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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. In which group of patients should aspirin be given as primary prevention for stroke?
1300 mg/day
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)
Women 55 - 79 yo
BP - Height - Weight

2. When should Gardasil be given and for what purposes?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
2mo - 4 mo - 6mo and 12-15 mo

3. How often do asplenic patients receive pneumococcal vaccine?
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
Every 5 years

4. What is USPSTF guideline for abdominal aortic aneurysm screening?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
One time abdominal X-ray for all MALES who ever SMOKES
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

5. 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
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

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

7. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
BP - Height - Weight
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. Measurement of which anatomic structure is best predictor for hip fracture?
1300 mg/day
Femoral neck
1000 mg/day
BP - Height - Weight

9. What tests are appropriate to order in an asymptomatic 57 yo male?
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
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)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

10. When should chest X-ray be used for screening?
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
NEVER
Rear facing

11. 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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

12. How much vit D should adults > 50 take?
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
Femoral neck
1000 IU/day

13. What 3 things should always be done in an office visit?
Rear facing
BP - Height - Weight
To get IgA protection
Women 55 - 79 yo

14. When is area of induration > 10 mm considered TB positive?
0.4 - 0.8 mg/day for 1 month prior to conception
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
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

15. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart

16. What are 2 conditions that have been proven to be beneficial to screened for?
Total cholesterol - FOBT
During 2nd - 3rd trimester
Smoking - Alcoholism
Stroke and DVT

17. What is the USPSTF guideline for chlamydial screening?
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
In all W < 24 who are sexually active - In W > 24 with increased risk

18. Who should get Tdap vaccine and how often?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

19. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 mg/day

20. How much vit D should adults < 50 take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
800 IU/ 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

21. What kind of sunscreen SPF is recommended for sun protection?
Smoking - Alcoholism
Adults > 60
More than 15
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

22. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo - 6mo and 12-15 mo
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

23. Who are at increased risk for adverse effect catching a flu?
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

24. When should tetanus immunoglobulin be given?
Children up to 7 yo and < 5' should be placed in a booster seat.
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
When they are > 40 lbs and still less then 5'

25. When is area of induration > 5mm considered TB positive?
One dose at 12-15 mod - Booster at least 4-weeks after
Femoral neck
Exercise or physical therapy and vit D for patients > 65
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

26. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
One dose at 12-15 mod - Booster at least 4-weeks after
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

27. How much folate and for How long should a woman take for planned pregnancy?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Start at 20 for all M and W regardless of RFs
More than 15

28. What is the schedule for rotavirus vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Men 45 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

29. Which children should use a semi-upright/forward facing carseat?
HISTORY
> 2 yo and less than 40 lbs
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo

30. In which group of patients should aspirin be given as primary prevention for MI?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo
Meningitis and Epiglottitis

31. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

32. How much flouride should non military children in the state of HI be given?
Forearm
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Femoral neck
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...

33. What are some RFs for DMT2?
Men 45 - 79 yo
Start at 20 for all M and W regardless of RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
When they are > 40 lbs and still less then 5'

34. What is the schedule for varicella vaccine?
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
During 2nd - 3rd trimester
0.4 - 0.8 mg/day for 1 month prior to conception

35. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise - Environmental hazard reduction - Close monitoring of medication

36. What is the schedule for Hep B vaccine?
Exercise or physical therapy and vit D for patients > 65
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12 - 23 mo - 2 doses are to be given 6 mo apart

37. What is the NCEP III guideline for cholesterol screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
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

38. What type of illnesses does Hib vaccine prevent?
1300 mg/day
Meningitis and Epiglottitis
Stroke and DVT
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

40. If traveling to endemic areas - Why should one get a dose of live vaccine?
Breast CA - thromboembolic event - stroke and CAD
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
To get IgA protection

41. When can children sit in a booster seat?

42. What kind of car seat should children < 2 yo be placed in?
Starts at 20 for both M and W
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. What are the guidelines for colon cancer screening?
Smoking - Alcoholism
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
NEVER
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

44. What is the schedule for MMR vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

45. How much folate should all women of child bearing age take?
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...
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

46. 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)
During 2nd - 3rd trimester
4 mg/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

47. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
1000 mg/day
Femoral neck
Rear facing

48. What is the schedule for DTap vaccine?
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
NEVER

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

50. What is the ADA guideline for DMT2 screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 mg/day
During 2nd - 3rd trimester