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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?
1200 mg/day
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
Breast CA - thromboembolic event - stroke and CAD

2. How much folate should all women of child bearing age take?
0.4 mg/day
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

3. What type of illnesses does Hib vaccine prevent?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
Stroke and DVT

4. What is the schedule for DTap vaccine?
4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

5. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
Breast CA - thromboembolic event - stroke and CAD

6. Which children should use a semi-upright/forward facing carseat?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
> 2 yo and less than 40 lbs
65 (earlier if have increased risk factors)

7. What 3 things should always be done in an office visit?
800 IU/ day
BP - Height - Weight
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. Who are at increased risk for adverse effect catching a flu?
Starts at 20 for both M and W
0.4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 50 (recommends against starting at 40) and every 2 years

9. When can children sit in a booster seat?

10. 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
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
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)

11. What is USPSTF guideline for abdominal aortic aneurysm screening?
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One time abdominal X-ray for all MALES who ever SMOKES
Forearm

12. What are the guidelines for colon cancer screening?
Start at 20 for all M and W regardless of RFs
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
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. When is area of induration > 5mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

14. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
Smoking - Alcoholism
0.4 mg/day
4 mg/day

15. Who should get Tdap vaccine and how often?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In adults with sustained BP > 135/80 mmHg
First dose at birth - Second dose at 1-2 mo - Third dose at 6 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

16. How much vit D should adults > 50 take?
2mo - 4mo - 6-18 mo and 4-6 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60
1000 IU/day

17. At what age should women have DEXA scan?
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)
800 IU/ day
To get IgA protection

18. What is the NCEP III guideline for cholesterol screening?
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day
Start at 20 for all M and W regardless of RFs
Rear facing

19. How often do asplenic patients receive pneumococcal vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
65 (earlier if have increased risk factors)
Every 5 years
BP - Height - Weight

20. What is the schedule for Hib vaccine?
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
2mo - 4 mo - 6mo and 12-15 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

21. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
HISTORY
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

22. 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 50 (recommends against starting at 40) and every 2 years
In adults with sustained BP > 135/80 mmHg

23. What kind of sunscreen SPF is recommended for sun protection?
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day
More than 15

24. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
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
To get IgA protection
Starts at 20 for both M and W

25. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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

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

27. Measurement of which anatomic structure is best predictor for hip fracture?
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
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...
Femoral neck

28. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
More than 15

29. 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
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
0.4 mg/day

30. What is HI law for booster seat?

31. What are some RFs for DMT2?
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
> 2 yo and less than 40 lbs

32. What kind of polio vaccine is preferred?
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT

33. 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo
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

34. What are the guidelines for visual screening?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day

35. What are the guidelines for pap smear?
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 yo and less than 40 lbs
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo

36. Unopposed estrogen increases risks for what conditions?
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
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
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

37. When is area of induration > 10 mm considered TB positive?
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
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

38. What is the schedule for MMR vaccine?
Start at 20 for all M and W regardless of RFs
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

39. What is the ADA guideline for DMT2 screening?
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
Start at 20 for all M and W regardless of RFs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

40. 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...
Women 55 - 79 yo
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
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)

41. When is area of induration > 15 mm considered TB positive?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY
Persons with no known risk factors
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

42. When should pregnant women get a flu shot?
Women 55 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
During 2nd - 3rd trimester
1200 mg/day

43. When should the meningococcal vaccine be given and to which group?
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

44. What kind of car seat should children < 2 yo be placed in?
Start at 20 for all M and W regardless of RFs
Rear facing
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

45. What is the schedule for Hep B vaccine?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
800 IU/ day

46. If traveling to endemic areas - Why should one get a dose of live vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Persons with no known risk factors
To get IgA protection
During 2nd - 3rd trimester

47. What is the schedule for Gardasil?
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs

48. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Forearm
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

49. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception
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

50. What are 2 conditions that have been proven to be beneficial to screened for?
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
Smoking - Alcoholism