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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. Unopposed estrogen increases risks for what conditions?
Adults > 60
Stroke and DVT
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

2. 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day

3. How much calcium should adolescents (9 -18) take?
1300 mg/day
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
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

4. What is the USPSTF guideline for chlamydial screening?
BP - Height - Weight
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection

5. What are 2 conditions that have been proven to be beneficial to screened for?
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
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
Smoking - Alcoholism
BP - Height - Weight

6. How much calcium should women > 50 take?
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

7. What are the guidelines for colon cancer screening?
One dose at 12-15 mod - Booster at least 4-weeks after
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
Stroke and DVT

8. What type of illnesses does Hib vaccine prevent?
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

9. What can decrease fall in the elderly?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise - Environmental hazard reduction - Close monitoring of medication

10. When should the meningococcal vaccine be given and to which group?
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
Total cholesterol - FOBT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

11. What is the schedule for Hib vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

12. What kind of car seat should children < 2 yo be placed in?
4 mg/day
When they are > 40 lbs and still less then 5'
Starts at 50 (recommends against starting at 40) and every 2 years
Rear facing

13. When should chest X-ray be used for screening?
Adults > 60
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD
NEVER

14. How much folate should all women of child bearing age take?
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day

15. When can children sit in a booster seat?

16. What is the schedule for varicella vaccine?
BP - Height - Weight
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

17. How much vit D should adults < 50 take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
When they are > 40 lbs and still less then 5'
800 IU/ day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

18. What is the ADA guideline for DMT2 screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Smoking - Alcoholism
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 overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

19. What is the USPSTF guideline for DMT2 screening?
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
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

20. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo - 6mo and 12-15 mo
One time abdominal X-ray for all MALES who ever SMOKES
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing

21. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

22. When is intensive individualized home-based intervention recommended?
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
800 IU/ day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

23. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs
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
4 mg/day

24. What is the USPSTF guideline for fall prevention in the elderly?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication
Exercise or physical therapy and vit D for patients > 65

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

26. 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
Start at 20 for all M and W regardless of RFs
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. What 3 things should always be done in an office visit?
Stroke and DVT
65 (earlier if have increased risk factors)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
BP - Height - Weight

28. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT
Exercise - Environmental hazard reduction - Close monitoring of medication

29. What is HI law for booster seat?

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

31. 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
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

32. 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)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
During 2nd - 3rd trimester
HISTORY

33. At what age should women have DEXA scan?
1000 IU/day
65 (earlier if have increased risk factors)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm

34. What is the schedule for MMR vaccine?
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
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

35. What are some safety issues you should counsel parents with young children?
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
NEVER
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...

36. What is the schedule for Hep B vaccine?
NEVER
When they are > 40 lbs and still less then 5'
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after

37. Which children should use a semi-upright/forward facing carseat?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
> 2 yo and less than 40 lbs

38. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

39. What kind of sunscreen SPF is recommended for sun protection?
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

40. When should tetanus immunoglobulin be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

41. What are the guidelines for pap smear?
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)

42. When should pregnant women get a flu shot?
1000 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester
One dose at 12-15 mod - Booster at least 4-weeks after

43. What is the NCEP III guideline for cholesterol screening?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W

44. What are the guidelines for visual screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
65 (earlier if have increased risk factors)

45. When is area of induration > 5mm considered TB positive?
Femoral neck
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 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

46. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
800 IU/ day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
Children up to 7 yo and < 5' should be placed in a booster seat.

47. How much calcium should adults (19 - 50) take?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day

48. Who should get shingles vaccine?
During 2nd - 3rd trimester
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
Adults > 60

49. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise or physical therapy and vit D for patients > 65
In adults with sustained BP > 135/80 mmHg
HISTORY

50. What is the schedule for Gardasil?
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 45 - 79 yo
Total cholesterol - FOBT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose