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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 sunscreen SPF is recommended for sun protection?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

2. When should pregnant women get a flu shot?
One time abdominal X-ray for all MALES who ever SMOKES
During 2nd - 3rd trimester
1000 mg/day
To get IgA protection

3. What is the NCEP III guideline for cholesterol screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
Start at 20 for all M and W regardless of RFs
1000 IU/day
65 (earlier if have increased risk factors)

4. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
BP - Height - Weight
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

5. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children up to 7 yo and < 5' should be placed in a booster seat.
Rear facing

6. What is the schedule for Gardasil?
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

7. What are some safety issues you should counsel parents with young children?
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'
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

8. What is the most important way to screen for CAD in an asymptomatic patients?
Women 55 - 79 yo
HISTORY
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo

9. When can children sit in a booster seat?

10. What is the schedule for varicella vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
One dose at 12-15 mod - Booster at least 4-weeks after
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

11. How much vit D should adults > 50 take?
Exercise or physical therapy and vit D for patients > 65
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
During 2nd - 3rd trimester

12. When should Gardasil be given and for what purposes?
Persons with no known risk factors
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more 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

13. How much vit D should adults < 50 take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism
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
800 IU/ day

14. What is the schedule for Hib vaccine?
HISTORY
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo

15. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

16. What are the USPSTF guidelines for mammogram?
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

17. How much calcium should women > 50 take?
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
Men 45 - 79 yo

18. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

19. At what age should women have DEXA scan?
BP - Height - Weight
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)
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

20. How much calcium should adolescents (9 -18) take?
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
To get IgA protection

21. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years

22. What tests are appropriate to order in an asymptomatic 57 yo male?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Total cholesterol - FOBT
Breast CA - thromboembolic event - stroke and CAD

23. Some contraindications for aspirin
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day

24. What are the risks of combination HRT?
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD
HISTORY

25. Who should get Tdap vaccine and how often?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Exercise or physical therapy and vit D for patients > 65
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
1300 mg/day

26. How much fluoride should military children in HI be given?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
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

27. When should chest X-ray be used for screening?
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
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER

28. If traveling to endemic areas - Why should one get a dose of live vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
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 - 4 mo - 6mo and 12-15 mo
To get IgA protection

29. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
1300 mg/day
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day

30. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
BP - Height - Weight
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

31. What 3 things should always be done in an office visit?
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg
Women 55 - 79 yo
Total cholesterol - FOBT

32. What is the schedule for DTap vaccine?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Women 55 - 79 yo

33. How much calcium should adults (19 - 50) take?
Stroke and DVT
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day

34. How often do asplenic patients receive pneumococcal vaccine?
1000 IU/day
Femoral neck
Persons with no known risk factors
Every 5 years

35. In which group of patients should aspirin be given as primary prevention for stroke?
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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Adults > 60
Women 55 - 79 yo

36. What is the schedule for polio vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

37. What is the USPSTF guideline for fall prevention in the elderly?
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
Smoking - Alcoholism
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis

38. When should the meningococcal vaccine be given and to which group?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
> 2 yo and less than 40 lbs

39. What type of illnesses does Hib vaccine prevent?
Forearm
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis
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

40. What is the schedule for Hep A vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

41. 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
More than 15
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

42. What are 2 conditions that have been proven to be beneficial to screened for?
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
More than 15
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception

43. Unopposed estrogen increases risks for what conditions?
More than 15
Stroke and DVT
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
1000 mg/day

44. When is area of induration > 10 mm considered TB positive?
Smoking - Alcoholism
1200 mg/day
During 2nd - 3rd trimester
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

45. What can decrease fall in the elderly?
2mo - 4mo - 6-18 mo and 4-6 yrs
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

46. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Adults > 60
HISTORY
More than 15

47. What kind of car seat should children < 2 yo be placed in?
Rear facing
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

48. When is area of induration > 15 mm considered TB positive?
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 all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Persons with no known risk factors

49. What is USPSTF guideline for abdominal aortic aneurysm screening?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
> 2 yo and less than 40 lbs
Smoking - Alcoholism
One time abdominal X-ray for all MALES who ever SMOKES

50. When should tetanus immunoglobulin be given?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'