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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 HI law for booster seat?

2. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
1000 IU/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

3. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Starts at 20 for both M and W
1300 mg/day
Adults > 60

4. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Adults > 60
Rear facing
Meningitis and Epiglottitis

5. Who should get Tdap vaccine and how often?
Femoral neck
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
BP - Height - Weight
Every 5 years

6. What are the guidelines for visual screening?
During 2nd - 3rd trimester
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Preschool children : 3-4 yo - Elderly patients: > 65 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...

7. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Meningitis and Epiglottitis
4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Men 45 - 79 yo

8. If traveling to endemic areas - Why should one get a dose of live vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
To get IgA protection
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

9. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
NEVER
Starts at 20 for both M and W
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

10. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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
In all W < 24 who are sexually active - In W > 24 with increased risk

11. When is area of induration > 10 mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD

12. How often do asplenic patients receive pneumococcal vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
Men 45 - 79 yo
Every 5 years
4 mg/day

13. What are the USPSTF guidelines for mammogram?
4 mg/day
Adults > 60
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT

14. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

15. What is the schedule for Hep A vaccine?
0.4 mg/day
Stroke and DVT
12 - 23 mo - 2 doses are to be given 6 mo apart
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

16. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Breast CA - thromboembolic event - stroke and CAD
Smoking - Alcoholism
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W

17. How much calcium should adults (19 - 50) take?
1300 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
1200 mg/day
1000 mg/day

18. When should the meningococcal vaccine be given and to which group?
Exercise or physical therapy and vit D for patients > 65
To get IgA protection
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

19. When is area of induration > 5mm considered TB positive?
In all W < 24 who are sexually active - In W > 24 with increased risk
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Women 55 - 79 yo
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

20. What are 2 conditions that have been proven to be beneficial to screened for?
1200 mg/day
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection

21. What are some safety issues you should counsel parents with young children?
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
Adults > 60
Total cholesterol - FOBT
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 is the schedule for Gardasil?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

23. Who should get shingles vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight

24. When should pregnant women get a flu shot?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
During 2nd - 3rd trimester

25. How much folate should all women of child bearing age take?
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 mg/day
To get IgA protection
Adults > 60

26. What are the risks of combination HRT?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65

27. Which children should use a semi-upright/forward facing carseat?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT
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
> 2 yo and less than 40 lbs

28. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

29. What is the schedule for rotavirus vaccine?
Stroke and DVT
More than 15
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

30. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs

31. How much flouride should non military children in the state of HI be given?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Breast CA - thromboembolic event - stroke and CAD

32. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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 mg/day
Men 45 - 79 yo

33. When is intensive individualized home-based intervention recommended?
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
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years

34. What are the guidelines for colon cancer screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing
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
2mo - 4mo - 6-18 mo and 4-6 yrs

35. In which group of patients should aspirin be given as primary prevention for stroke?
Starts at 20 for both M and W
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

36. What kind of sunscreen SPF is recommended for sun protection?
Children up to 7 yo and < 5' should be placed in a booster seat.
To get IgA protection
More than 15
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

37. In which group of patients should aspirin be given as primary prevention for MI?
BP - Height - Weight
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
Men 45 - 79 yo

38. What is the USPSTF guideline for chlamydial screening?
To get IgA protection
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

39. How much vit D should adults > 50 take?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
During 2nd - 3rd trimester
1000 IU/day

40. When should Gardasil be given and for what purposes?
Rear facing
Femoral neck
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

41. How much calcium should adolescents (9 -18) take?
Adults > 60
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day
65 (earlier if have increased risk factors)

42. What can decrease fall in the elderly?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Smoking - Alcoholism
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication

43. How much calcium should women > 50 take?
Men 45 - 79 yo
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day

44. What kind of polio vaccine is preferred?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

45. What 3 things should always be done in an office visit?
BP - Height - Weight
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
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

46. What is the schedule for DTap vaccine?
During 2nd - 3rd trimester
Exercise - Environmental hazard reduction - Close monitoring of medication
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
12 - 23 mo - 2 doses are to be given 6 mo apart

47. What is the USPSTF guideline for fall prevention in the elderly?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
More than 15
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after

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

49. What are the guidelines for pap smear?
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)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Meningitis and Epiglottitis
Every 5 years

50. Unopposed estrogen increases risks for what conditions?
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT
Forearm