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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. When should chest X-ray be used for screening?
NEVER
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
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...

2. What are some safety issues you should counsel parents with young children?
Persons with no known risk factors
800 IU/ day
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...

3. Who should get Tdap vaccine and how often?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

4. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 20 for both M and W
NEVER
1000 IU/day

5. What is the NCEP III guideline for cholesterol screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs
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
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...

6. What kind of car seat should children < 2 yo be placed in?
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years

7. When is area of induration > 5mm considered TB positive?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

8. How much folate should all women of child bearing age take?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
0.4 mg/day
1000 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

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

10. 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
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 - 23 mo - 2 doses are to be given 6 mo apart
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

11. What is the schedule for DTap vaccine?
HISTORY
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

12. How much calcium should women > 50 take?
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

13. 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)
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

14. Which children should use a semi-upright/forward facing carseat?
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
> 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
Children up to 7 yo and < 5' should be placed in a booster seat.

15. How much vit D should adults < 50 take?
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
800 IU/ day

16. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
BP - Height - Weight
Stroke and DVT
1300 mg/day

17. Measurement of which anatomic structure is best predictor for hip fracture?
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

18. What is the schedule for varicella vaccine?
Forearm
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
Femoral neck

19. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
800 IU/ day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4mo - 6-18 mo and 4-6 yrs

20. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Total cholesterol - FOBT
Starts at 20 for both M and W
Women 55 - 79 yo
More than 15

21. How much flouride should non military children in the state of HI be given?
Femoral neck
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

22. What is the schedule for rotavirus vaccine?
Women 55 - 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Meningitis and Epiglottitis

23. What is the ADA guideline for DMT2 screening?
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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 45 - 79 yo

24. When should Gardasil be given and for what purposes?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo - 6mo and 12-15 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

25. What type of illnesses does Hib vaccine prevent?
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs

26. What are the risks of combination HRT?
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)
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...
Breast CA - thromboembolic event - stroke and CAD

27. In which group of patients should aspirin be given as primary prevention for MI?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
When they are > 40 lbs and still less then 5'

28. How often do asplenic patients receive pneumococcal vaccine?
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

29. What is the schedule for Hib vaccine?
Start at 20 for all M and W regardless of RFs
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
2mo - 4 mo - 6mo and 12-15 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

30. How much fluoride should military children in HI be given?
NEVER
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

31. What kind of sunscreen SPF is recommended for sun protection?
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
More than 15
During 2nd - 3rd trimester

32. Some contraindications for aspirin
Forearm
Men 45 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Rear facing

33. When should pregnant women get a flu shot?
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 - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester
1300 mg/day

34. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm

35. What is the schedule for MMR vaccine?
Meningitis and Epiglottitis
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

36. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
1000 IU/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
65 (earlier if have increased risk factors)

37. 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
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 or physical therapy and vit D for patients > 65
65 (earlier if have increased risk factors)

38. What is the schedule for polio vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W

39. What are some RFs for DMT2?
Exercise or physical therapy and vit D for patients > 65
0.4 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

40. 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
Exercise or physical therapy and vit D for patients > 65
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

41. What are the USPSTF guidelines for mammogram?
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)
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection

42. When is intensive individualized home-based intervention recommended?
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
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

43. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
2mo - 4 mo - 6mo and 12-15 mo
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

44. Who should get shingles vaccine?
Adults > 60
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

45. When should the meningococcal vaccine be given and to which group?
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

46. What is the schedule for Hep A vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Meningitis and Epiglottitis

47. How much vit D should adults > 50 take?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after

48. How much calcium should adults (19 - 50) take?
1000 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk
When they are > 40 lbs and still less then 5'

49. Unopposed estrogen increases risks for what conditions?
> 2 yo and less than 40 lbs
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT

50. What is the USPSTF guideline for DMT2 screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day
In adults with sustained BP > 135/80 mmHg
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks