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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 Hep A 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
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg

2. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck
1200 mg/day

3. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Starts at 20 for both M and W
4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Breast CA - thromboembolic event - stroke and CAD

4. What is the schedule for Hep B vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

5. What is the schedule for rotavirus vaccine?
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
More than 15
During 2nd - 3rd trimester

6. In which group of patients should aspirin be given as primary prevention for MI?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
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

7. What is the schedule for varicella vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
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

8. When should tetanus immunoglobulin be given?
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

9. What 3 things should always be done in an office visit?
Persons with no known risk factors
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
BP - Height - Weight
More than 15

10. What kind of polio vaccine is preferred?
Stroke and DVT
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

11. Who are at increased risk for adverse effect catching a flu?
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
HISTORY
To get IgA protection

12. What are the USPSTF guidelines for mammogram?
1300 mg/day
1000 IU/day
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

13. What is the schedule for MMR vaccine?
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In all W < 24 who are sexually active - In W > 24 with increased risk

14. How much folate should all women of child bearing age take?
When they are > 40 lbs and still less then 5'
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)
0.4 mg/day

15. What is the USPSTF guideline for DMT2 screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
Persons with no known risk factors
In adults with sustained BP > 135/80 mmHg

16. How much calcium should women > 50 take?
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
1200 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

17. What is the schedule for Hib vaccine?
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after

18. What kind of sunscreen SPF is recommended for sun protection?
BP - Height - Weight
0.4 - 0.8 mg/day for 1 month prior to conception
Start at 20 for all M and W regardless of RFs
More than 15

19. What are 2 conditions that have been proven to be beneficial to screened for?
1300 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
Exercise or physical therapy and vit D for patients > 65

20. What is the schedule for polio vaccine?
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
In adults with sustained BP > 135/80 mmHg
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY

21. How much vit D should adults < 50 take?
800 IU/ day
More than 15
During 2nd - 3rd trimester
HISTORY

22. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo
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
Rear facing

23. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
More than 15
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

24. Who should get Tdap vaccine and how often?
12 - 23 mo - 2 doses are to be given 6 mo apart
4 mg/day
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
In adults with sustained BP > 135/80 mmHg

25. What are some risk factors for CAD?
0.4 mg/day
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

26. What is the schedule for Gardasil?
800 IU/ day
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day

27. What kind of car seat should children < 2 yo be placed in?
12 - 23 mo - 2 doses are to be given 6 mo apart
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Rear facing
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

28. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)

29. How much flouride should non military children in the state of HI be given?
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

30. What are the guidelines for pap smear?
Forearm
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)
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

31. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Women 55 - 79 yo
To get IgA protection
Forearm

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years
HISTORY

33. What are the guidelines for visual screening?
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart
When they are > 40 lbs and still less then 5'
Preschool children : 3-4 yo - Elderly patients: > 65 yo

34. When is area of induration > 10 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 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
Men 45 - 79 yo

35. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
1200 mg/day
800 IU/ day
Start at 20 for all M and W regardless of RFs

36. Measurement of which anatomic structure is best predictor for hip fracture?
Stroke and DVT
Forearm
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

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

38. What type of illnesses does Hib vaccine prevent?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15
Meningitis and Epiglottitis

39. When is intensive individualized home-based intervention recommended?
One dose at 12-15 mod - Booster at least 4-weeks after
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 - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo

40. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day

41. What is the schedule for DTap vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

42. What is HI law for booster seat?

43. In which group of patients should aspirin be given as primary prevention for stroke?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo

44. When should Gardasil be given and for what purposes?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more 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
Exercise or physical therapy and vit D for patients > 65

45. 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
Children up to 7 yo and < 5' should be placed in a booster seat.
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 IU/day

46. 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
1200 mg/day
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)

47. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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...
0.4 mg/day
Forearm
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

48. What are some safety issues you should counsel parents with young children?
Women 55 - 79 yo
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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...

49. Which children should use a semi-upright/forward facing carseat?
Men 45 - 79 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
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

50. 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
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)
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