every 5 years
HISTORY
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

42. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

43. Which children should use a semi-upright/forward facing carseat?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
> 2 yo and less than 40 lbs
1200 mg/day

44. When is intensive individualized home-based intervention recommended?
800 IU/ day
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
12 - 23 mo - 2 doses are to be given 6 mo apart

45. What can decrease fall in the elderly?
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.
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

46. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER
Breast CA - thromboembolic event - stroke and CAD

47. What are the guidelines for visual screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

48. When can children sit in a booster seat?

49. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4mo - 6-18 mo and 4-6 yrs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

50. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Every 5 years
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs