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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 kind of sunscreen SPF is recommended for sun protection?
Meningitis and Epiglottitis
Total cholesterol - FOBT
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)

2. What are the guidelines for pap smear?
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
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

3. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise - Environmental hazard reduction - Close monitoring of medication

4. How much fluoride should military children in HI be given?
Stroke and DVT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

5. What are the risks of combination HRT?
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)
Breast CA - thromboembolic event - stroke and CAD
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. What kind of polio vaccine is preferred?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

7. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT
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)
Adults > 60

8. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart

9. When is area of induration > 5mm 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
0.4 mg/day
1300 mg/day
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

10. What is the schedule for DTap vaccine?
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
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

11. When should Gardasil be given and for what purposes?
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
More than 15
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES

12. How much calcium should adults (19 - 50) take?
Persons with no known risk factors
Forearm
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...

13. What is the USPSTF guideline for chlamydial screening?
65 (earlier if have increased risk factors)
0.4 mg/day
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk

14. What are the USPSTF guidelines for mammogram?
In all W < 24 who are sexually active - In W > 24 with increased risk
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years

15. What is the schedule for MMR vaccine?
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)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

16. Unopposed estrogen increases risks for what conditions?
Breast CA - thromboembolic event - stroke and CAD
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
Adults > 60
Stroke and DVT

17. How much vit D should adults > 50 take?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 IU/day
Breast CA - thromboembolic event - stroke and CAD
Forearm

18. When should tetanus immunoglobulin be given?
Every 5 years
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

19. What is the schedule for Hib vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4 mo - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD

20. What 3 things should always be done in an office visit?
1000 mg/day
BP - Height - Weight
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

21. What is the schedule for varicella vaccine?
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo

22. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Stroke and DVT
4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

23. What are some risk factors for CAD?
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 IU/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

24. Measurement of which anatomic structure is best predictor for hip fracture?
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
0.4 mg/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

25. What is the USPSTF guideline for fall prevention in the elderly?
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise or physical therapy and vit D for patients > 65
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication

26. How much folate should all women of child bearing age take?
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
Women 55 - 79 yo
More than 15
0.4 mg/day

27. What are the guidelines for colon cancer screening?
Men 45 - 79 yo
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
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

28. What are 2 conditions that have been proven to be beneficial to screened for?
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
Smoking - Alcoholism

29. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 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
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)
Smoking - Alcoholism

30. When can children sit in a booster seat?

31. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Rear facing
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

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

33. What is HI law for booster seat?

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

35. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

36. What is the schedule for Hep A vaccine?
0.4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
12 - 23 mo - 2 doses are to be given 6 mo apart
Rear facing

37. How much flouride should non military children in the state of HI be given?
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

38. When is intensive individualized home-based intervention recommended?
0.4 mg/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
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

39. What is the most important way to screen for CAD in an asymptomatic patients?
BP - Height - Weight
HISTORY
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

40. What kind of car seat should children < 2 yo be placed in?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
65 (earlier if have increased risk factors)
Rear facing
Total cholesterol - FOBT

41. What is the schedule for polio vaccine?
Total cholesterol - FOBT
2mo - 4mo - 6-18 mo and 4-6 yrs
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

42. What is the ADA guideline for DMT2 screening?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What is the NCEP III guideline for cholesterol screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Start at 20 for all M and W regardless of RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

44. What are some safety issues you should counsel parents with young children?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...
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)
0.4 - 0.8 mg/day for 1 month prior to conception

45. How much vit D should adults < 50 take?
800 IU/ day
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing

46. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Meningitis and Epiglottitis

47. 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
65 (earlier if have increased risk factors)
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs

48. Who should get shingles vaccine?
Women 55 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60
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

49. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs
Forearm
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

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
Meningitis and Epiglottitis
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound