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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?
Persons with no known risk factors
4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Men 45 - 79 yo

2. What is the schedule for Hep A vaccine?
> 2 yo and less than 40 lbs
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 - 23 mo - 2 doses are to be given 6 mo apart
1000 mg/day

3. What is the most important way to screen for CAD in an asymptomatic patients?
> 2 yo and less than 40 lbs
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
Children up to 7 yo and < 5' should be placed in a booster seat.

4. 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)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

5. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 mg/day
1300 mg/day
Exercise or physical therapy and vit D for patients > 65

6. When is area of induration > 10 mm considered TB positive?
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
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
Exercise - Environmental hazard reduction - Close monitoring of medication

7. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY
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
Persons with no known risk factors

8. Some contraindications for aspirin
Start at 20 for all M and W regardless of RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. How much calcium should women > 50 take?
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

10. What are the guidelines for colon cancer screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In adults with sustained BP > 135/80 mmHg
To get IgA protection
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

11. Who should get shingles vaccine?
800 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)
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

12. When should chest X-ray be used for screening?
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER

13. What is HI law for booster seat?

14. How much folate should all women of child bearing age take?
More than 15
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
0.4 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

15. 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
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day

16. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
Exercise - Environmental hazard reduction - Close monitoring of medication
When they are > 40 lbs and still less then 5'

17. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT
BP - Height - Weight
1000 IU/day

18. What are some safety issues you should counsel parents with young children?
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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...
1000 mg/day

19. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing

20. What are some RFs for DMT2?
Starts at 50 (recommends against starting at 40) and every 2 years
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'
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. At what age should women have DEXA scan?
Total cholesterol - FOBT
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
65 (earlier if have increased risk factors)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

22. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
4 mg/day

23. When can children sit in a booster seat?

24. How much calcium should adults (19 - 50) take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 mg/day
Start at 20 for all M and W regardless of RFs

25. What is the schedule for rotavirus vaccine?
> 2 yo and less than 40 lbs
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
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

26. What is the NCEP III guideline for cholesterol screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day

27. How much vit D should adults < 50 take?
Smoking - Alcoholism
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
800 IU/ day
Men 45 - 79 yo

28. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
HISTORY
In all W < 24 who are sexually active - In W > 24 with increased risk
During 2nd - 3rd trimester

29. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Stroke and DVT
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart

30. How much calcium should adolescents (9 -18) take?
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65
1300 mg/day
Rear facing

31. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
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)

32. What 3 things should always be done in an office visit?
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
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
BP - Height - Weight

33. What are the guidelines for pap smear?
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)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

34. What are the USPSTF guidelines for mammogram?
1000 IU/day
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD

35. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4 mo - 6mo and 12-15 mo
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
Femoral neck

36. When should tetanus immunoglobulin be given?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism

37. What kind of car seat should children < 2 yo be placed in?
Rear facing
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

38. What is the schedule for varicella vaccine?
1000 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

39. Who should get Tdap vaccine and how often?
1200 mg/day
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 IU/day
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

40. When should Gardasil be given and for what purposes?
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

41. What can decrease fall in the elderly?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

42. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise or physical therapy and vit D for patients > 65
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

43. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Starts at 20 for both M and W
During 2nd - 3rd trimester
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

44. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Meningitis and Epiglottitis

45. 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
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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

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

47. 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
More than 15
Men 45 - 79 yo
Start at 20 for all M and W regardless of RFs

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

49. How much fluoride should military children in HI be given?
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 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
Adults > 60

50. How much vit D should adults > 50 take?
Start at 20 for all M and W regardless of RFs
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
In adults with sustained BP > 135/80 mmHg