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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. Who should get Tdap vaccine and how often?
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
0.4 mg/day
1200 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

2. How much calcium should women > 50 take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day
Start at 20 for all M and W regardless of RFs
Children up to 7 yo and < 5' should be placed in a booster seat.

3. Who are at increased risk for adverse effect catching a flu?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12 - 23 mo - 2 doses are to be given 6 mo apart
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs

4. What is the schedule for Hep B vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

5. What is the USPSTF guideline for DMT2 screening?
4 mg/day
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
Children up to 7 yo and < 5' should be placed in a booster seat.

6. What are the USPSTF guidelines for mammogram?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
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

7. When can children sit in a booster seat?

8. What 3 things should always be done in an office visit?
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

9. What is the USPSTF guideline for chlamydial screening?
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
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

10. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60

11. What is the schedule for Hep A vaccine?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
One dose at 12-15 mod - Booster at least 4-weeks after
Total cholesterol - FOBT

12. How much folate and for How long should a woman take for planned pregnancy?
Stroke and DVT
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 20 for both M and W

13. How much calcium should adolescents (9 -18) take?
Smoking - Alcoholism
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

14. What is the schedule for Gardasil?
0.4 mg/day
When they are > 40 lbs and still less then 5'
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. What is the schedule for MMR vaccine?
NEVER
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Stroke and DVT

16. What is the USPSTF guideline for fall prevention in the elderly?
To get IgA protection
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

17. What tests are appropriate to order in an asymptomatic 57 yo male?
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
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception

18. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
Femoral neck

19. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
Femoral neck
4 mg/day

20. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
BP - Height - Weight
2mo - 4mo - 6-18 mo and 4-6 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W

21. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

22. How much vit D should adults > 50 take?
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
1000 IU/day
Rear facing

23. Unopposed estrogen increases risks for what conditions?
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
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
To get IgA protection

24. In which group of patients should aspirin be given as primary prevention for stroke?
To get IgA protection
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

25. What are the guidelines for pap smear?
1300 mg/day
1000 IU/day
Men 45 - 79 yo
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. When should chest X-ray be used for screening?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
NEVER
1000 IU/day

27. How much calcium should adults (19 - 50) take?
4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day

28. What are some safety issues you should counsel parents with young children?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
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...

29. When is area of induration > 15 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis
Persons with no known risk factors
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

30. Measurement of which anatomic structure is best predictor for hip fracture?
1300 mg/day
Smoking - Alcoholism
During 2nd - 3rd trimester
Femoral neck

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

32. What are some risk factors for CAD?
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
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication

33. What is the schedule for polio vaccine?
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W

34. What are the guidelines for colon cancer screening?
Meningitis and Epiglottitis
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
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

35. Who should get shingles vaccine?
Adults > 60
Stroke and DVT
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg

36. How much vit D should adults < 50 take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day

37. Some contraindications for aspirin
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs

38. What is the schedule for Hib vaccine?
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

39. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

40. What is the schedule for DTap vaccine?
Exercise or physical therapy and vit D for patients > 65
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

41. When is area of induration > 5mm considered TB positive?
One time abdominal X-ray for all MALES who ever SMOKES
Meningitis and Epiglottitis
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
Exercise or physical therapy and vit D for patients > 65

42. How often do asplenic patients receive pneumococcal vaccine?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years

43. In which group of patients should aspirin be given as primary prevention for MI?
Exercise or physical therapy and vit D for patients > 65
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo

44. When is area of induration > 10 mm considered TB positive?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
NEVER

45. How much fluoride should military children in HI be given?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT
Starts at 20 for both M and W

46. What kind of sunscreen SPF is recommended for sun protection?
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)
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
More than 15

47. What is the schedule for rotavirus vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

48. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
1300 mg/day
Men 45 - 79 yo

49. How much folate should all women of child bearing age take?
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 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER

50. What is the schedule for varicella vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/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)
Smoking - Alcoholism
One dose at 12-15 mod - Booster at least 4-weeks after