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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 schedule for Hep B vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck
NEVER
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

2. Who are at increased risk for adverse effect catching a flu?
Femoral neck
Women 55 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

3. At what age should women have DEXA scan?
In all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
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. What are the guidelines for colon cancer screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Exercise or physical therapy and vit D for patients > 65

5. What 3 things should always be done in an office visit?
In adults with sustained BP > 135/80 mmHg
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight

6. When is area of induration > 10 mm considered TB positive?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

7. When should tetanus immunoglobulin be given?
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

8. What type of illnesses does Hib vaccine prevent?
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
Meningitis and Epiglottitis
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

9. What kind of sunscreen SPF is recommended for sun protection?
Women 55 - 79 yo
1000 mg/day
More than 15
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

10. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Breast CA - thromboembolic event - stroke and CAD
0.4 - 0.8 mg/day for 1 month prior to conception
Rear facing

11. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs
800 IU/ day

12. Measurement of which anatomic structure is best predictor for hip fracture?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck
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 degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

13. How often do asplenic patients receive pneumococcal vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
65 (earlier if have increased risk factors)
Every 5 years
Forearm

14. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT

15. What is the schedule for Hib vaccine?
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
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo

16. What is the schedule for MMR vaccine?
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise or physical therapy and vit D for patients > 65
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

17. In which group of patients should aspirin be given as primary prevention for stroke?
Total cholesterol - FOBT
Stroke and DVT
1000 mg/day
Women 55 - 79 yo

18. How much calcium should women > 50 take?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1200 mg/day

19. How much calcium should adults (19 - 50) take?
1000 mg/day
HISTORY
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

20. What is the ADA guideline for DMT2 screening?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Meningitis and Epiglottitis
Starts at 20 for both M and W

21. What tests are appropriate to order in an asymptomatic 57 yo male?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT
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

22. Who should get shingles vaccine?
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
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

23. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
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
Children up to 7 yo and < 5' should be placed in a booster seat.

24. In which group of patients should aspirin be given as primary prevention for MI?
BP - Height - Weight
HISTORY
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years

25. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
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
Forearm
4 mg/day

26. 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
1000 mg/day
1300 mg/day

27. When should pregnant women get a flu shot?
One dose at 12-15 mod - Booster at least 4-weeks after
Rear facing
Persons with no known risk factors
During 2nd - 3rd trimester

28. What is the schedule for rotavirus vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

29. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception

30. What is the schedule for Gardasil?
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day

31. What are some risk factors for CAD?
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis

32. What kind of car seat should children < 2 yo be placed in?
NEVER
Rear facing
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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

33. When should Gardasil be given and for what purposes?
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
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
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

34. Unopposed estrogen increases risks for what conditions?
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
Smoking - Alcoholism
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

35. What is the USPSTF guideline for fall prevention in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

36. What are some safety issues you should counsel parents with young children?
More than 15
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Start at 20 for all M and W regardless of RFs

37. What are the guidelines for visual screening?
0.4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
65 (earlier if have increased risk factors)

38. What are the guidelines for pap smear?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 20 for both M and W
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 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)

39. 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
Every 5 years
1200 mg/day
Adults > 60

40. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
Meningitis and Epiglottitis

41. What is the NCEP III guideline for cholesterol 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
1200 mg/day
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'

42. What are the risks of combination HRT?
Adults > 60
Breast CA - thromboembolic event - stroke and CAD
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

43. How much vit D should adults < 50 take?
4 mg/day
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
800 IU/ day

44. What are the USPSTF guidelines for mammogram?
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 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...

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Rear facing
Starts at 20 for both M and W
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD

46. When is area of induration > 15 mm considered TB positive?
One time abdominal X-ray for all MALES who ever SMOKES
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)
Persons with no known risk factors

47. What is USPSTF guideline for abdominal aortic aneurysm screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors
One time abdominal X-ray for all MALES who ever SMOKES
Adults > 60

48. How much calcium should adolescents (9 -18) take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
Exercise or physical therapy and vit D for patients > 65
Persons with no known risk factors

49. What is the schedule for DTap vaccine?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
NEVER

50. 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)
800 IU/ day
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after