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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. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
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
One time abdominal X-ray for all MALES who ever SMOKES
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
1200 mg/day

3. 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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

4. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Women 55 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...

5. When should Gardasil be given and for what purposes?
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD
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

6. How much folate should all women of child bearing age take?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day

7. What are some risk factors for CAD?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

8. How much vit D should adults > 50 take?
800 IU/ day
1000 IU/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
In adults with sustained BP > 135/80 mmHg

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

10. What is the schedule for polio vaccine?
Femoral neck
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight
2mo - 4mo - 6-18 mo and 4-6 yrs

11. What kind of sunscreen SPF is recommended for sun protection?
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
More than 15
HISTORY
Starts at 20 for both M and W

12. 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
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs

13. What are the USPSTF guidelines for mammogram?
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 years
BP - Height - Weight
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

14. When should chest X-ray be used for screening?
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)
NEVER
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

15. Some contraindications for aspirin
Breast CA - thromboembolic event - stroke and CAD
> 2 yo and less than 40 lbs
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

16. How much calcium should adolescents (9 -18) take?
Breast CA - thromboembolic event - stroke and CAD
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
1300 mg/day

17. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Starts at 20 for both M and W
4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Every 5 years

18. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 mg/day
1000 IU/day

19. When should tetanus immunoglobulin be given?
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...
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 - 4 mo - 6mo and 12-15 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

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

21. What kind of polio vaccine is preferred?
One time abdominal X-ray for all MALES who ever SMOKES
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

22. What is the schedule for Gardasil?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Forearm
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

23. What kind of car seat should children < 2 yo be placed in?
Rear facing
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

24. 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
Rear facing
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
1000 mg/day

25. What is the USPSTF guideline for DMT2 screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day
In adults with sustained BP > 135/80 mmHg
One time abdominal X-ray for all MALES who ever SMOKES

26. What is HI law for booster seat?

27. What 3 things should always be done in an office visit?
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
2mo - 4mo - 6-18 mo and 4-6 yrs
BP - Height - Weight

28. Unopposed estrogen increases risks for what conditions?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT

29. What is the schedule for Hep A vaccine?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15
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

30. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
HISTORY

31. 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
BP - Height - Weight
1300 mg/day

32. 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...
Forearm
Meningitis and Epiglottitis
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

33. How much calcium should women > 50 take?
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
1200 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)

34. 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
1300 mg/day
4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

35. Who should get Tdap vaccine and how often?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
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

36. What are 2 conditions that have been proven to be beneficial to screened for?
1000 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
Smoking - Alcoholism
Breast CA - thromboembolic event - stroke and CAD

37. How often do asplenic patients receive pneumococcal vaccine?
NEVER
More than 15
Every 5 years
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

38. What are some RFs for DMT2?
1000 mg/day
0.4 mg/day
Women 55 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

39. What is the schedule for Hib 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...
2mo - 4 mo - 6mo and 12-15 mo
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
1000 IU/day

40. At what age should women have DEXA scan?
When they are > 40 lbs and still less then 5'
65 (earlier if have increased risk factors)
Adults > 60
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

41. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

42. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
Persons with no known risk factors

43. How much folate and for How long should a woman take for planned pregnancy?
Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

44. What can decrease fall in the elderly?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
More than 15
Exercise - Environmental hazard reduction - Close monitoring of medication

45. How much calcium should adults (19 - 50) take?
HISTORY
0.4 - 0.8 mg/day for 1 month prior to conception
1000 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

46. What are the risks of combination HRT?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
12 - 23 mo - 2 doses are to be given 6 mo apart

47. How much flouride should non military children in the state of HI be given?
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
800 IU/ day

48. When is intensive individualized home-based intervention recommended?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

49. What is the USPSTF guideline for fall prevention in the elderly?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
When they are > 40 lbs and still less then 5'
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

50. When is area of induration > 10 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Women 55 - 79 yo
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo