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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. How much flouride should non military children in the state of HI be given?
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Total cholesterol - FOBT

2. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In adults with sustained BP > 135/80 mmHg
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

3. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo - 6mo and 12-15 mo
HISTORY

4. 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
4 mg/day
1000 IU/day
Exercise or physical therapy and vit D for patients > 65

5. When can children sit in a booster seat?

6. What is the schedule for varicella vaccine?
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Every 5 years

7. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs
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
800 IU/ day

8. What are the USPSTF guidelines for mammogram?
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
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)

9. How much vit D should adults > 50 take?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60

10. When should pregnant women get a flu shot?
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
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
2mo - 4mo - 6-18 mo and 4-6 yrs

11. What are some safety issues you should counsel parents with young children?
Persons with no known risk factors
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
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...

12. What is the USPSTF guideline for chlamydial screening?
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
In all W < 24 who are sexually active - In W > 24 with increased risk
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...

13. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

14. 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
Women 55 - 79 yo
Men 45 - 79 yo

15. What are the guidelines for colon cancer 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
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis

16. How much calcium should women > 50 take?
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 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)
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

17. When should tetanus immunoglobulin be given?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men 45 - 79 yo

18. What kind of car seat should children < 2 yo be placed in?
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 IU/day

19. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.
Persons with no known risk factors
4 mg/day

20. How much calcium should adolescents (9 -18) take?
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
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)
1300 mg/day

21. What is the USPSTF guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
In adults with sustained BP > 135/80 mmHg
Femoral neck

22. What is the schedule for MMR vaccine?
Total cholesterol - FOBT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart

23. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Men 45 - 79 yo
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

24. If traveling to endemic areas - Why should one get a dose of live vaccine?
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism
To get IgA protection
When they are > 40 lbs and still less then 5'

25. What are 2 conditions that have been proven to be beneficial to screened for?
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
Persons with no known risk factors
Smoking - Alcoholism
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

26. What is the USPSTF guideline for fall prevention in the elderly?
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
> 2 yo and less than 40 lbs
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

27. 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
In adults with sustained BP > 135/80 mmHg
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 all W < 24 who are sexually active - In W > 24 with increased risk

28. When should chest X-ray be used for screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

29. When is area of induration > 10 mm considered TB positive?
Stroke and DVT
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

30. What is the schedule for Hep B vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

31. In which group of patients should aspirin be given as primary prevention for stroke?
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
Women 55 - 79 yo
65 (earlier if have increased risk factors)

32. What is the schedule for polio vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4mo - 6-18 mo and 4-6 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12 - 23 mo - 2 doses are to be given 6 mo apart

33. What are the risks of combination HRT?
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 - 4mo - 6-18 mo and 4-6 yrs
Breast CA - thromboembolic event - stroke and CAD
0.4 mg/day

34. When should the meningococcal vaccine be given and to which group?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

35. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

36. What is the schedule for Hib vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

37. Who should get shingles vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
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 - 4mo - 6-18 mo and 4-6 yrs
Adults > 60

38. 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
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W
Rear facing

39. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
Men 45 - 79 yo

40. How much vit D should adults < 50 take?
Breast CA - thromboembolic event - stroke and CAD
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

41. What is HI law for booster seat?

42. How much calcium should adults (19 - 50) take?
To get IgA protection
Stroke and DVT
One time abdominal X-ray for all MALES who ever SMOKES
1000 mg/day

43. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
BP - Height - Weight
Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

44. 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
HISTORY
Total cholesterol - FOBT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

45. Measurement of which anatomic structure is best predictor for hip fracture?
To get IgA protection
1000 IU/day
Femoral neck
1200 mg/day

46. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4 mo - 6mo and 12-15 mo

47. What is the ADA guideline for DMT2 screening?
One dose at 12-15 mod - Booster at least 4-weeks after
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
Persons with no known risk factors

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

49. What kind of sunscreen SPF is recommended for sun protection?
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
More than 15

50. Which children should use a semi-upright/forward facing carseat?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs
> 2 yo and less than 40 lbs