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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. Which children should use a semi-upright/forward facing carseat?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
NEVER
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.

2. What is the schedule for polio vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT
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

3. What can decrease fall in the elderly?
4 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
Exercise - Environmental hazard reduction - Close monitoring of medication
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

4. How much calcium should women > 50 take?
1200 mg/day
4 mg/day
1300 mg/day
1000 IU/day

5. When should tetanus immunoglobulin be given?
Breast CA - thromboembolic event - stroke and CAD
Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. What type of illnesses does Hib vaccine prevent?
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
Total cholesterol - FOBT
Rear facing
Meningitis and Epiglottitis

7. When should chest X-ray be used for screening?
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
NEVER
Exercise - Environmental hazard reduction - Close monitoring of medication

8. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
Rear facing
More than 15

9. What are the USPSTF guidelines for mammogram?
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years

10. What is the USPSTF guideline for chlamydial screening?
1200 mg/day
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo

11. When is area of induration > 10 mm considered TB positive?
800 IU/ day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

12. Who should get Tdap vaccine and how often?
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
In adults with sustained BP > 135/80 mmHg

13. When can children sit in a booster seat?

14. When should pregnant women get a flu shot?
When they are > 40 lbs and still less then 5'
1200 mg/day
During 2nd - 3rd trimester
Starts at 20 for both M and W

15. What are 2 conditions that have been proven to be beneficial to screened for?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism

16. Who are at increased risk for adverse effect catching a flu?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
HISTORY
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

17. How much folate should all women of child bearing age take?
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day

18. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
To get IgA protection

19. What 3 things should always be done in an office visit?
When they are > 40 lbs and still less then 5'
12 - 23 mo - 2 doses are to be given 6 mo apart
> 2 yo and less than 40 lbs
BP - Height - Weight

20. How much calcium should adults (19 - 50) take?
1000 mg/day
Smoking - Alcoholism
1300 mg/day
Meningitis and Epiglottitis

21. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight
4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

22. What is the schedule for Hep A vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Meningitis and Epiglottitis

23. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Smoking - Alcoholism
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
Persons with no known risk factors

24. When should the meningococcal vaccine be given and to which group?
800 IU/ 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
HISTORY
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What are some RFs for DMT2?
Exercise - Environmental hazard reduction - Close monitoring of medication
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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)

26. If traveling to endemic areas - Why should one get a dose of live vaccine?
Persons with no known risk factors
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
To get IgA protection

27. What is the schedule for MMR vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
During 2nd - 3rd trimester

28. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
2mo - 4mo - 6-18 mo and 4-6 yrs

29. How much flouride should non military children in the state of HI be given?
4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4 mo - 6mo and 12-15 mo

30. When is area of induration > 5mm considered TB positive?
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
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

31. What kind of car seat should children < 2 yo be placed in?
Women 55 - 79 yo
Rear facing
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

32. How much fluoride should military children in HI be given?
Stroke and DVT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/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
One dose at 12-15 mod - Booster at least 4-weeks after

33. What is USPSTF guideline for abdominal aortic aneurysm screening?
1300 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES
When they are > 40 lbs and still less then 5'

34. What are the risks of combination HRT?
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD

35. At what age should women have DEXA scan?
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)
65 (earlier if have increased risk factors)

36. When is area of induration > 15 mm considered TB positive?
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

37. What are the guidelines for pap smear?
Total cholesterol - FOBT
65 (earlier if have increased risk factors)
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 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)

38. How much calcium should adolescents (9 -18) take?
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo
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

39. What kind of polio vaccine is preferred?
Starts at 50 (recommends against starting at 40) and every 2 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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
NEVER

40. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
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)
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

41. In which group of patients should aspirin be given as primary prevention for stroke?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
Starts at 20 for both M and W
In adults with sustained BP > 135/80 mmHg

42. What is the most important way to screen for CAD in an asymptomatic patients?
Rear facing
HISTORY
Adults > 60
When they are > 40 lbs and still less then 5'

43. What kind of sunscreen SPF is recommended for sun protection?
800 IU/ day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15

44. What is the schedule for varicella vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo

45. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Breast CA - thromboembolic event - stroke and CAD
Women 55 - 79 yo

46. What is HI law for booster seat?

47. What is the schedule for Gardasil?
HISTORY
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1200 mg/day
Femoral neck

48. What is the schedule for DTap vaccine?
Femoral neck
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

49. What is the ADA guideline for DMT2 screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Rear facing
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
When they are > 40 lbs and still less then 5'

50. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
> 2 yo and less than 40 lbs
1200 mg/day
1300 mg/day