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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. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo
HISTORY
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

2. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

3. Unopposed estrogen increases risks for what conditions?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Stroke and DVT

4. At what age should women have DEXA scan?
4 mg/day
65 (earlier if have increased risk factors)
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

5. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

6. When should pregnant women get a flu shot?
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)
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after

7. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

8. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
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
Women 55 - 79 yo

9. When is area of induration > 10 mm considered TB positive?
To get IgA protection
1300 mg/day
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

10. How much calcium should adolescents (9 -18) take?
1300 mg/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
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing

11. What are 2 conditions that have been proven to be beneficial to screened for?
Men 45 - 79 yo
1300 mg/day
Women 55 - 79 yo
Smoking - Alcoholism

12. 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
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk

13. When should chest X-ray be used for screening?
NEVER
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
Exercise or physical therapy and vit D for patients > 65

14. What is the schedule for DTap vaccine?
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
Women 55 - 79 yo
0.4 mg/day

15. Who should get Tdap vaccine and how often?
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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

16. What is the USPSTF guideline for DMT2 screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

17. How much flouride should non military children in the state of HI be given?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

18. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Forearm
65 (earlier if have increased risk factors)

19. 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...
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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck

20. What are some risk factors for CAD?
2mo - 4 mo - 6mo and 12-15 mo
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
2mo - 4mo - 6-18 mo and 4-6 yrs

21. What are the USPSTF guidelines for mammogram?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 mg/day
Rear facing

22. What is the most important way to screen for CAD in an asymptomatic patients?
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
Starts at 20 for both M and W
0.4 mg/day

23. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Persons with no known risk factors
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

24. How much folate and for How long should a woman take for planned pregnancy?
4 mg/day
Rear facing
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 years

25. What is the schedule for varicella vaccine?
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)
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
1000 IU/day

26. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men 45 - 79 yo
Forearm

27. What kind of sunscreen SPF is recommended for sun protection?
In adults with sustained BP > 135/80 mmHg
More than 15
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

28. How much vit D should adults < 50 take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ day
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after

29. What are the guidelines for pap smear?
NEVER
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

30. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
In all W < 24 who are sexually active - In W > 24 with increased risk

31. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
BP - Height - Weight
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...

32. When can children sit in a booster seat?

33. What 3 things should always be done in an office visit?
Total cholesterol - FOBT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight

34. What kind of polio vaccine is preferred?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism

35. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
> 2 yo and less than 40 lbs
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs

36. How much vit D should adults > 50 take?
When they are > 40 lbs and still less then 5'
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)
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day

37. What are some RFs for DMT2?
Forearm
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years

38. What kind of car seat should children < 2 yo be placed in?
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication

39. What is the USPSTF guideline for fall prevention in the elderly?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60
Exercise or physical therapy and vit D for patients > 65
0.4 mg/day

40. How much calcium should women > 50 take?
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
Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1200 mg/day

41. What is HI law for booster seat?

42. What are the USPSTF guidelines for cholesterol screening in people with normal 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)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
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 50 (recommends against starting at 40) and every 2 years
In adults with sustained BP > 135/80 mmHg

44. When is intensive individualized home-based intervention recommended?
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
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

45. What are the risks of combination HRT?
To get IgA protection
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
Breast CA - thromboembolic event - stroke and CAD

46. What are the guidelines for colon cancer screening?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
65 (earlier if have increased risk factors)
In all W < 24 who are sexually active - In W > 24 with increased risk

47. Who should get shingles vaccine?
1200 mg/day
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
Adults > 60
4 mg/day

48. Which children should use a semi-upright/forward facing carseat?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing
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

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

50. How much folate should all women of child bearing age take?
800 IU/ day
0.4 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
NEVER