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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 schedule for rotavirus vaccine?
Men 45 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors

2. What is the NCEP III guideline for cholesterol screening?
Starts at 20 for both M and W
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...
Start at 20 for all M and W regardless of RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

3. In which group of patients should aspirin be given as primary prevention for stroke?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1200 mg/day
HISTORY
Women 55 - 79 yo

4. What is the ADA guideline for DMT2 screening?
More than 15
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

5. What are some risk factors for CAD?
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
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

6. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Persons with no known risk factors
BP - Height - Weight

7. What are the USPSTF guidelines for mammogram?
BP - Height - Weight
Starts at 50 (recommends against starting at 40) and every 2 years
Persons with no known risk factors
Rear facing

8. When should chest X-ray be used for screening?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day
NEVER

9. What is the schedule for varicella 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
One dose at 12-15 mod - Booster at least 4-weeks after
Femoral neck
2mo - 4mo - 6-18 mo and 4-6 yrs

10. What type of illnesses does Hib vaccine prevent?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis
Adults > 60
One time abdominal X-ray for all MALES who ever SMOKES

11. What is the schedule for DTap vaccine?
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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

12. What is HI law for booster seat?

13. What is the schedule for Gardasil?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo

14. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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

15. How often do asplenic patients receive pneumococcal vaccine?
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT
Every 5 years

16. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
To get IgA protection
Preschool children : 3-4 yo - Elderly patients: > 65 yo

17. 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
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day

18. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
One dose at 12-15 mod - Booster at least 4-weeks after

19. How much calcium should women > 50 take?
Forearm
4 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
1200 mg/day

20. Measurement of which anatomic structure is best predictor for hip fracture?
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck
BP - Height - Weight
1000 mg/day

21. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)

22. At what age should women have DEXA scan?
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
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after

23. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
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

24. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Men 45 - 79 yo
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

25. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

26. What kind of sunscreen SPF is recommended for sun protection?
Starts at 20 for both M and W
More than 15
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

27. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

28. What is USPSTF guideline for abdominal aortic aneurysm screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs
1000 IU/day

29. Who should get shingles vaccine?
Adults > 60
BP - Height - Weight
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

30. How much folate should all women of child bearing age take?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
800 IU/ day
Rear facing

31. How much calcium should adolescents (9 -18) take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

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

33. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Smoking - Alcoholism
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)

34. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Smoking - Alcoholism
Starts at 20 for both M and W
Children up to 7 yo and < 5' should be placed in a booster seat.

35. When is area of induration > 10 mm considered TB positive?
Forearm
2mo - 4 mo - 6mo and 12-15 mo
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
Start at 20 for all M and W regardless of RFs

36. 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...
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
1300 mg/day

37. Who should get Tdap vaccine and how often?
HISTORY
Men 45 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

38. Some contraindications for aspirin
Stroke and DVT
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...
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

39. What is the schedule for polio vaccine?
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years

40. What can decrease fall in the elderly?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. How much calcium should adults (19 - 50) take?
1000 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

42. How much vit D should adults < 50 take?
800 IU/ day
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

43. How much fluoride should military children in HI be given?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication

44. What kind of car seat should children < 2 yo be placed in?
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES

45. What is the USPSTF guideline for chlamydial screening?
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 mg/day

46. When is area of induration > 15 mm considered TB positive?
65 (earlier if have increased risk factors)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Persons with no known risk factors
Breast CA - thromboembolic event - stroke and CAD

47. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
NEVER
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W
To get IgA protection

48. When should Gardasil be given and for what purposes?
To get IgA protection
Every 5 years
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

49. What is the schedule for Hep A vaccine?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo

50. 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)
4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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...