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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. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Femoral neck
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

2. How much vit D should adults < 50 take?
800 IU/ day
> 2 yo and less than 40 lbs
NEVER
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

3. Which children should use a semi-upright/forward facing carseat?
More than 15
12 - 23 mo - 2 doses are to be given 6 mo apart
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

4. If traveling to endemic areas - Why should one get a dose of live vaccine?
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)
> 2 yo and less than 40 lbs
To get IgA protection

5. How much calcium should adolescents (9 -18) take?
1300 mg/day
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
Meningitis and Epiglottitis

6. What is the USPSTF guideline for chlamydial screening?
HISTORY
In all W < 24 who are sexually active - In W > 24 with increased risk
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
During 2nd - 3rd trimester

7. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
HISTORY
800 IU/ day

8. What is HI law for booster seat?

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9. What is the USPSTF guideline for DMT2 screening?
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

10. Some contraindications for aspirin
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
2mo - 4mo - 6-18 mo and 4-6 yrs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

11. What are some safety issues you should counsel parents with young children?
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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...

12. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 mg/day
Stroke and DVT
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

13. When should chest X-ray be used for screening?
In adults with sustained BP > 135/80 mmHg
Adults > 60
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception

14. What are the guidelines for pap smear?
1000 IU/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)
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day

15. What is the schedule for varicella vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
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

16. What is the schedule for DTap vaccine?
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
1000 mg/day
Every 5 years

17. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
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)
Meningitis and Epiglottitis
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

18. Who should get Tdap vaccine and how often?
1000 IU/day
BP - Height - Weight
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 mg/day

19. What is USPSTF guideline for abdominal aortic aneurysm screening?
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
When they are > 40 lbs and still less then 5'

20. What is the schedule for polio vaccine?
More than 15
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

21. What type of illnesses does Hib vaccine prevent?
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day

22. What is the ADA guideline for DMT2 screening?
1000 mg/day
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...
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In all W < 24 who are sexually active - In W > 24 with increased risk

23. When can children sit in a booster seat?

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24. What are the USPSTF guidelines for mammogram?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection

25. What are the guidelines for visual screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo

26. What 3 things should always be done in an office visit?
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
BP - Height - Weight
Adults > 60

27. When is area of induration > 10 mm considered TB positive?
Men 45 - 79 yo
Forearm
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

28. 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
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
Rear facing

29. What is the schedule for Hep B vaccine?
1000 mg/day
Persons with no known risk factors
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT

30. What are some RFs for DMT2?
In adults with sustained BP > 135/80 mmHg
800 IU/ day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

31. What tests are appropriate to order in an asymptomatic 57 yo male?
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis
Total cholesterol - FOBT

32. Who should get shingles vaccine?
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
1000 IU/day

33. How much calcium should adults (19 - 50) take?
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 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

34. What are the guidelines for colon cancer screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

35. What is the schedule for MMR vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men 45 - 79 yo
Start at 20 for all M and W regardless of RFs

36. What kind of sunscreen SPF is recommended for sun protection?
0.4 - 0.8 mg/day for 1 month prior to conception
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
More than 15

37. What is the schedule for Hib vaccine?
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
Smoking - Alcoholism
0.4 mg/day

38. When is intensive individualized home-based intervention recommended?
Adults > 60
Starts at 20 for both M and W
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

39. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis

40. What are the risks of combination HRT?
4 mg/day
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection
Start at 20 for all M and W regardless of RFs

41. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after

42. What is the schedule for Gardasil?
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
Adults > 60
Persons with no known risk factors

43. When is area of induration > 5mm considered TB positive?
More than 15
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
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

44. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W
Femoral neck
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

45. What is the schedule for Hep A vaccine?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
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 > 60

46. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Smoking - Alcoholism
Persons with no known risk factors
During 2nd - 3rd trimester

47. What can decrease fall in the elderly?
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
One time abdominal X-ray for all MALES who ever SMOKES

48. How much folate should all women of child bearing age take?
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception

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

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50. In which group of patients should aspirin be given as primary prevention for MI?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
Forearm
Men 45 - 79 yo