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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 are the guidelines for pap smear?
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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)

2. How much calcium should adults (19 - 50) take?
> 2 yo and less than 40 lbs
1000 mg/day
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk

3. What is the schedule for rotavirus 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
Starts at 20 for both M and W
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

4. What 3 things should always be done in an office visit?
BP - Height - Weight
800 IU/ 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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

5. 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
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
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

6. What are some RFs for DMT2?
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

7. When should Gardasil be given and for what purposes?
1300 mg/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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day

8. Some contraindications for aspirin
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism

9. When can children sit in a booster seat?

10. Measurement of which anatomic structure is best predictor for hip fracture?
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
Femoral neck
1000 mg/day
When they are > 40 lbs and still less then 5'

11. What is the NCEP III guideline for cholesterol screening?
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs
800 IU/ day

12. What are the guidelines for colon cancer screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60
Start at 20 for all M and W regardless of RFs
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

13. What is the schedule for Hib vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
To get IgA protection
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo

14. When is area of induration > 15 mm considered TB positive?
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...
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors

15. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
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
1200 mg/day
> 2 yo and less than 40 lbs

16. What can decrease fall in the elderly?
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Exercise or physical therapy and vit D for patients > 65

17. If traveling to endemic areas - Why should one get a dose of live vaccine?
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
65 (earlier if have increased risk factors)
To get IgA protection

18. When should tetanus immunoglobulin 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
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

19. What is the schedule for polio vaccine?
Breast CA - thromboembolic event - stroke and CAD
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...
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
2mo - 4mo - 6-18 mo and 4-6 yrs

20. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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)
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

21. What is the schedule for DTap vaccine?
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
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. How much vit D should adults > 50 take?
To get IgA protection
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day

23. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs
Persons with no known risk factors
1200 mg/day

24. What type of illnesses does Hib vaccine prevent?
65 (earlier if have increased risk factors)
Smoking - Alcoholism
Meningitis and Epiglottitis
Every 5 years

25. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Adults > 60
> 2 yo and less than 40 lbs
Starts at 20 for both M and W

26. When is area of induration > 5mm considered TB positive?
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

27. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
NEVER
4 mg/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

28. What is the most important way to screen for CAD in an asymptomatic patients?
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
HISTORY
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

29. How much calcium should women > 50 take?
Stroke and DVT
1200 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

30. How much flouride should non military children in the state of HI be given?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

31. What is the schedule for MMR vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after

33. In which group of patients should aspirin be given as primary prevention for MI?
Forearm
Men 45 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

34. Unopposed estrogen increases risks for what conditions?
Children up to 7 yo and < 5' should be placed in a booster seat.
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)
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

35. When should chest X-ray be used for screening?
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs
1000 mg/day

36. At what age should women have DEXA scan?
1300 mg/day
65 (earlier if have increased risk factors)
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)
Breast CA - thromboembolic event - stroke and CAD

37. What kind of sunscreen SPF is recommended for sun protection?
Total cholesterol - FOBT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

38. Who should get Tdap vaccine and how often?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
More than 15
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
Children up to 7 yo and < 5' should be placed in a booster seat.

39. What are the guidelines for visual screening?
When they are > 40 lbs and still less then 5'
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
Femoral neck

40. What kind of car seat should children < 2 yo be placed in?
Rear facing
Every 5 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

41. What kind of polio vaccine is preferred?
1300 mg/day
1000 IU/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

42. Which children should use a semi-upright/forward facing carseat?
NEVER
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
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs

43. What is USPSTF guideline for abdominal aortic aneurysm screening?
Women 55 - 79 yo
HISTORY
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

44. How much folate and for How long should a woman take for planned pregnancy?
BP - Height - Weight
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 years
Rear facing

45. What is the schedule for Hep B vaccine?
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

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

47. What tests are appropriate to order in an asymptomatic 57 yo male?
Stroke and DVT
Total cholesterol - FOBT
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

48. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

49. How much folate should all women of child bearing age take?
0.4 mg/day
Total cholesterol - FOBT
When they are > 40 lbs and still less then 5'
4 mg/day

50. What are the risks of combination HRT?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
Stroke and DVT