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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 fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg

2. What is the USPSTF guideline for chlamydial screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY

3. When is area of induration > 10 mm considered TB positive?
Exercise or physical therapy and vit D for patients > 65
Every 5 years
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
To get IgA protection

4. What is the USPSTF guideline for DMT2 screening?
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 adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

5. When should pregnant women get a flu shot?
Start at 20 for all M and W regardless of RFs
Breast CA - thromboembolic event - stroke and CAD
During 2nd - 3rd trimester
800 IU/ day

6. When is area of induration > 15 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day

7. What is the schedule for Hep A vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
12 - 23 mo - 2 doses are to be given 6 mo apart
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 up to 7 yo and < 5' should be placed in a booster seat.

8. 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

9. What is the schedule for MMR vaccine?
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

10. What is HI law for booster seat?

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

12. How much calcium should women > 50 take?
4 mg/day
1200 mg/day
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg

13. When should the meningococcal vaccine be given and to which group?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

14. Who should get shingles vaccine?
4 mg/day
Adults > 60
1000 IU/day
0.4 - 0.8 mg/day for 1 month prior to conception

15. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What is the schedule for Gardasil?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
800 IU/ day

17. Who should get Tdap vaccine and how often?
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
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
More than 15

18. What is the schedule for varicella vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 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

19. How much calcium should adults (19 - 50) take?
NEVER
Total cholesterol - FOBT
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

20. When is intensive individualized home-based intervention recommended?
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
Smoking - Alcoholism
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

21. What is the ADA guideline for DMT2 screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
More than 15
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

22. What kind of car seat should children < 2 yo be placed in?
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise or physical therapy and vit D for patients > 65
Rear facing

23. What are some risk factors for CAD?
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
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

24. What are the risks of combination HRT?
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
Adults > 60
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
Breast CA - thromboembolic event - stroke and CAD

25. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 20 for both M and W

26. 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
BP - Height - Weight
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

27. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
When they are > 40 lbs and still less then 5'
1300 mg/day
Total cholesterol - FOBT

28. What is the NCEP III guideline for cholesterol screening?
1000 IU/day
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs

29. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
Total cholesterol - FOBT
Stroke and DVT

30. What is the most important way to screen for CAD in an asymptomatic patients?
> 2 yo and less than 40 lbs
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
HISTORY

31. How much flouride should non military children in the state of HI be given?
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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.

32. Some contraindications for aspirin
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs

33. What are some safety issues you should counsel parents with young children?
Adults > 60
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...

34. Measurement of which anatomic structure is best predictor for hip fracture?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

35. What is the schedule for DTap vaccine?
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
4 mg/day
When they are > 40 lbs and still less then 5'
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

36. Which children should use a semi-upright/forward facing carseat?
HISTORY
Men 45 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
> 2 yo and less than 40 lbs

37. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Smoking - Alcoholism
Forearm
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after

38. What is the USPSTF guideline for fall prevention in the elderly?
HISTORY
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
Exercise or physical therapy and vit D for patients > 65
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)

39. When can children sit in a booster seat?

40. How much vit D should adults > 50 take?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

41. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES

42. Unopposed estrogen increases risks for what conditions?
Breast CA - thromboembolic event - stroke and CAD
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
Stroke and DVT

43. What 3 things should always be done in an office visit?
During 2nd - 3rd trimester
BP - Height - Weight
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

44. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
Starts at 20 for both M and W

45. What kind of polio vaccine is preferred?
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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise or physical therapy and vit D for patients > 65
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

46. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
Women 55 - 79 yo
Meningitis and Epiglottitis
In adults with sustained BP > 135/80 mmHg

47. How much calcium should adolescents (9 -18) take?
Total cholesterol - FOBT
1300 mg/day
Starts at 20 for both M and W
Stroke and DVT

48. When should chest X-ray be used for screening?
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
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4mo - 6-18 mo and 4-6 yrs

49. What kind of sunscreen SPF is recommended for sun protection?
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
More than 15
BP - Height - Weight
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

50. When should Gardasil be given and for what purposes?
Children up to 7 yo and < 5' should be placed in a booster seat.
When they are > 40 lbs and still less then 5'
0.4 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