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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. Who should get shingles vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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...
1000 IU/day
Adults > 60

2. What is the USPSTF guideline for fall prevention in the elderly?
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
Exercise or physical therapy and vit D for patients > 65
Starts at 20 for both M and W

3. What are the USPSTF guidelines for mammogram?
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

4. When is intensive individualized home-based intervention recommended?
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
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
800 IU/ day

5. What is the USPSTF guideline for chlamydial screening?
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 all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

6. If traveling to endemic areas - Why should one get a dose of live vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
To get IgA protection

7. What kind of sunscreen SPF is recommended for sun protection?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
More than 15

8. What is the most important way to screen for CAD in an asymptomatic patients?
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

9. What are the risks of combination HRT?
2mo - 4 mo - 6mo and 12-15 mo
Forearm
Breast CA - thromboembolic event - stroke and CAD
Starts at 50 (recommends against starting at 40) and every 2 years

10. In which group of patients should aspirin be given as primary prevention for stroke?
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...
Rear facing
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo

11. When is area of induration > 5mm considered TB positive?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Meningitis and Epiglottitis
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

12. Unopposed estrogen increases risks for what conditions?
One dose at 12-15 mod - Booster at least 4-weeks after
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
Stroke and DVT
Total cholesterol - FOBT

13. What is the schedule for rotavirus vaccine?
NEVER
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...
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

14. What 3 things should always be done in an office visit?
BP - Height - Weight
1300 mg/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)
4 mg/day

15. How much folate should all women of child bearing age take?
0.4 mg/day
Meningitis and Epiglottitis
1000 mg/day
1200 mg/day

16. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism
Starts at 20 for both M and W
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

17. 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
800 IU/ 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...
2mo - 4 mo - 6mo and 12-15 mo

18. What are some safety issues you should counsel parents with young children?
2mo - 4mo - 6-18 mo and 4-6 yrs
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
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...

19. What are some RFs for DMT2?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. How often do asplenic patients receive pneumococcal vaccine?
Men 45 - 79 yo
Rear facing
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES

21. What are some risk factors for 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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

22. When should tetanus immunoglobulin be given?
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

23. What kind of car seat should children < 2 yo be placed in?
Adults > 60
Rear facing
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...
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

24. What is the schedule for Hib vaccine?
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

25. What are the guidelines for colon cancer screening?
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

26. What type of illnesses does Hib vaccine prevent?
Adults > 60
Forearm
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

27. How much vit D should adults > 50 take?
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
Stroke and DVT

28. How much flouride should non military children in the state of HI be given?
HISTORY
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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

29. How much vit D should adults < 50 take?
800 IU/ day
1000 mg/day
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo

30. How much calcium should adults (19 - 50) take?
1000 mg/day
Total cholesterol - FOBT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

31. 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
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Femoral neck

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

33. What is the schedule for MMR vaccine?
4 mg/day
Meningitis and Epiglottitis
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

34. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
Exercise or physical therapy and vit D for patients > 65
Adults > 60

35. What is the schedule for Hep A vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart

36. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W

37. What is the schedule for Hep B vaccine?
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
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

38. What is the ADA guideline for DMT2 screening?
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Forearm
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

40. How much calcium should adolescents (9 -18) take?
> 2 yo and less than 40 lbs
1300 mg/day
4 mg/day
Adults > 60

41. Who should get Tdap vaccine and how often?
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
Total cholesterol - FOBT
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
When they are > 40 lbs and still less then 5'

42. What are the guidelines for visual screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W

43. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
During 2nd - 3rd trimester
4 mg/day
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. When should pregnant women get a flu shot?
Femoral neck
Every 5 years
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

45. When should Gardasil be given and for what purposes?
Starts at 20 for both M and W
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
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

46. What is the schedule for DTap vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

47. What is the schedule for polio vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Total cholesterol - FOBT
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs

48. When is area of induration > 10 mm considered TB positive?
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)
4 mg/day
Forearm
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

49. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
NEVER
> 2 yo and less than 40 lbs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

50. When should chest X-ray be used for screening?
NEVER
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1300 mg/day
In adults with sustained BP > 135/80 mmHg