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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 folate should all women of child bearing age take?
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 mg/day
> 2 yo and less than 40 lbs
65 (earlier if have increased risk factors)

2. When is area of induration > 5mm considered TB positive?
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
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)

3. What kind of polio vaccine is preferred?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
To get IgA protection

4. What is the USPSTF guideline for chlamydial screening?
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk
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

5. How often do asplenic patients receive pneumococcal vaccine?
1000 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
BP - Height - Weight

6. How much calcium should women > 50 take?
1000 IU/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

7. How much calcium should adolescents (9 -18) take?
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. What are some RFs for DMT2?
0.4 mg/day
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)
1200 mg/day

9. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Women 55 - 79 yo
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

10. What are 2 conditions that have been proven to be beneficial to screened for?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

11. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
1000 mg/day
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65

12. How much fluoride should military children in HI be given?
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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...

13. What is the ADA guideline for DMT2 screening?
During 2nd - 3rd trimester
More than 15
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
800 IU/ day

14. What 3 things should always be done in an office visit?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck
BP - Height - Weight

15. When should Gardasil be given and for what purposes?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Starts at 20 for both M and W

16. When is area of induration > 15 mm considered TB positive?
Meningitis and Epiglottitis
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

17. Who should get Tdap vaccine and how often?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Rear facing
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

18. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In adults with sustained BP > 135/80 mmHg

19. When should the meningococcal vaccine be given and to which group?
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
Femoral neck
> 2 yo and less than 40 lbs

20. What is HI law for booster seat?

21. What tests are appropriate to order in an asymptomatic 57 yo male?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
Total cholesterol - FOBT

22. What are the USPSTF guidelines for mammogram?
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65

23. When can children sit in a booster seat?

24. What is USPSTF guideline for abdominal aortic aneurysm screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
BP - Height - Weight
Men 45 - 79 yo

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
Starts at 20 for both M and W

26. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 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
1000 IU/day
Stroke and DVT

27. How much vit D should adults > 50 take?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years
More than 15
1000 IU/day

28. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
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

29. Which children should use a semi-upright/forward facing carseat?
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
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
> 2 yo and less than 40 lbs

30. When is area of induration > 10 mm considered TB positive?
Total cholesterol - FOBT
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 50 (recommends against starting at 40) and every 2 years
NEVER

31. What are the guidelines for colon cancer screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
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

32. 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

33. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
More than 15
Starts at 20 for both M and W
12 - 23 mo - 2 doses are to be given 6 mo apart
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

34. Unopposed estrogen increases risks for what conditions?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT

35. How much vit D should adults < 50 take?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck

36. Some contraindications for aspirin
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One dose at 12-15 mod - Booster at least 4-weeks after
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

37. What is the schedule for Hib vaccine?
During 2nd - 3rd trimester
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 - 4 mo - 6mo and 12-15 mo
HISTORY

38. When should tetanus immunoglobulin be given?
Starts at 50 (recommends against starting at 40) and every 2 years
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. How much flouride should non military children in the state of HI be given?
HISTORY
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

40. What kind of car seat should children < 2 yo be placed in?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk

41. What is the schedule for Gardasil?
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
When they are > 40 lbs and still less then 5'
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

42. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Men 45 - 79 yo

43. 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Total cholesterol - FOBT

44. What is the schedule for varicella 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
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after

45. What are some safety issues you should counsel parents with young children?
BP - Height - Weight
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...
Forearm
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

46. Who should get shingles vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
Smoking - Alcoholism
Adults > 60

47. At what age should women have DEXA scan?
During 2nd - 3rd trimester
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
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

48. What type of illnesses does Hib vaccine prevent?
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
Every 5 years

49. When should pregnant women get a flu shot?
Meningitis and Epiglottitis
During 2nd - 3rd trimester
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)

50. What are some risk factors for CAD?
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
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65