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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. In which group of patients should aspirin be given as primary prevention for MI?
Total cholesterol - FOBT
Rear facing
Men 45 - 79 yo
More than 15

2. What is the schedule for Gardasil?
2mo - 4 mo - 6mo and 12-15 mo
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
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

3. When should the meningococcal vaccine be given and to which group?
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

4. When is intensive individualized home-based intervention recommended?
Total cholesterol - FOBT
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One time abdominal X-ray for all MALES who ever SMOKES

5. How much folate should all women of child bearing age take?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
0.4 mg/day

6. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

7. Who should get shingles vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
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 > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

8. What kind of sunscreen SPF is recommended for sun protection?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
More than 15
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

9. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs
HISTORY

10. How much vit D should adults < 50 take?
> 2 yo and less than 40 lbs
800 IU/ day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors

11. 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 50 (recommends against starting at 40) and every 2 years

12. What is the USPSTF guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg
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. How much folate and for How long should a woman take for planned pregnancy?
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
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

14. What kind of car seat should children < 2 yo be placed in?
Rear facing
Persons with no known risk factors
1000 mg/day
BP - Height - Weight

15. What are some RFs for DMT2?
1200 mg/day
Meningitis and Epiglottitis
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

16. What are some safety issues you should counsel parents with young children?
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

17. 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
Women 55 - 79 yo
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)
HISTORY

18. Who are at increased risk for adverse effect catching a flu?
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
1300 mg/day
Rear facing

19. What is the schedule for rotavirus vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
Forearm

20. What is the schedule for varicella vaccine?
HISTORY
1000 IU/day
One dose at 12-15 mod - Booster at least 4-weeks after
To get IgA protection

21. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
Forearm

22. What type of illnesses does Hib vaccine prevent?
2mo - 4 mo - 6mo and 12-15 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

23. How much calcium should adolescents (9 -18) take?
1300 mg/day
Smoking - Alcoholism
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

24. What is the NCEP III guideline for cholesterol screening?
1000 IU/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Start at 20 for all M and W regardless of RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

25. What is the USPSTF guideline for chlamydial screening?
0.4 - 0.8 mg/day for 1 month prior to conception
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

26. How much flouride should non military children in the state of HI be given?
Starts at 20 for both M and W
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

27. How much calcium should women > 50 take?
Rear facing
1200 mg/day
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

28. What is HI law for booster seat?

29. Who should get Tdap vaccine and how often?
2mo - 4 mo - 6mo and 12-15 mo
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
More than 15

30. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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
> 2 yo and less than 40 lbs
BP - Height - Weight

31. How much fluoride should military children in HI be given?
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism
Adults > 60
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

32. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck

33. Some contraindications for aspirin
When they are > 40 lbs and still less then 5'
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT
Men 45 - 79 yo

34. What kind of polio vaccine is preferred?
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

35. Unopposed estrogen increases risks for what conditions?
Start at 20 for all M and W regardless of RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT

36. What is the schedule for polio vaccine?
To get IgA protection
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
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT

37. What is the schedule for MMR vaccine?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise - Environmental hazard reduction - Close monitoring of medication
4 mg/day

38. How much calcium should adults (19 - 50) take?
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 mg/day
BP - Height - Weight

39. 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
800 IU/ day
Adults > 60
Breast CA - thromboembolic event - stroke and CAD

40. What are the guidelines for pap smear?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

41. When should tetanus immunoglobulin be given?
800 IU/ day
NEVER
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

42. When can children sit in a booster seat?

43. How much vit D should adults > 50 take?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day

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

45. When should Gardasil be given and for what purposes?
Starts at 20 for both M and W
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 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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

46. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
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
Adults > 60

47. What are the guidelines for colon cancer screening?
Meningitis and Epiglottitis
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
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)
In adults with sustained BP > 135/80 mmHg

48. What are the guidelines for visual screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

49. When should chest X-ray be used for screening?
NEVER
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

50. What is the schedule for Hib vaccine?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo - 6mo and 12-15 mo