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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 schedule for rotavirus vaccine?
To get IgA protection
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

2. What is the NCEP III guideline for cholesterol screening?
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs
1000 IU/day

3. How much calcium should adolescents (9 -18) take?
1300 mg/day
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart

4. What is HI law for booster seat?

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5. How much fluoride should military children in HI be given?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

6. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg

7. What are the guidelines for colon cancer screening?
NEVER
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
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

8. What is the schedule for Hep A vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart
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...

9. When can children sit in a booster seat?

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10. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
Men 45 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.

11. What are some risk factors for CAD?
One dose at 12-15 mod - Booster at least 4-weeks after
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
One time abdominal X-ray for all MALES who ever SMOKES

12. What kind of car seat should children < 2 yo be placed in?
Starts at 20 for both M and W
Rear facing
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

13. What are some safety issues you should counsel parents with young children?
0.4 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...
1300 mg/day
1000 IU/day

14. What is the schedule for MMR vaccine?
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
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

15. In which group of patients should aspirin be given as primary prevention for MI?
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 yo

16. What is USPSTF guideline for abdominal aortic aneurysm 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
When they are > 40 lbs and still less then 5'
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES

17. What is the schedule for varicella vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after

18. Unopposed estrogen increases risks for what conditions?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

19. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Adults > 60
HISTORY
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

20. Who are at increased risk for adverse effect catching a flu?
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
800 IU/ day
To get IgA protection

21. What is the schedule for Hep B vaccine?
When they are > 40 lbs and still less then 5'
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
One time abdominal X-ray for all MALES who ever SMOKES
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. What is the schedule for Hib vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
2mo - 4 mo - 6mo and 12-15 mo
During 2nd - 3rd trimester

23. What is the ADA guideline for DMT2 screening?
4 mg/day
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

24. How much calcium should women > 50 take?
In adults with sustained BP > 135/80 mmHg
1200 mg/day
To get IgA protection
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

25. At what age should women have DEXA scan?
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
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
65 (earlier if have increased risk factors)
1200 mg/day

26. What are the risks of combination HRT?
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD

27. When is area of induration > 5mm considered TB positive?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
12 - 23 mo - 2 doses are to be given 6 mo apart
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

28. What are the USPSTF guidelines for mammogram?
During 2nd - 3rd trimester
NEVER
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years

29. What is the schedule for Gardasil?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 50 (recommends against starting at 40) and every 2 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after

30. What type of illnesses does Hib vaccine prevent?
Adults > 60
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
Meningitis and Epiglottitis
To get IgA protection

31. What are 2 conditions that have been proven to be beneficial to screened for?
1000 IU/day
Men 45 - 79 yo
Smoking - Alcoholism
BP - Height - Weight

32. What are the guidelines for pap smear?
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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
800 IU/ day

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

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34. How much calcium should adults (19 - 50) take?
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

35. Some contraindications for aspirin
One time abdominal X-ray for all MALES who ever SMOKES
Stroke and DVT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight

36. What 3 things should always be done in an office visit?
BP - Height - Weight
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
NEVER

37. When should the meningococcal vaccine be given and to which group?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo - 6mo and 12-15 mo

38. What is the USPSTF guideline for fall prevention in the elderly?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
Every 5 years

39. What tests are appropriate to order in an asymptomatic 57 yo male?
65 (earlier if have increased risk factors)
Total cholesterol - FOBT
Adults > 60
NEVER

40. Which children should use a semi-upright/forward facing carseat?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
> 2 yo and less than 40 lbs

41. When should Gardasil be given and for what purposes?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.
HISTORY
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

42. What is the USPSTF guideline for chlamydial screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk

43. How much folate should all women of child bearing age take?
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES

44. What can decrease fall in the elderly?
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 - Environmental hazard reduction - Close monitoring of medication
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

45. In which group of patients should aspirin be given as primary prevention for stroke?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
Women 55 - 79 yo

46. When is area of induration > 10 mm considered TB positive?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
More than 15
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

47. How much folate and for How long should a woman take for planned pregnancy?
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. How much vit D should adults > 50 take?
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)
Starts at 50 (recommends against starting at 40) and every 2 years
1000 IU/day
Start at 20 for all M and W regardless of RFs

49. When should chest X-ray be used for screening?
NEVER
Femoral neck
Men 45 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

50. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day
Forearm
Total cholesterol - FOBT