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Family Medicine Health Maintenance

Subjects : health-sciences, family-medicine

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Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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1. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception

2. Measurement of which anatomic structure is best predictor for hip fracture?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise or physical therapy and vit D for patients > 65

3. When should pregnant women get a flu shot?
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
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
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

4. What tests are appropriate to order in an asymptomatic 57 yo male?
Smoking - Alcoholism
Starts at 20 for both M and W
0.4 mg/day
Total cholesterol - FOBT

5. When should Gardasil be given and for what purposes?
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)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day
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. What is the USPSTF guideline for chlamydial 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
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

7. What 3 things should always be done in an office visit?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
Starts at 20 for both M and W
Rear facing

8. What are some safety issues you should counsel parents with young children?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Total cholesterol - FOBT
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...

9. What type of illnesses does Hib vaccine prevent?
Every 5 years
Meningitis and Epiglottitis
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65

10. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
To get IgA protection
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...
In adults with sustained BP > 135/80 mmHg

11. When can children sit in a booster seat?

12. What kind of polio vaccine is preferred?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

13. How often do asplenic patients receive pneumococcal vaccine?
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
Every 5 years

14. Who should get shingles vaccine?
Adults > 60
Persons with no known risk factors
0.4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

15. What is the ADA guideline for DMT2 screening?
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
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
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

16. What are some risk factors for CAD?
0.4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
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

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

18. What are 2 conditions that have been proven to be beneficial to screened for?
1200 mg/day
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Rear facing

19. What is the most important way to screen for CAD in an asymptomatic patients?
1000 IU/day
800 IU/ day
Men 45 - 79 yo
HISTORY

20. In which group of patients should aspirin be given as primary prevention for MI?
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
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)
Men 45 - 79 yo

21. What kind of sunscreen SPF is recommended for sun protection?
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
Exercise or physical therapy and vit D for patients > 65
More than 15

22. How much calcium should women > 50 take?
1200 mg/day
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

23. What is USPSTF guideline for abdominal aortic aneurysm screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

24. 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
When they are > 40 lbs and still less then 5'
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years

25. When is area of induration > 15 mm considered TB positive?
65 (earlier if have increased risk factors)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Stroke and DVT
Persons with no known risk factors

26. 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
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

27. Unopposed estrogen increases risks for what conditions?
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'
Stroke and DVT

28. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

29. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
800 IU/ day
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)
NEVER

30. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/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. Who are at increased risk for adverse effect catching a flu?
Total cholesterol - FOBT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk

32. How much vit D should adults > 50 take?
1000 IU/day
Rear facing
1200 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. 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
Start at 20 for all M and W regardless of RFs
2mo - 4mo - 6-18 mo and 4-6 yrs
Adults > 60

34. How much vit D should adults < 50 take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
800 IU/ day

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
More than 15
Forearm

36. What can decrease fall in the elderly?
HISTORY
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)
Exercise - Environmental hazard reduction - Close monitoring of medication
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

37. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

38. If traveling to endemic areas - Why should one get a dose of live vaccine?
Rear facing
1300 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
To get IgA protection

39. 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
Persons with no known risk factors
65 (earlier if have increased risk factors)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

40. What is the schedule for varicella vaccine?
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
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs

41. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
0.4 mg/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...

42. How much fluoride should military children in 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

43. What is the schedule for polio vaccine?
Forearm
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
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs

44. How much calcium should adolescents (9 -18) take?
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ day
> 2 yo and less than 40 lbs

45. What kind of car seat should children < 2 yo be placed in?
Exercise or physical therapy and vit D for patients > 65
1300 mg/day
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk

46. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

47. What is the schedule for Hib vaccine?
BP - Height - Weight
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo

48. What is the schedule for rotavirus vaccine?
To get IgA protection
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 mg/day
0.4 mg/day

49. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
0.4 mg/day
Forearm
12 - 23 mo - 2 doses are to be given 6 mo apart

50. Who should get Tdap vaccine and how often?
Meningitis and Epiglottitis
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo

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Family Medicine Health Maintenance

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3d Computer Modeling

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After Effects Keyboard Shortcuts

Agile Development

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