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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 NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
More than 15
Forearm

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
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
Starts at 50 (recommends against starting at 40) and every 2 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

3. When should Gardasil be given and for what purposes?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
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

4. 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...
In adults with sustained BP > 135/80 mmHg
1200 mg/day
Men 45 - 79 yo

5. What type of illnesses does Hib vaccine prevent?
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)
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
Meningitis and Epiglottitis

6. What is the schedule for Hib vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
Adults > 60

7. How much vit D should adults < 50 take?
Meningitis and Epiglottitis
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ 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

8. What are some risk factors for CAD?
To get IgA protection
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

9. How much calcium should adolescents (9 -18) take?
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
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)
4 mg/day

10. What are the risks of combination HRT?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo

11. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Every 5 years
4 mg/day
Stroke and DVT
Forearm

12. 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
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

13. When can children sit in a booster seat?

14. What is the ADA guideline for DMT2 screening?
Smoking - Alcoholism
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

15. What tests are appropriate to order in an asymptomatic 57 yo male?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo
Total cholesterol - FOBT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

16. When should pregnant women get a flu shot?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester
One dose at 12-15 mod - Booster at least 4-weeks after
When they are > 40 lbs and still less then 5'

17. 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
1300 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 IU/day

18. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
More than 15
In adults with sustained BP > 135/80 mmHg
Starts at 20 for both M and W

19. What is the schedule for varicella vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception

20. When should the meningococcal vaccine be given and to which group?
NEVER
1300 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Breast CA - thromboembolic event - stroke and CAD

21. What kind of polio vaccine is preferred?
More than 15
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

22. What are the guidelines for visual screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1300 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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

23. What is HI law for booster seat?

24. When is area of induration > 15 mm considered TB positive?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
BP - Height - Weight
Persons with no known risk factors

25. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
More than 15
> 2 yo and less than 40 lbs
Adults > 60

26. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm

27. What are the guidelines for colon cancer screening?
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
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
1000 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)

28. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

29. What is the most important way to screen for CAD in an asymptomatic patients?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
HISTORY

30. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo

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

32. Which children should use a semi-upright/forward facing carseat?
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
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
Forearm

33. If traveling to endemic areas - Why should one get a dose of live vaccine?
Adults > 60
To get IgA protection
Breast CA - thromboembolic event - stroke and CAD
4 mg/day

34. What is the schedule for Hep A vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Forearm
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 mg/day

35. In which group of patients should aspirin be given as primary prevention for stroke?
When they are > 40 lbs and still less then 5'
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One dose at 12-15 mod - Booster at least 4-weeks after

36. How often do asplenic patients receive pneumococcal vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise or physical therapy and vit D for patients > 65
Every 5 years
Femoral neck

37. Measurement of which anatomic structure is best predictor for hip fracture?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Femoral neck

38. What 3 things should always be done in an office visit?
Exercise - Environmental hazard reduction - Close monitoring of medication
HISTORY
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

39. When should chest X-ray be used for screening?
NEVER
Children up to 7 yo and < 5' should be placed in a booster seat.
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Breast CA - thromboembolic event - stroke and CAD

40. Some contraindications for aspirin
In adults with sustained BP > 135/80 mmHg
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

41. What is the schedule for DTap vaccine?
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

42. Who should get shingles vaccine?
NEVER
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Adults > 60
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)

43. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Forearm
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

44. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60

45. Who are at increased risk for adverse effect catching a flu?
BP - Height - Weight
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo
Starts at 20 for both M and W

46. When is area of induration > 10 mm considered TB positive?
HISTORY
Forearm
Breast CA - thromboembolic event - stroke and CAD
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

47. What is the schedule for Gardasil?
Femoral neck
Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
4 mg/day

48. At what age should women have DEXA scan?
More than 15
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)
800 IU/ day

49. What is the schedule for Hep B vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs

50. What are 2 conditions that have been proven to be beneficial to screened for?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/day
Smoking - Alcoholism
NEVER