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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?
Children up to 7 yo and < 5' should be placed in a booster seat.
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
HISTORY
Start at 20 for all M and W regardless of RFs

2. Who should get shingles vaccine?
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

3. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
To get IgA protection
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

4. What 3 things should always be done in an office visit?
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
BP - Height - Weight
Stroke and DVT

5. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Exercise - Environmental hazard reduction - Close monitoring of medication
Every 5 years
4 mg/day
Starts at 20 for both M and W

6. What are some RFs for DMT2?
HISTORY
Adults > 60
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
During 2nd - 3rd trimester

7. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
0.4 mg/day

8. What is the schedule for Gardasil?
Persons with no known risk factors
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Total cholesterol - FOBT

9. How much vit D should adults > 50 take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
When they are > 40 lbs and still less then 5'
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

10. What kind of car seat should children < 2 yo be placed in?
Femoral neck
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

11. What is the schedule for rotavirus vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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 - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 50 (recommends against starting at 40) and every 2 years

12. What are the guidelines for colon cancer screening?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
800 IU/ day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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 USPSTF guideline for chlamydial screening?
Smoking - Alcoholism
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
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk

14. What tests are appropriate to order in an asymptomatic 57 yo male?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children up to 7 yo and < 5' should be placed in a booster seat.

15. When is area of induration > 10 mm considered TB positive?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

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

17. How much folate and for How long should a woman take for planned pregnancy?
Stroke and DVT
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception

18. When should the meningococcal vaccine be given and to which group?
To get IgA protection
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60

19. Some contraindications for aspirin
Every 5 years
To get IgA protection
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. When can children sit in a booster seat?

21. What is the schedule for varicella vaccine?
Every 5 years
HISTORY
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One dose at 12-15 mod - Booster at least 4-weeks after

22. What are the guidelines for pap smear?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.
Persons with no known 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)

23. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
To get IgA protection
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)

24. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
HISTORY
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection

25. How much calcium should women > 50 take?
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

26. 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
In adults with sustained BP > 135/80 mmHg
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

27. When is intensive individualized home-based intervention recommended?
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
Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

28. 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
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

29. What is the NCEP III guideline for cholesterol screening?
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs

30. What are the risks of combination HRT?
0.4 mg/day
Persons with no known risk factors
Breast CA - thromboembolic event - stroke and CAD
One dose at 12-15 mod - Booster at least 4-weeks after

31. What is the schedule for Hib 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
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

32. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

33. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
Breast CA - thromboembolic event - stroke and CAD
Women 55 - 79 yo

34. 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
4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
NEVER

35. Who should get Tdap vaccine and how often?
Stroke and DVT
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
Start at 20 for all M and W regardless of RFs

36. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
4 mg/day
Women 55 - 79 yo
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...

37. 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
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart

38. Measurement of which anatomic structure is best predictor for hip fracture?
Smoking - Alcoholism
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. When should chest X-ray be used for screening?
1000 mg/day
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

40. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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 - 23 mo - 2 doses are to be given 6 mo apart

41. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

42. In which group of patients should aspirin be given as primary prevention for MI?
More than 15
1200 mg/day
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years

43. How often do asplenic patients receive pneumococcal vaccine?
0.4 mg/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)
1300 mg/day
Every 5 years

44. What is the schedule for DTap vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

45. What is HI law for booster seat?

46. How much fluoride should military children in HI be given?
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
HISTORY
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...

47. How much calcium should adults (19 - 50) take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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...
Smoking - Alcoholism
1000 mg/day

48. What are the guidelines for visual screening?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm

49. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
NEVER
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

50. At what age should women have DEXA scan?
HISTORY
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES
Forearm