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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 USPSTF guideline for fall prevention in the elderly?
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 IU/day
Exercise or physical therapy and vit D for patients > 65
In adults with sustained BP > 135/80 mmHg

2. What is the schedule for Hib vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
When they are > 40 lbs and still less then 5'
2mo - 4 mo - 6mo and 12-15 mo
More than 15

3. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs
1200 mg/day
Women 55 - 79 yo

4. When should tetanus immunoglobulin be given?
4 mg/day
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

5. When should the meningococcal vaccine be given and to which group?
1200 mg/day
NEVER
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

6. How much flouride should non military children in the state of HI be given?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

7. How much vit D should adults < 50 take?
800 IU/ day
0.4 mg/day
Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

8. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
One time abdominal X-ray for all MALES who ever SMOKES
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

10. How much calcium should adults (19 - 50) take?
Breast CA - thromboembolic event - stroke and CAD
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)
1000 mg/day
Men 45 - 79 yo

11. 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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication

12. What kind of polio vaccine is preferred?
NEVER
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

13. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Start at 20 for all M and W regardless of RFs

14. When is intensive individualized home-based intervention recommended?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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

15. What is the USPSTF guideline for chlamydial screening?
Exercise or physical therapy and vit D for patients > 65
1200 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
In all W < 24 who are sexually active - In W > 24 with increased risk

16. What are the risks of combination HRT?
Persons with no known risk factors
When they are > 40 lbs and still less then 5'
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)
Breast CA - thromboembolic event - stroke and CAD

17. What type of illnesses does Hib vaccine prevent?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Meningitis and Epiglottitis
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years

18. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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...
Exercise or physical therapy and vit D for patients > 65

19. What are the guidelines for visual screening?
Starts at 50 (recommends against starting at 40) and every 2 years
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

20. What is the NCEP III guideline for cholesterol screening?
Forearm
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

21. What are some RFs for DMT2?
Persons with no known 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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
In all W < 24 who are sexually active - In W > 24 with increased risk

22. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Women 55 - 79 yo
When they are > 40 lbs and still less then 5'
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. 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12 - 23 mo - 2 doses are to be given 6 mo apart

24. What is the schedule for MMR vaccine?
Femoral neck
Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

25. What are the guidelines for colon cancer screening?
Men 45 - 79 yo
BP - Height - Weight
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. How much calcium should women > 50 take?
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
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

27. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
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
Smoking - Alcoholism

28. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
To get IgA protection
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Every 5 years

29. Who should get shingles vaccine?
4 mg/day
Forearm
1300 mg/day
Adults > 60

30. Unopposed estrogen increases risks for what conditions?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
In adults with sustained BP > 135/80 mmHg
Stroke and DVT

31. How much fluoride should military children in HI be given?
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

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33. When is area of induration > 15 mm considered TB positive?
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
Persons with no known risk factors
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

34. What is the USPSTF guideline for DMT2 screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In adults with sustained BP > 135/80 mmHg
Stroke and DVT

35. When should pregnant women get a flu shot?
Persons with no known risk factors
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
During 2nd - 3rd trimester
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...

36. What is the schedule for polio 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
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years
BP - Height - Weight

37. In which group of patients should aspirin be given as primary prevention for stroke?
65 (earlier if have increased risk factors)
Women 55 - 79 yo
Smoking - Alcoholism
During 2nd - 3rd trimester

38. When can children sit in a booster seat?

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39. Who are at increased risk for adverse effect catching a flu?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

40. Measurement of which anatomic structure is best predictor for hip fracture?
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
Femoral neck
Total cholesterol - FOBT

41. What is the ADA guideline for DMT2 screening?
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

42. When is area of induration > 10 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
Persons with no known risk factors
Starts at 20 for both M and W

43. What is HI law for booster seat?

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44. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

45. What can decrease fall in the elderly?
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One dose at 12-15 mod - Booster at least 4-weeks after

46. What are some risk factors for CAD?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

47. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. What kind of car seat should children < 2 yo be placed in?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
800 IU/ day
Rear facing

49. 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
0.4 - 0.8 mg/day for 1 month prior to conception
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

50. What is the schedule for Gardasil?
Total cholesterol - FOBT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose