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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 kind of sunscreen SPF is recommended for sun protection?
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo
More than 15
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

2. What kind of polio vaccine is preferred?
Persons with no known risk factors
BP - Height - Weight
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

3. What 3 things should always be done in an office visit?
One dose at 12-15 mod - Booster at least 4-weeks after
BP - Height - Weight
Smoking - Alcoholism
1300 mg/day

4. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

5. What is the schedule for varicella vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after
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
In all W < 24 who are sexually active - In W > 24 with increased risk

6. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

7. 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
Breast CA - thromboembolic event - stroke and CAD
When they are > 40 lbs and still less then 5'
BP - Height - Weight

8. What is HI law for booster seat?

9. What are 2 conditions that have been proven to be beneficial to screened for?
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
NEVER

10. When is area of induration > 5mm considered TB positive?
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
Rear facing
1000 mg/day

11. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W

12. What are some RFs for DMT2?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception
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)

13. When should chest X-ray be used for screening?
NEVER
When they are > 40 lbs and still less then 5'
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

14. How much flouride should non military children in the state of HI be given?
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Femoral neck

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

16. What are the risks of combination HRT?
1000 mg/day
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD
Every 5 years

17. 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT
Preschool children : 3-4 yo - Elderly patients: > 65 yo

18. How much fluoride should military children in HI be given?
65 (earlier if have increased risk factors)
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

19. What are some safety issues you should counsel parents with young children?
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...
NEVER
> 2 yo and less than 40 lbs
1000 mg/day

20. How much calcium should adults (19 - 50) take?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
To get IgA protection
1000 mg/day
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

21. When should tetanus immunoglobulin be given?
Starts at 50 (recommends against starting at 40) and every 2 years
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
In adults with sustained BP > 135/80 mmHg

22. 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
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.
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

23. What is the schedule for polio vaccine?
> 2 yo and less than 40 lbs
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)
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

24. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Exercise or physical therapy and vit D for patients > 65
More than 15

25. Some contraindications for aspirin
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

26. How much calcium should adolescents (9 -18) take?
Women 55 - 79 yo
1200 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

27. What are the guidelines for colon cancer screening?
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
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day

28. What is the schedule for Hep B vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

29. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
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)
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

30. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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 - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'

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
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
Adults > 60

32. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Femoral neck
BP - Height - Weight
4 mg/day

33. When should the meningococcal vaccine be given and to which group?
Femoral neck
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

34. When should Gardasil be given and for what purposes?
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
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

35. What is the schedule for Gardasil?
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

36. What are the USPSTF guidelines for mammogram?
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...
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
Every 5 years

37. Measurement of which anatomic structure is best predictor for hip fracture?
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Femoral neck

38. What is the most important way to screen for CAD in an asymptomatic patients?
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
Every 5 years
HISTORY

39. In which group of patients should aspirin be given as primary prevention for MI?
When they are > 40 lbs and still less then 5'
Men 45 - 79 yo
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)

40. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
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

41. How much vit D should adults > 50 take?
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
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
1000 IU/day
Meningitis and Epiglottitis

42. Who are at increased risk for adverse effect catching a flu?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

43. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
800 IU/ day
During 2nd - 3rd trimester

44. How much calcium should women > 50 take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
1200 mg/day

45. What are the guidelines for pap smear?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
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)

46. What is the schedule for Hib vaccine?
65 (earlier if have increased risk factors)
2mo - 4 mo - 6mo and 12-15 mo
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
Women 55 - 79 yo

47. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Exercise - Environmental hazard reduction - Close monitoring of medication
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 adults with sustained BP > 135/80 mmHg

48. What is the schedule for Hep A vaccine?
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart

49. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 years
Starts at 20 for both M and W
Rear facing
0.4 - 0.8 mg/day for 1 month prior to conception

50. When can children sit in a booster seat?