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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 most important way to screen for CAD in an asymptomatic patients?
HISTORY
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
When they are > 40 lbs and still less then 5'

2. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

3. What type of illnesses does Hib vaccine prevent?
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception

4. 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
More than 15
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
Every 5 years

5. Who should get shingles vaccine?
Adults > 60
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
Exercise or physical therapy and vit D for patients > 65
Smoking - Alcoholism

6. When should pregnant women get a flu shot?
NEVER
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
HISTORY
During 2nd - 3rd trimester

7. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
More than 15
Rear facing
Forearm
Stroke and DVT

8. What are the risks of combination HRT?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg

9. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

10. 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo - 6mo and 12-15 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)

11. How much flouride should non military children in the state of HI be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

12. What is the schedule for Hep A vaccine?
Persons with no known risk factors
Starts at 20 for both M and W
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER

13. What is the USPSTF guideline for fall prevention in the elderly?
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT

14. What tests are appropriate to order in an asymptomatic 57 yo male?
Femoral neck
Women 55 - 79 yo
More than 15
Total cholesterol - FOBT

15. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
During 2nd - 3rd trimester
4 mg/day
In adults with sustained BP > 135/80 mmHg

16. In which group of patients should aspirin be given as primary prevention for stroke?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES

17. 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
Women 55 - 79 yo
> 2 yo and less than 40 lbs
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

18. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis
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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

19. What are the guidelines for visual screening?
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Rear facing

20. What is the schedule for Hep B vaccine?
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
0.4 - 0.8 mg/day for 1 month prior to conception
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

21. How much vit D should adults < 50 take?
Femoral neck
800 IU/ day
Start at 20 for all M and W regardless of RFs
65 (earlier if have increased risk factors)

22. When can children sit in a booster seat?

23. Measurement of which anatomic structure is best predictor for hip fracture?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo
Starts at 20 for both M and W

24. What 3 things should always be done in an office visit?
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs
More than 15
BP - Height - Weight

25. How much vit D should adults > 50 take?
Women 55 - 79 yo
1200 mg/day
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

26. What are the guidelines for colon cancer screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
NEVER
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

28. What is the USPSTF guideline for chlamydial screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65

30. What are some safety issues you should counsel parents with young children?
Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
800 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...

31. How much calcium should adolescents (9 -18) take?
In adults with sustained BP > 135/80 mmHg
1300 mg/day
Smoking - Alcoholism
Men 45 - 79 yo

32. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
> 2 yo and less than 40 lbs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

33. How much folate and for How long should a woman take for planned pregnancy?
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 - 0.8 mg/day for 1 month prior to conception
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

34. Unopposed estrogen increases risks for what conditions?
Adults > 60
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)
Starts at 20 for both M and W
Stroke and DVT

35. What is the schedule for varicella vaccine?
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
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

36. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
NEVER
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

37. When is intensive individualized home-based intervention recommended?
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
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

38. What are some RFs for DMT2?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1200 mg/day
BP - Height - Weight
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

39. What is HI law for booster seat?

40. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs
More than 15

41. How much calcium should adults (19 - 50) take?
Men 45 - 79 yo
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day

42. When should the meningococcal vaccine be given and to which group?
In adults with sustained BP > 135/80 mmHg
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

43. What is the ADA guideline for DMT2 screening?
> 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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Stroke and DVT

44. How much folate should all women of child bearing age take?
Men 45 - 79 yo
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection

45. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
0.4 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
One time abdominal X-ray for all MALES who ever SMOKES

46. When is area of induration > 10 mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Women 55 - 79 yo

47. What are the guidelines for pap smear?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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)
Every 5 years

48. What kind of car seat should children < 2 yo be placed in?
12 - 23 mo - 2 doses are to be given 6 mo apart
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Rear facing
Forearm

49. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Total cholesterol - FOBT
Exercise or physical therapy and vit D for patients > 65
Every 5 years

50. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...