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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 are the guidelines for colon cancer screening?
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

2. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4mo - 6-18 mo and 4-6 yrs
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day

3. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
Stroke and DVT
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

4. 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
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
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

5. What are some risk factors for CAD?
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
During 2nd - 3rd trimester

6. What are the risks of combination HRT?
Total cholesterol - FOBT
When they are > 40 lbs and still less then 5'
Persons with no known risk factors
Breast CA - thromboembolic event - stroke and CAD

7. When is area of induration > 10 mm considered TB positive?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES

8. In which group of patients should aspirin be given as primary prevention for MI?
2mo - 4 mo - 6mo and 12-15 mo
12 - 23 mo - 2 doses are to be given 6 mo apart
Every 5 years
Men 45 - 79 yo

9. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60
4 mg/day

10. In which group of patients should aspirin be given as primary prevention for stroke?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Stroke and DVT

11. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
Starts at 20 for both M and W

12. What are the guidelines for visual screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors
Preschool children : 3-4 yo - Elderly patients: > 65 yo

13. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Men 45 - 79 yo
Stroke and DVT

14. What are 2 conditions that have been proven to be beneficial to screened for?
When they are > 40 lbs and still less then 5'
Breast CA - thromboembolic event - stroke and CAD
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism

15. What is the NCEP III guideline for cholesterol screening?
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
NEVER
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

16. Which children should use a semi-upright/forward facing carseat?
Meningitis and Epiglottitis
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs

17. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Starts at 20 for both M and W
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

18. What 3 things should always be done in an office visit?
BP - Height - Weight
Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo

19. At what age should women have DEXA scan?
Smoking - Alcoholism
65 (earlier if have increased risk factors)
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
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

20. If traveling to endemic areas - Why should one get a dose of live vaccine?
More than 15
Persons with no known risk factors
1200 mg/day
To get IgA protection

21. Who should get Tdap vaccine and how often?
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
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

22. What is the schedule for MMR vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

23. How much calcium should women > 50 take?
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'
1200 mg/day

24. 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
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
65 (earlier if have increased risk factors)

25. Who are at increased risk for adverse effect catching a flu?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. When should pregnant women get a flu shot?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
During 2nd - 3rd trimester

27. When should chest X-ray be used for screening?
More than 15
HISTORY
NEVER
Total cholesterol - FOBT

28. Some contraindications for aspirin
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
Total cholesterol - FOBT
1300 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

29. How much calcium should adults (19 - 50) take?
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
During 2nd - 3rd trimester
HISTORY

30. How often do asplenic patients receive pneumococcal vaccine?
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years

31. What are the USPSTF guidelines for mammogram?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
During 2nd - 3rd trimester

32. What is the schedule for rotavirus vaccine?
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

33. What is the schedule for DTap vaccine?
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
0.4 mg/day
Femoral neck

34. What kind of car seat should children < 2 yo be placed in?
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
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
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

35. What are some safety issues you should counsel parents with young children?
Rear facing
Femoral neck
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...
Starts at 50 (recommends against starting at 40) and every 2 years

36. How much folate should all women of child bearing age take?
0.4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
During 2nd - 3rd trimester

37. How much vit D should adults < 50 take?
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day

38. What is the schedule for Hib vaccine?
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
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

39. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

40. When should Gardasil be given and for what purposes?
Rear facing
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 50 (recommends against starting at 40) and every 2 years
NEVER

41. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years

42. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
NEVER
Persons with no known risk factors

43. What is the most important way to screen for CAD in an asymptomatic patients?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
HISTORY
BP - Height - Weight

44. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
NEVER
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo

45. When should tetanus immunoglobulin be given?
Smoking - Alcoholism
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

46. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
Stroke and DVT

47. What is HI law for booster seat?

48. How much folate and for How long should a woman take for planned pregnancy?
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

49. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
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...

50. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
During 2nd - 3rd trimester
BP - Height - Weight
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
Forearm