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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 are some risk factors for CAD?
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

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

3. Who should get Tdap vaccine and how often?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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

4. 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
Smoking - Alcoholism

5. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 - 0.8 mg/day for 1 month prior to conception
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.
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

6. How much calcium should adolescents (9 -18) take?
> 2 yo and less than 40 lbs
1300 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
One time abdominal X-ray for all MALES who ever SMOKES

7. How much vit D should adults > 50 take?
800 IU/ day
1000 IU/day
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

8. What is the schedule for polio vaccine?
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 - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after

9. At what age should women have DEXA scan?
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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
65 (earlier if have increased risk factors)
BP - Height - Weight

10. What 3 things should always be done in an office visit?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
BP - Height - Weight
Exercise or physical therapy and vit D for patients > 65

11. What is the NCEP III guideline for cholesterol screening?
Women 55 - 79 yo
Every 5 years
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'

12. 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 mg/day
When they are > 40 lbs and still less then 5'

13. 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
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Femoral neck

14. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

15. How much calcium should women > 50 take?
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
In adults with sustained BP > 135/80 mmHg
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

16. What is the schedule for MMR vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

17. What type of illnesses does Hib vaccine prevent?
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years

18. When is intensive individualized home-based intervention recommended?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Persons with no known risk factors
1200 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

19. How much folate and for How long should a woman take for planned pregnancy?
In adults with sustained BP > 135/80 mmHg
Start at 20 for all M and W regardless of RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 - 0.8 mg/day for 1 month prior to conception

20. What are some safety issues you should counsel parents with young children?
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...
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

21. How often do asplenic patients receive pneumococcal vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
BP - Height - Weight
Every 5 years

22. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years

23. What kind of polio vaccine is preferred?
Start at 20 for all M and W regardless of RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication

24. How much calcium should adults (19 - 50) take?
1000 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day

25. When is area of induration > 10 mm considered TB positive?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
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

26. How much folate should all women of child bearing age take?
800 IU/ day
0.4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
BP - Height - Weight

27. When can children sit in a booster seat?

28. What are the guidelines for pap smear?
When they are > 40 lbs and still less then 5'
Breast CA - thromboembolic event - stroke and CAD
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)
During 2nd - 3rd trimester

29. What is the schedule for Hep B vaccine?
4 mg/day
Start at 20 for all M and W regardless of RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT

30. What kind of car seat should children < 2 yo be placed in?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4mo - 6-18 mo and 4-6 yrs
Rear facing

31. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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...
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

32. When should Gardasil be given and for what purposes?
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
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
When they are > 40 lbs and still less then 5'
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
1000 IU/day

34. When should the meningococcal vaccine be given and to which group?
Forearm
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
Stroke and DVT

35. How much vit D should adults < 50 take?
Women 55 - 79 yo
800 IU/ day
In adults with sustained BP > 135/80 mmHg
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. What is the schedule for Hep A vaccine?
1000 mg/day
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
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
12 - 23 mo - 2 doses are to be given 6 mo apart

37. What are 2 conditions that have been proven to be beneficial to screened for?
Rear facing
Femoral neck
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart

38. What is USPSTF guideline for abdominal aortic aneurysm screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
One time abdominal X-ray for all MALES who ever SMOKES

39. When should tetanus immunoglobulin be given?
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
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

40. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
Forearm
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

41. Who should get shingles 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
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
2mo - 4 mo - 6mo and 12-15 mo

42. What are the USPSTF guidelines for mammogram?
Persons with no known risk factors
Starts at 50 (recommends against starting at 40) and every 2 years
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
Women 55 - 79 yo

43. What is the schedule for Gardasil?
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...
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

44. How much flouride should non military children in the state of HI be given?
2mo - 4 mo - 6mo and 12-15 mo
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
When they are > 40 lbs and still less then 5'

45. What is the most important way to screen for CAD in an asymptomatic patients?
Exercise or physical therapy and vit D for patients > 65
HISTORY
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years

46. What are the guidelines for colon cancer screening?
Rear facing
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

47. How much fluoride should military children in HI be given?
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

48. When is area of induration > 5mm considered TB positive?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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 - 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
Adults > 60

49. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo
Starts at 20 for both M and W

50. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
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)