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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. How much calcium should women > 50 take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo
BP - Height - Weight
1200 mg/day

2. What are 2 conditions that have been proven to be beneficial to screened for?
Breast CA - thromboembolic event - stroke and CAD
Smoking - Alcoholism
BP - Height - Weight
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

3. What is the schedule for Hep B vaccine?
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs
Stroke and DVT

4. What is the schedule for MMR vaccine?
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

5. When can children sit in a booster seat?

6. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
During 2nd - 3rd trimester

7. When is area of induration > 10 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
To get IgA protection
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
One time abdominal X-ray for all MALES who ever SMOKES

8. What is the USPSTF guideline for chlamydial screening?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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 all W < 24 who are sexually active - In W > 24 with increased risk

9. How much calcium should adolescents (9 -18) take?
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

10. Who should get shingles vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1200 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
Adults > 60

11. Unopposed estrogen increases risks for what conditions?
One dose at 12-15 mod - Booster at least 4-weeks after
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT
800 IU/ day

12. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
1300 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

13. What is the NCEP III guideline for cholesterol screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

14. Who should get Tdap vaccine and how often?
65 (earlier if have increased risk factors)
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

15. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
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

16. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Femoral neck

17. How much fluoride should military children in HI be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

18. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing

19. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Stroke and DVT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

20. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Persons with no known risk factors
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1300 mg/day

21. What type of illnesses does Hib vaccine prevent?
Exercise - Environmental hazard reduction - Close monitoring of medication
In all W < 24 who are sexually active - In W > 24 with increased risk
When they are > 40 lbs and still less then 5'
Meningitis and Epiglottitis

22. What is the schedule for rotavirus vaccine?
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
To get IgA protection

23. What 3 things should always be done in an office visit?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

24. 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
More than 15
NEVER
HISTORY

25. What are the guidelines for colon cancer 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after

26. What is the schedule for Gardasil?
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)
Forearm
Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

27. Measurement of which anatomic structure is best predictor for hip fracture?
Meningitis and Epiglottitis
During 2nd - 3rd trimester
Exercise - Environmental hazard reduction - Close monitoring of medication
Femoral neck

28. How much calcium should adults (19 - 50) take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
HISTORY

29. In which group of patients should aspirin be given as primary prevention for stroke?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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 - Environmental hazard reduction - Close monitoring of medication
Women 55 - 79 yo

30. In which group of patients should aspirin be given as primary prevention for MI?
Adults > 60
More than 15
Men 45 - 79 yo
1300 mg/day

31. How much vit D should adults < 50 take?
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day
Forearm

32. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight
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
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

33. When is intensive individualized home-based intervention recommended?
0.4 - 0.8 mg/day for 1 month prior to conception
Total cholesterol - FOBT
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
Men 45 - 79 yo

34. What is the schedule for polio vaccine?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W
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

35. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One time abdominal X-ray for all MALES who ever SMOKES
NEVER
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

36. When should tetanus immunoglobulin be given?
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

37. What is the ADA guideline for DMT2 screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Stroke and DVT

38. What kind of car seat should children < 2 yo be placed in?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing
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

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

40. What is HI law for booster seat?

41. What is the most important way to screen for CAD in an asymptomatic patients?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ day
HISTORY
Women 55 - 79 yo

42. What is the USPSTF guideline for DMT2 screening?
65 (earlier if have increased risk factors)
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg

43. When is area of induration > 5mm considered TB positive?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
2mo - 4 mo - 6mo and 12-15 mo

44. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
1300 mg/day
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

45. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

46. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

47. What is the schedule for Hep A vaccine?
Exercise or physical therapy and vit D for patients > 65
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12 - 23 mo - 2 doses are to be given 6 mo apart

48. What tests are appropriate to order in an asymptomatic 57 yo male?
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

49. What are the guidelines for visual screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo

50. How much folate should all women of child bearing age take?
Femoral neck
0.4 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day