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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. 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
Smoking - Alcoholism
1300 mg/day
BP - Height - Weight

2. Who should get Tdap vaccine and how often?
Breast CA - thromboembolic event - stroke and CAD
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
Persons with no known risk factors
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

3. How much calcium should women > 50 take?
1200 mg/day
Forearm
1300 mg/day
Rear facing

4. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day
Men 45 - 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

5. What are the guidelines for colon cancer screening?
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
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
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

6. What is the USPSTF guideline for fall prevention in the elderly?
1000 IU/day
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
One dose at 12-15 mod - Booster at least 4-weeks after

7. What is HI law for booster seat?

8. What kind of car seat should children < 2 yo be placed in?
Rear facing
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
Meningitis and Epiglottitis

9. What are the guidelines for pap smear?
Children up to 7 yo and < 5' should be placed in a booster seat.
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

10. What are some risk factors for CAD?
During 2nd - 3rd trimester
1300 mg/day
800 IU/ day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

11. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

12. What are 2 conditions that have been proven to be beneficial to screened for?
4 mg/day
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15

13. How much folate and for How long should a woman take for planned pregnancy?
Breast CA - thromboembolic event - stroke and CAD
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo

14. What are the USPSTF guidelines for mammogram?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
800 IU/ day

15. What are some safety issues you should counsel parents with young children?
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
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...
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

16. When should the meningococcal vaccine be given and to which group?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
During 2nd - 3rd trimester
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

17. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing
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...

18. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo

19. What is the schedule for rotavirus 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
> 2 yo and less than 40 lbs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

20. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

21. How much vit D should adults > 50 take?
1000 IU/day
Men 45 - 79 yo
During 2nd - 3rd trimester
Femoral neck

22. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

23. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
Children up to 7 yo and < 5' should be placed in a booster seat.
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

24. What is the schedule for Hep A vaccine?
Stroke and DVT
1000 IU/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
12 - 23 mo - 2 doses are to be given 6 mo apart

25. When is area of induration > 10 mm considered TB positive?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
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

26. Measurement of which anatomic structure is best predictor for hip fracture?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Femoral neck

27. What are the guidelines for visual screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Preschool children : 3-4 yo - Elderly patients: > 65 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
2mo - 4 mo - 6mo and 12-15 mo

28. What is the schedule for Gardasil?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 - 0.8 mg/day for 1 month prior to conception
Rear facing
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

29. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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
12 - 23 mo - 2 doses are to be given 6 mo apart

30. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise or physical therapy and vit D for patients > 65
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
To get IgA protection

31. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm
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
During 2nd - 3rd trimester

32. What is the schedule for DTap vaccine?
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. What type of illnesses does Hib vaccine prevent?
Starts at 50 (recommends against starting at 40) and every 2 years
When they are > 40 lbs and still less then 5'
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...
Meningitis and Epiglottitis

34. How much fluoride should military children in HI be given?
Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

35. At what age should women have DEXA scan?
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)
Starts at 20 for both M and W

36. What are some RFs for DMT2?
More than 15
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Starts at 50 (recommends against starting at 40) and every 2 years

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

38. When is intensive individualized home-based intervention recommended?
4 mg/day
Stroke and DVT
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
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

39. When should tetanus immunoglobulin be given?
In all W < 24 who are sexually active - In W > 24 with increased risk
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
NEVER

40. What tests are appropriate to order in an asymptomatic 57 yo male?
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs
NEVER
Total cholesterol - FOBT

41. What 3 things should always be done in an office visit?
When they are > 40 lbs and still less then 5'
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
BP - Height - Weight

42. Which children should use a semi-upright/forward facing carseat?
Persons with no known risk factors
> 2 yo and less than 40 lbs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism

43. What is the schedule for Hib vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs

44. How much calcium should adolescents (9 -18) take?
Starts at 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

45. Who should get shingles vaccine?
1000 mg/day
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
Adults > 60

46. What is the most important way to screen for CAD in an asymptomatic patients?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection

47. What is the schedule for MMR vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise - Environmental hazard reduction - Close monitoring of medication
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

48. When should pregnant women get a flu shot?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
During 2nd - 3rd trimester

49. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
When they are > 40 lbs and still less then 5'
Starts at 50 (recommends against starting at 40) and every 2 years

50. How often do asplenic patients receive pneumococcal vaccine?
Men 45 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age