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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 are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm
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

2. What kind of sunscreen SPF is recommended for sun 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
Men 45 - 79 yo
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

3. When should Gardasil be given and for what purposes?
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
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
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 is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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 - 0.8 mg/day for 1 month prior to conception
Persons with no known risk factors

5. When is intensive individualized home-based intervention recommended?
During 2nd - 3rd trimester
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. How much fluoride should military children in HI be given?
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck
During 2nd - 3rd trimester

7. What is the ADA guideline for DMT2 screening?
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

8. What kind of polio vaccine is preferred?
HISTORY
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
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)

10. How much folate should all women of child bearing age take?
To get IgA protection
0.4 mg/day
Rear facing
Breast CA - thromboembolic event - stroke and CAD

11. Who should get Tdap vaccine and how often?
During 2nd - 3rd trimester
4 mg/day
BP - Height - Weight
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

12. In which group of patients should aspirin be given as primary prevention for MI?
Meningitis and Epiglottitis
Every 5 years
Men 45 - 79 yo
In adults with sustained BP > 135/80 mmHg

13. What is the schedule for varicella 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...
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
Men 45 - 79 yo

14. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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
Starts at 20 for both M and W
HISTORY

15. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

16. What is the most important way to screen for CAD in an asymptomatic patients?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
HISTORY
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

17. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day
Forearm
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

18. How often do asplenic patients receive pneumococcal vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years
During 2nd - 3rd trimester

19. How much folate and for How long should a woman take for planned pregnancy?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight

20. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Total cholesterol - FOBT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years

21. What 3 things should always be done in an office visit?
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
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

22. Which children should use a semi-upright/forward facing carseat?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Stroke and DVT
To get IgA protection
> 2 yo and less than 40 lbs

23. Unopposed estrogen increases risks for what conditions?
Start at 20 for all M and W regardless of RFs
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)
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT

24. 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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

25. What are the risks of combination HRT?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD
Stroke and DVT

26. How much vit D should adults > 50 take?
Stroke and DVT
1000 IU/day
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk

27. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
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

28. What are the USPSTF guidelines for mammogram?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

29. How much flouride should non military children in the state of HI be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 yo
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. When can children sit in a booster seat?

31. What can decrease fall in the elderly?
One time abdominal X-ray for all MALES who ever SMOKES
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)
Exercise - Environmental hazard reduction - Close monitoring of medication

32. What kind of car seat should children < 2 yo be placed in?
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
Rear facing

33. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Total cholesterol - FOBT

34. If traveling to endemic areas - Why should one get a dose of live vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
To get IgA protection
Total cholesterol - FOBT
Breast CA - thromboembolic event - stroke and CAD

35. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Adults > 60
Persons with no known risk factors
1000 IU/day

36. What is the schedule for rotavirus vaccine?
Women 55 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing

37. What is the USPSTF guideline for DMT2 screening?
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo

38. Who are at increased risk for adverse effect catching a flu?
Forearm
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication

39. When is area of induration > 15 mm considered TB positive?
Persons with no known 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
Total cholesterol - FOBT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

40. When should chest X-ray be used for screening?
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
NEVER
Rear facing

41. What is USPSTF guideline for abdominal aortic aneurysm screening?
Men 45 - 79 yo
1000 IU/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

42. What are the guidelines for pap smear?
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
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)
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...

43. What is HI law for booster seat?

44. What tests are appropriate to order in an asymptomatic 57 yo male?
1200 mg/day
Smoking - Alcoholism
Total cholesterol - FOBT
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

45. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
When they are > 40 lbs and still less then 5'
Preschool children : 3-4 yo - Elderly patients: > 65 yo

46. What is the USPSTF guideline for fall prevention in the elderly?
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
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)
Exercise or physical therapy and vit D for patients > 65

47. How much calcium should adolescents (9 -18) take?
BP - Height - Weight
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day

48. How much vit D should adults < 50 take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
65 (earlier if have increased risk factors)

49. Who should get shingles vaccine?
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
Every 5 years
1000 mg/day
Adults > 60

50. What is the schedule for Hep A vaccine?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
BP - Height - Weight