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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 risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.
4 mg/day

2. What is the schedule for Hep B 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)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

3. When should Gardasil be given and for what purposes?
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

4. When is area of induration > 5mm considered TB positive?
Forearm
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

5. What type of illnesses does Hib vaccine prevent?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Total cholesterol - FOBT
Meningitis and Epiglottitis
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)

6. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

7. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
To get IgA protection
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
4 mg/day

8. What 3 things should always be done in an office visit?
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
Rear facing
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

9. How much calcium should adolescents (9 -18) take?
1300 mg/day
Femoral neck
Total cholesterol - FOBT
Persons with no known risk factors

10. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

11. 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
Persons with no known risk factors
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - 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

12. When can children sit in a booster seat?

13. What is USPSTF guideline for abdominal aortic aneurysm screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs
0.4 - 0.8 mg/day for 1 month prior to conception

14. What is the most important way to screen for CAD in an asymptomatic patients?
Start at 20 for all M and W regardless of RFs
1000 IU/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY

15. How often do asplenic patients receive pneumococcal 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)
Women 55 - 79 yo
Every 5 years
1000 mg/day

16. What is the schedule for Hib vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo - 6mo and 12-15 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
65 (earlier if have increased risk factors)

17. How much vit D should adults > 50 take?
1000 IU/day
More than 15
HISTORY
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...

18. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
BP - Height - Weight
During 2nd - 3rd trimester
Forearm

19. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Every 5 years

20. What is the USPSTF guideline for fall prevention in the elderly?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise or physical therapy and vit D for patients > 65

21. Who should get shingles vaccine?
1200 mg/day
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
Breast CA - thromboembolic event - stroke and CAD
Adults > 60

22. How much calcium should women > 50 take?
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

23. What are some RFs for DMT2?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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. What kind of polio vaccine is preferred?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
During 2nd - 3rd trimester
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

25. When should pregnant women get a flu shot?
To get IgA protection
During 2nd - 3rd trimester
1200 mg/day
In adults with sustained BP > 135/80 mmHg

26. What is the schedule for Hep A vaccine?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
Preschool children : 3-4 yo - Elderly patients: > 65 yo

27. What are the guidelines for colon cancer screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
Breast CA - thromboembolic event - stroke and CAD
During 2nd - 3rd trimester

28. What is the schedule for MMR vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. If traveling to endemic areas - Why should one get a dose of live vaccine?
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)
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

30. What is the USPSTF guideline for DMT2 screening?
Women 55 - 79 yo
4 mg/day
In adults with sustained BP > 135/80 mmHg
More than 15

31. What is HI law for booster seat?

32. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

33. How much calcium should adults (19 - 50) take?
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
1000 mg/day
HISTORY

34. In which group of patients should aspirin be given as primary prevention for stroke?
More than 15
Adults > 60
Women 55 - 79 yo
NEVER

35. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

36. What tests are appropriate to order in an asymptomatic 57 yo male?
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
Total cholesterol - FOBT
1000 IU/day

37. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
800 IU/ day
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day

38. When should tetanus immunoglobulin be given?
Femoral neck
4 mg/day
Men 45 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. Who are at increased risk for adverse effect catching a flu?
Persons with no known risk factors
HISTORY
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.

40. 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...
1200 mg/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
Start at 20 for all M and W regardless of RFs

41. When should chest X-ray be used for screening?
0.4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
When they are > 40 lbs and still less then 5'
NEVER

42. What kind of sunscreen SPF is recommended for sun protection?
Start at 20 for all M and W regardless of RFs
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
More than 15

43. What kind of car seat should children < 2 yo be placed in?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Rear facing
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years

44. What can decrease fall in the elderly?
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication

45. Unopposed estrogen increases risks for what conditions?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Adults > 60
Stroke and DVT
1000 IU/day

46. How much fluoride should military children in HI be given?
Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD

47. How much vit D should adults < 50 take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Total cholesterol - FOBT
During 2nd - 3rd trimester
800 IU/ day

48. When should the meningococcal vaccine be given and to which group?
Adults > 60
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

49. 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
1000 IU/day
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...
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

50. What is the schedule for varicella vaccine?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
Children up to 7 yo and < 5' should be placed in a booster seat.
In all W < 24 who are sexually active - In W > 24 with increased risk