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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 flouride should non military children in the state of HI be given?
Starts at 20 for both M and W
HISTORY
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

2. Some contraindications for aspirin
When they are > 40 lbs and still less then 5'
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 20 for both M and W
More than 15

3. What are 2 conditions that have been proven to be beneficial to screened for?
Exercise or physical therapy and vit D for patients > 65
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism

4. What can decrease fall in the elderly?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
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
During 2nd - 3rd trimester

5. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
4 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

6. What is the USPSTF guideline for fall prevention in the elderly?
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65

7. Who should get shingles vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Breast CA - thromboembolic event - stroke and CAD
Adults > 60
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. Measurement of which anatomic structure is best predictor for hip fracture?
Women 55 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years
Femoral neck
When they are > 40 lbs and still less then 5'

9. What is USPSTF guideline for abdominal aortic aneurysm screening?
More than 15
65 (earlier if have increased risk factors)
NEVER
One time abdominal X-ray for all MALES who ever SMOKES

10. What is HI law for booster seat?

11. When can children sit in a booster seat?

12. What is the ADA guideline for DMT2 screening?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
During 2nd - 3rd trimester

13. 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
Stroke and DVT
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

14. What is the schedule for Hep A vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

15. When should tetanus immunoglobulin be given?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In adults with sustained BP > 135/80 mmHg

16. What are some RFs for DMT2?
Starts at 50 (recommends against starting at 40) and every 2 years
During 2nd - 3rd trimester
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
More than 15

17. What are the guidelines for colon cancer screening?
Femoral neck
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

18. How much calcium should adults (19 - 50) take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day

19. In which group of patients should aspirin be given as primary prevention for MI?
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
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
Children up to 7 yo and < 5' should be placed in a booster seat.

20. What 3 things should always be done in an office visit?
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

21. What are the guidelines for visual screening?
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis
Stroke and DVT
Preschool children : 3-4 yo - Elderly patients: > 65 yo

22. What kind of sunscreen SPF is recommended for sun protection?
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
When they are > 40 lbs and still less then 5'

23. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

24. What kind of polio vaccine is preferred?
> 2 yo and less than 40 lbs
Adults > 60
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

25. What tests are appropriate to order in an asymptomatic 57 yo male?
Women 55 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
Total cholesterol - FOBT
Smoking - Alcoholism

26. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day
Adults > 60
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

27. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Women 55 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day

28. What is the most important way to screen for CAD in an asymptomatic patients?
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

29. What is the NCEP III guideline for cholesterol 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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs

30. How much vit D should adults > 50 take?
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 45 - 79 yo
1000 IU/day
0.4 - 0.8 mg/day for 1 month prior to conception

31. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
More than 15
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

32. How much fluoride should military children in HI be given?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Every 5 years

33. When should pregnant women get a flu shot?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
During 2nd - 3rd trimester
One dose at 12-15 mod - Booster at least 4-weeks after
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

34. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 20 for both M and W
Children up to 7 yo and < 5' should be placed in a booster seat.

35. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Meningitis and Epiglottitis
Start at 20 for all M and W regardless of RFs

36. How much calcium should adolescents (9 -18) take?
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1300 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

37. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk
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

38. What kind of car seat should children < 2 yo be placed in?
Rear facing
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo
1000 IU/day

39. When should Gardasil be given and for what purposes?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 50 (recommends against starting at 40) and every 2 years

40. Unopposed estrogen increases risks for what conditions?
4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men 45 - 79 yo
Stroke and DVT

41. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection
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. Who are at increased risk for adverse effect catching a flu?
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
> 2 yo and less than 40 lbs
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

43. 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...
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

44. When should chest X-ray be used for screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

46. What is the schedule for DTap vaccine?
When they are > 40 lbs and still less then 5'
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
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

47. What is the USPSTF guideline for chlamydial screening?
Breast CA - thromboembolic event - stroke and CAD
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
In all W < 24 who are sexually active - In W > 24 with increased risk

48. When is area of induration > 10 mm considered TB positive?
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)
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

49. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

50. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years