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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 some risk factors for CAD?
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 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
800 IU/ day

2. How much flouride should non military children in the state of HI be given?
BP - Height - Weight
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
One dose at 12-15 mod - Booster at least 4-weeks after

3. 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
0.4 - 0.8 mg/day for 1 month prior to conception
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck

4. When should pregnant women get a flu shot?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester

5. When is intensive individualized home-based intervention recommended?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo
1200 mg/day
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

6. What is the most important way to screen for CAD in an asymptomatic patients?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
HISTORY
BP - Height - Weight

7. Who should get Tdap vaccine and how often?
Breast CA - thromboembolic event - stroke and CAD
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
In all W < 24 who are sexually active - In W > 24 with increased risk

8. Unopposed estrogen increases risks for what conditions?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day
Stroke and DVT
During 2nd - 3rd trimester

9. What is the schedule for Hep B 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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

10. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

11. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

12. What are the risks of combination HRT?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
BP - Height - Weight
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD

13. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'

14. What are the guidelines for pap smear?
In all W < 24 who are sexually active - In W > 24 with increased risk
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)
Rear facing
65 (earlier if have increased risk factors)

15. What is the schedule for MMR vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
Rear facing

16. In which group of patients should aspirin be given as primary prevention for stroke?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

17. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
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
Adults > 60

18. When is area of induration > 15 mm considered TB positive?
Women 55 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 20 for both M and W
Persons with no known risk factors

19. What is the USPSTF guideline for DMT2 screening?
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Forearm
In adults with sustained BP > 135/80 mmHg

20. If traveling to endemic areas - Why should one get a dose of live vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
4 mg/day
1000 IU/day
To get IgA protection

21. What tests are appropriate to order in an asymptomatic 57 yo male?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
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

22. What kind of sunscreen SPF is recommended for sun protection?
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
More than 15

23. Who are at increased risk for adverse effect catching a flu?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1200 mg/day
Stroke and DVT

24. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
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

25. When can children sit in a booster seat?

26. When is area of induration > 5mm considered TB positive?
800 IU/ day
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
NEVER
1300 mg/day

27. When should Gardasil be given and for what purposes?
NEVER
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
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

28. What are some RFs for DMT2?
HISTORY
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

29. What are the USPSTF guidelines for mammogram?
Starts at 20 for both M and W
Starts at 50 (recommends against starting at 40) and every 2 years
1000 mg/day
BP - Height - Weight

30. In which group of patients should aspirin be given as primary prevention for MI?
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

31. What kind of car seat should children < 2 yo be placed in?
1300 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Rear facing
Adults > 60

32. How much calcium should women > 50 take?
1200 mg/day
Every 5 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
2mo - 4 mo - 6mo and 12-15 mo

33. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
Adults > 60

34. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
> 2 yo and less than 40 lbs
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

35. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day

36. What is HI law for booster seat?

37. How much folate should all women of child bearing age take?
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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men 45 - 79 yo
0.4 mg/day

38. When should tetanus immunoglobulin be given?
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

39. Which children should use a semi-upright/forward facing carseat?
800 IU/ day
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk

40. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Exercise or physical therapy and vit D for patients > 65
One time abdominal X-ray for all MALES who ever SMOKES
Adults > 60
Forearm

41. What is the USPSTF guideline for fall prevention in the elderly?
1300 mg/day
NEVER
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT

42. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise or physical therapy and vit D for patients > 65
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

43. What is the ADA guideline for DMT2 screening?
4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

44. How much calcium should adults (19 - 50) take?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
4 mg/day

45. What is the USPSTF guideline for chlamydial screening?
0.4 mg/day
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

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

47. What 3 things should always be done in an office visit?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight
Breast CA - thromboembolic event - stroke and CAD
Rear facing

48. What is the schedule for Hep A 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
12 - 23 mo - 2 doses are to be given 6 mo apart
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

49. What is USPSTF guideline for abdominal aortic aneurysm screening?
1000 IU/day
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
One time abdominal X-ray for all MALES who ever SMOKES
More than 15

50. What are the guidelines for colon cancer screening?
800 IU/ day
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
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years