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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 colon cancer screening?
Forearm
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
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. What are the 4 main groups of people who are candidates for pneumococcal vaccine?

3. Some contraindications for aspirin
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day
NEVER

4. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Persons with no known risk factors

5. When should Gardasil be given and for what purposes?
Stroke and DVT
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
In adults with sustained BP > 135/80 mmHg
Femoral neck

6. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

7. What is the ADA guideline for DMT2 screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

8. What is the schedule for DTap vaccine?
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
2mo - 4 mo - 6mo and 12-15 mo
1000 IU/day

9. What is the most important way to screen for CAD in an asymptomatic patients?
NEVER
0.4 mg/day
Smoking - Alcoholism
HISTORY

10. When should tetanus immunoglobulin be given?
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

11. What are the guidelines for pap smear?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Stroke and DVT
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

12. If traveling to endemic areas - Why should one get a dose of live vaccine?
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 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 time abdominal X-ray for all MALES who ever SMOKES
To get IgA protection

13. 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...
800 IU/ day
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism

14. How much vit D should adults > 50 take?
1000 IU/day
When they are > 40 lbs and still less then 5'
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

15. How much vit D should adults < 50 take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk

16. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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
Men 45 - 79 yo

17. What is USPSTF guideline for abdominal aortic aneurysm 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
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES

18. 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
Rear facing
Meningitis and Epiglottitis
Forearm

19. 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)
Persons with no known risk factors
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

20. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
Meningitis and Epiglottitis
Stroke and DVT

21. In which group of patients should aspirin be given as primary prevention for stroke?
12 - 23 mo - 2 doses are to be given 6 mo apart
Meningitis and Epiglottitis
Women 55 - 79 yo
In adults with sustained BP > 135/80 mmHg

22. What is the schedule for polio vaccine?
> 2 yo and less than 40 lbs
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)
4 mg/day

23. When is area of induration > 5mm considered TB positive?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
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

24. Measurement of which anatomic structure is best predictor for hip fracture?
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD
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
Femoral neck

25. When should the meningococcal vaccine be given and to which group?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

26. When can children sit in a booster seat?

27. What is the schedule for Hib vaccine?
Men 45 - 79 yo
During 2nd - 3rd trimester
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

28. At what age should women have DEXA scan?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs
1300 mg/day

29. What is the USPSTF guideline for fall prevention in the elderly?
Meningitis and Epiglottitis
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

30. How much folate should all women of child bearing age take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
65 (earlier if have increased risk factors)
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

31. When is area of induration > 15 mm considered TB positive?
1000 IU/day
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
Persons with no known risk factors

32. How much calcium should women > 50 take?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
During 2nd - 3rd trimester
Exercise - Environmental hazard reduction - Close monitoring of medication
1200 mg/day

33. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Exercise or physical therapy and vit D for patients > 65
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

34. When is intensive individualized home-based intervention recommended?
1200 mg/day
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
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

35. When is area of induration > 10 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
Children up to 7 yo and < 5' should be placed in a booster seat.
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised 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

36. Which children should use a semi-upright/forward facing carseat?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children up to 7 yo and < 5' should be placed in a booster seat.
> 2 yo and less than 40 lbs

37. What are the USPSTF guidelines for mammogram?
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
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart

38. How much fluoride should military children in HI be given?
Children up to 7 yo and < 5' should be placed in a booster seat.
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. Who should get shingles vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
Adults > 60
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

40. What is the schedule for Hep B vaccine?
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
1000 mg/day
BP - Height - Weight
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Stroke and DVT
Forearm
4 mg/day
65 (earlier if have increased risk factors)

42. What are some risk factors for CAD?
Starts at 50 (recommends against starting at 40) and every 2 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

43. What is the schedule for Hep A vaccine?
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart

44. How much calcium should adolescents (9 -18) take?
When they are > 40 lbs and still less then 5'
0.4 - 0.8 mg/day for 1 month prior to conception
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)
1300 mg/day

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4 mo - 6mo and 12-15 mo
Starts at 20 for both M and W
Forearm

46. How much flouride should non military children in the state of HI be given?
Exercise or physical therapy and vit D for patients > 65
Persons with no known risk factors
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

47. What is the USPSTF guideline for chlamydial screening?
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

48. What is the schedule for Gardasil?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

49. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Exercise or physical therapy and vit D for patients > 65
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

50. What 3 things should always be done in an office visit?
One time abdominal X-ray for all MALES who ever SMOKES
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
BP - Height - Weight