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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 Hib vaccine?
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
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
During 2nd - 3rd trimester

2. What 3 things should always be done in an office visit?
> 2 yo and less than 40 lbs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight
Exercise - Environmental hazard reduction - Close monitoring of medication

3. How much folate should all women of child bearing age take?
One time abdominal X-ray for all MALES who ever SMOKES
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
0.4 mg/day
Adults > 60

4. When should chest X-ray be used for screening?
1200 mg/day
NEVER
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception

5. What is the USPSTF guideline for fall prevention in the elderly?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
In adults with sustained BP > 135/80 mmHg
Exercise or physical therapy and vit D for patients > 65

6. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

7. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm

8. Which children should use a semi-upright/forward facing carseat?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.

9. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Persons with no known risk factors
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day

10. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
HISTORY
NEVER

11. What is the schedule for MMR vaccine?
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
One time abdominal X-ray for all MALES who ever SMOKES
4 mg/day

12. What is the USPSTF guideline for DMT2 screening?
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
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

13. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

14. What is the schedule for DTap vaccine?
800 IU/ day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo

15. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Women 55 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What are some safety issues you should counsel parents with young children?
> 2 yo and less than 40 lbs
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...
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
During 2nd - 3rd trimester

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

18. What are the guidelines for pap smear?
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg
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)
65 (earlier if have increased risk factors)

19. What type of illnesses does Hib vaccine prevent?
Men 45 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis
800 IU/ day

20. At what age should women have DEXA scan?
Exercise - Environmental hazard reduction - Close monitoring of medication
65 (earlier if have increased risk factors)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Preschool children : 3-4 yo - Elderly patients: > 65 yo

21. What is the schedule for Hep B vaccine?
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
BP - Height - Weight
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. What are the USPSTF guidelines for mammogram?
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
Starts at 50 (recommends against starting at 40) and every 2 years
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

23. 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
One dose at 12-15 mod - Booster at least 4-weeks after
1300 mg/day
Starts at 20 for both M and W

24. Measurement of which anatomic structure is best predictor for hip fracture?
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
Men 45 - 79 yo
Femoral neck

25. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise or physical therapy and vit D for patients > 65
Starts at 50 (recommends against starting at 40) and every 2 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. What is the schedule for varicella vaccine?
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
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
One dose at 12-15 mod - Booster at least 4-weeks after

27. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY

28. How much vit D should adults < 50 take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
800 IU/ day
0.4 mg/day

29. What are the guidelines for colon cancer screening?
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
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

30. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception

31. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Starts at 50 (recommends against starting at 40) and every 2 years
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

32. How much calcium should adults (19 - 50) take?
> 2 yo and less than 40 lbs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/day
0.4 mg/day

33. What is USPSTF guideline for abdominal aortic aneurysm screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day
Starts at 20 for both M and W

34. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Stroke and DVT
Every 5 years
NEVER

35. What are 2 conditions that have been proven to be beneficial to screened for?
One time abdominal X-ray for all MALES who ever SMOKES
Exercise - Environmental hazard reduction - Close monitoring of medication
Smoking - Alcoholism
Meningitis and Epiglottitis

36. Who are at increased risk for adverse effect catching a flu?
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day
More than 15
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

37. How much calcium should women > 50 take?
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

38. When is area of induration > 5mm considered TB positive?
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...
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
Breast CA - thromboembolic event - stroke and CAD
Femoral neck

39. What is the USPSTF guideline for chlamydial screening?
When they are > 40 lbs and still less then 5'
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
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

40. When can children sit in a booster seat?

41. Who should get Tdap vaccine and how often?
Rear facing
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
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 dose at 12-15 mod - Booster at least 4-weeks after

42. What are some risk factors for CAD?
More than 15
1300 mg/day
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

43. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
1200 mg/day
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...

44. What kind of polio vaccine is preferred?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 mg/day
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

45. How much fluoride should military children in HI be given?
2mo - 4 mo - 6mo and 12-15 mo
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

46. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)
1300 mg/day
HISTORY

47. What is the schedule for polio 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...
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism

48. When is area of induration > 15 mm considered TB positive?
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
1000 IU/day
Persons with no known risk factors
Femoral neck

49. How much folate and for How long should a woman take for planned pregnancy?
1300 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception

50. What is the most important way to screen for CAD in an asymptomatic patients?
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
Adults > 60
During 2nd - 3rd trimester
HISTORY