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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. Which children should use a semi-upright/forward facing carseat?
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
HISTORY
> 2 yo and less than 40 lbs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

2. What type of illnesses does Hib vaccine prevent?
Persons with no known risk factors
Meningitis and Epiglottitis
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children up to 7 yo and < 5' should be placed in a booster seat.

3. What kind of polio vaccine is preferred?
Preschool children : 3-4 yo - Elderly patients: > 65 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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

4. How much calcium should adolescents (9 -18) take?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
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

5. How much calcium should women > 50 take?
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1200 mg/day

6. 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
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day

7. How much fluoride should military children in HI be given?
Femoral neck
HISTORY
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

8. What are some safety issues you should counsel parents with young children?
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...
Men 45 - 79 yo
1000 IU/day

9. If traveling to endemic areas - Why should one get a dose of live vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection
Women 55 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

10. What is the USPSTF guideline for DMT2 screening?
1000 IU/day
Femoral neck
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In adults with sustained BP > 135/80 mmHg

11. When is intensive individualized home-based intervention recommended?
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
Total cholesterol - FOBT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

12. What are the risks of combination HRT?
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD
HISTORY
Forearm

13. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Smoking - Alcoholism
Starts at 20 for both M and W
2mo - 4 mo - 6mo and 12-15 mo
Forearm

14. How much folate and for How long should a woman take for planned pregnancy?
Stroke and DVT
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
During 2nd - 3rd trimester
0.4 - 0.8 mg/day for 1 month prior to conception

15. Who should get Tdap vaccine and how often?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT
65 (earlier if have increased risk factors)

16. When is area of induration > 5mm 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
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day

17. When should pregnant women get a flu shot?
1000 IU/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
HISTORY
During 2nd - 3rd trimester

18. What is the schedule for Hep A vaccine?
BP - Height - Weight
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

19. When should chest X-ray be used for screening?
NEVER
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 mg/day
Rear facing

20. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
800 IU/ day

21. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
12 - 23 mo - 2 doses are to be given 6 mo apart
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

22. 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
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
0.4 mg/day

23. In which group of patients should aspirin be given as primary prevention for stroke?
Breast CA - thromboembolic event - stroke and CAD
Women 55 - 79 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
More than 15

24. How much folate should all women of child bearing age take?
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
Persons with no known risk factors
Every 5 years

25. How much vit D should adults > 50 take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg
1000 IU/day

26. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
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
To get IgA protection
Starts at 20 for both M and W

27. When should tetanus immunoglobulin be given?
Smoking - Alcoholism
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

28. What are some risk factors for CAD?
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

29. What is the schedule for MMR vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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 schedule for Hep B vaccine?
Adults > 60
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 overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

31. When is area of induration > 10 mm considered TB positive?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

32. What is HI law for booster seat?

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33. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
Adults > 60
Femoral neck

34. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs

35. What 3 things should always be done in an office visit?
More than 15
Women 55 - 79 yo
BP - Height - Weight
1300 mg/day

36. What kind of sunscreen SPF is recommended for sun protection?
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
During 2nd - 3rd trimester
More than 15

37. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Women 55 - 79 yo
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication

38. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

39. What is the schedule for Gardasil?
Exercise or physical therapy and vit D for patients > 65
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Preschool children : 3-4 yo - Elderly patients: > 65 yo

40. Who should get shingles vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60
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...

41. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
Men 45 - 79 yo
Femoral neck

42. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
BP - Height - Weight
4 mg/day
To get IgA protection

43. What are the USPSTF guidelines for cholesterol screening in 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
Starts at 20 for both M and W
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

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

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45. What is the schedule for rotavirus vaccine?
Adults > 60
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

46. What are some RFs for DMT2?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 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)

47. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
To get IgA protection
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

48. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
Stroke and DVT
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...

49. What are the guidelines for colon cancer screening?
Women 55 - 79 yo
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
> 2 yo and less than 40 lbs

50. Measurement of which anatomic structure is best predictor for hip fracture?
In adults with sustained BP > 135/80 mmHg
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day