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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 fall prevention in the elderly?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise or physical therapy and vit D for patients > 65
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs

2. How much folate and for How long should a woman take for planned pregnancy?
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 - 0.8 mg/day for 1 month prior to conception
Forearm

3. What kind of car seat should children < 2 yo be placed in?
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing
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

4. 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
1000 IU/day
HISTORY
Exercise - Environmental hazard reduction - Close monitoring of medication

5. What are the guidelines for pap smear?
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 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)
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart

6. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception

7. How much calcium should adolescents (9 -18) take?
In adults with sustained BP > 135/80 mmHg
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after

8. When should chest X-ray be used for screening?
NEVER
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

9. What 3 things should always be done in an office visit?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
BP - Height - Weight
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

10. At what age should women have DEXA scan?
Exercise - Environmental hazard reduction - Close monitoring of medication
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES

11. What kind of polio vaccine is preferred?
Smoking - Alcoholism
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

12. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day

13. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester

14. When can children sit in a booster seat?

15. What is the ADA guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
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
One dose at 12-15 mod - Booster at least 4-weeks after
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

16. What kind of sunscreen SPF is recommended for sun protection?
In all W < 24 who are sexually active - In W > 24 with increased risk
More than 15
800 IU/ day
In adults with sustained BP > 135/80 mmHg

17. Measurement of which anatomic structure is best predictor for hip fracture?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Femoral neck
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs

18. 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
4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo

19. Who should get Tdap vaccine and how often?
> 2 yo and less than 40 lbs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

20. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
More than 15
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

21. How much flouride should non military children in the state of HI be given?
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)
Women 55 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

22. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Stroke and DVT
During 2nd - 3rd trimester

23. What are some RFs for DMT2?
1000 IU/day
1300 mg/day
Men 45 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

24. When is area of induration > 5mm considered TB positive?
BP - Height - Weight
Exercise - Environmental hazard reduction - Close monitoring of medication
1300 mg/day
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

25. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Breast CA - thromboembolic event - stroke and CAD
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

26. How much calcium should women > 50 take?
When they are > 40 lbs and still less then 5'
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1200 mg/day

27. How much folate should all women of child bearing age take?
1000 IU/day
4 mg/day
0.4 mg/day
Women 55 - 79 yo

28. What is the schedule for Hep A 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...
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
1000 IU/day

29. How much vit D should adults > 50 take?
More than 15
1200 mg/day
1000 IU/day
Exercise - Environmental hazard reduction - Close monitoring of medication

30. If traveling to endemic areas - Why should one get a dose of live vaccine?
> 2 yo and less than 40 lbs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
65 (earlier if have increased risk factors)
To get IgA protection

31. Who should get shingles vaccine?
Adults > 60
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 20 for both M and W
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

33. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
Forearm

34. What are the guidelines for colon cancer screening?
More than 15
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

35. How much fluoride should military children in HI be given?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Stroke and DVT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

36. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
> 2 yo and less than 40 lbs
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

37. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo
Adults > 60
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

38. Who are at increased risk for adverse effect catching a flu?
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

39. What is the most important way to screen for CAD in an asymptomatic patients?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
HISTORY

40. When is intensive individualized home-based intervention recommended?
Starts at 50 (recommends against starting at 40) and every 2 years
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60

41. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
More than 15
During 2nd - 3rd trimester
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

42. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
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
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

43. What are the guidelines for visual screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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...

44. In which group of patients should aspirin be given as primary prevention for MI?
Start at 20 for all M and W regardless of RFs
Starts at 50 (recommends against starting at 40) and every 2 years
Men 45 - 79 yo
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

45. How often do asplenic patients receive pneumococcal vaccine?
1200 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
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

46. What are some risk factors for CAD?
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

47. What is the schedule for Gardasil?
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
Adults > 60
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. What type of illnesses does Hib vaccine prevent?
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs

49. When should tetanus immunoglobulin be given?
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children up to 7 yo and < 5' should be placed in a booster seat.

50. How much vit D should adults < 50 take?
More than 15
Men 45 - 79 yo
Stroke and DVT
800 IU/ day