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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 vit D should adults > 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
1000 IU/day

2. 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
Forearm
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER

3. Who should get Tdap vaccine and how often?
When they are > 40 lbs and still less then 5'
BP - Height - Weight
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

4. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day

5. What can decrease fall in the elderly?
1000 IU/day
1200 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs

6. How often do asplenic patients receive pneumococcal vaccine?
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
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

7. At what age should women have DEXA scan?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
To get IgA protection
65 (earlier if have increased risk factors)

8. What are the risks of combination HRT?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

9. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Starts at 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day
More than 15

10. In which group of patients should aspirin be given as primary prevention for MI?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
When they are > 40 lbs and still less then 5'

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

12. What kind of polio vaccine is preferred?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children up to 7 yo and < 5' should be placed in a booster seat.
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Persons with no known risk factors

13. How much calcium should adolescents (9 -18) take?
During 2nd - 3rd trimester
0.4 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
1300 mg/day

14. Who should get shingles vaccine?
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 yrs
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

15. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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 20 for both M and W
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
Meningitis and Epiglottitis

16. When should chest X-ray be used for screening?
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
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

17. What are some safety issues you should counsel parents with young children?
> 2 yo and less than 40 lbs
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
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...
When they are > 40 lbs and still less then 5'

18. How much fluoride should military children in HI be given?
4 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 20 for both M and W

19. What is the schedule for Hep A vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart
Preschool children : 3-4 yo - Elderly patients: > 65 yo

20. How much vit D should adults < 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
800 IU/ day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo

21. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo
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...

22. What 3 things should always be done in an office visit?
Total cholesterol - FOBT
BP - Height - Weight
800 IU/ day
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

23. What are the guidelines for pap smear?
Adults > 60
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
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. What is the schedule for varicella vaccine?
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after
Women 55 - 79 yo
Men 45 - 79 yo

25. 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
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
To get IgA protection

26. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT

27. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
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
2mo - 4mo - 6-18 mo and 4-6 yrs
In adults with sustained BP > 135/80 mmHg

28. What is the ADA guideline for DMT2 screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

29. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1200 mg/day
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

30. What is the schedule for MMR vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15

31. 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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

32. How much folate should all women of child bearing age take?
One time abdominal X-ray for all MALES who ever SMOKES
More than 15
0.4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

33. 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
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 20 for both M and W

34. When can children sit in a booster seat?

35. How much calcium should adults (19 - 50) take?
1000 mg/day
0.4 mg/day
To get IgA protection
1300 mg/day

36. What are some RFs for DMT2?
Total cholesterol - FOBT
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

37. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
To get IgA protection
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

38. What kind of car seat should children < 2 yo be placed in?
Rear facing
800 IU/ day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

39. What is the schedule for polio vaccine?
NEVER
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs

40. When is area of induration > 5mm considered TB positive?
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 50 (recommends against starting at 40) and every 2 years
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
Smoking - Alcoholism

41. What is the USPSTF guideline for chlamydial screening?
4 mg/day
800 IU/ day
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection

42. What is HI law for booster seat?

43. When should Gardasil be given and for what purposes?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and 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
> 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

44. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
1300 mg/day
In adults with sustained BP > 135/80 mmHg

46. What type of illnesses does Hib vaccine prevent?
In all W < 24 who are sexually active - In W > 24 with increased risk
Smoking - Alcoholism
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

47. What are the USPSTF guidelines for mammogram?
Breast CA - thromboembolic event - stroke and CAD
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo

48. 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
One time abdominal X-ray for all MALES who ever SMOKES
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

49. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
4 mg/day
0.4 mg/day

50. How much calcium should women > 50 take?
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...
0.4 - 0.8 mg/day for 1 month prior to conception
1200 mg/day
NEVER