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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. Who are at increased risk for adverse effect catching a flu?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

2. How often do asplenic patients receive pneumococcal vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day
Every 5 years
Breast CA - thromboembolic event - stroke and CAD

3. What are the risks of combination HRT?
800 IU/ day
Breast CA - thromboembolic event - stroke and CAD
4 mg/day
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

4. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
One dose at 12-15 mod - Booster at least 4-weeks after
4 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
0.4 - 0.8 mg/day for 1 month prior to conception

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

6. What type of illnesses does Hib vaccine prevent?
800 IU/ day
Meningitis and Epiglottitis
To get IgA 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

7. What is the USPSTF guideline for fall prevention in the elderly?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65

8. Which children should use a semi-upright/forward facing carseat?
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
> 2 yo and less than 40 lbs
Exercise or physical therapy and vit D for patients > 65

9. In which group of patients should aspirin be given as primary prevention for stroke?
1300 mg/day
Men 45 - 79 yo
Women 55 - 79 yo
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

10. At what age should women have DEXA scan?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)

11. What are the guidelines for pap smear?
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
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)
To get IgA protection
> 2 yo and less than 40 lbs

12. What kind of polio vaccine is preferred?
In adults with sustained BP > 135/80 mmHg
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD

13. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Adults > 60
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.

14. 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
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

15. How much folate and for How long should a woman take for planned pregnancy?
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
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception

16. What is the USPSTF guideline for chlamydial screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60
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

17. Who should get shingles vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo
Adults > 60

18. When is area of induration > 5mm considered TB positive?
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
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
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

19. When is intensive individualized home-based intervention recommended?
1300 mg/day
To get IgA protection
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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 HI law for booster seat?

21. What is the schedule for Hep A vaccine?
4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

22. What are the guidelines for colon cancer screening?
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

23. What is the USPSTF guideline for DMT2 screening?
Total cholesterol - FOBT
1200 mg/day
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo - 6mo and 12-15 mo

24. Unopposed estrogen increases risks for what conditions?
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children up to 7 yo and < 5' should be placed in a booster seat.

25. 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
Femoral neck
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years

26. How much flouride should non military children in the state of HI be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight

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

28. How much calcium should adults (19 - 50) take?
Adults > 60
1000 mg/day
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. What are some risk factors for 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65
1000 mg/day

30. How much calcium should women > 50 take?
800 IU/ day
1200 mg/day
1000 mg/day
During 2nd - 3rd trimester

31. What can decrease fall in the elderly?
Total cholesterol - FOBT
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

32. What 3 things should always be done in an office visit?
During 2nd - 3rd trimester
65 (earlier if have increased risk factors)
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Smoking - Alcoholism
> 2 yo and less than 40 lbs

34. When should Gardasil be given and for what purposes?
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)
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 all W < 24 who are sexually active - In W > 24 with increased risk

35. What kind of sunscreen SPF is recommended for sun protection?
1000 mg/day
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

36. How much vit D should adults > 50 take?
1000 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

37. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight
> 2 yo and less than 40 lbs
Exercise - Environmental hazard reduction - Close monitoring of medication

38. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
Persons with no known risk factors

39. What kind of car seat should children < 2 yo be placed in?
Rear facing
Adults > 60
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

40. How much calcium should adolescents (9 -18) take?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

41. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

42. When can children sit in a booster seat?

43. What is the schedule for DTap vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
Children up to 7 yo and < 5' should be placed in a booster seat.
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Exercise or physical therapy and vit D for patients > 65

44. When should chest X-ray be used for screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

45. Who should get Tdap vaccine and how often?
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
Forearm
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years

46. What is the schedule for polio 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
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing
2mo - 4mo - 6-18 mo and 4-6 yrs

47. How much folate should all women of child bearing age take?
0.4 mg/day
> 2 yo and less than 40 lbs
1000 mg/day
One time abdominal X-ray for all MALES who ever SMOKES

48. In which group of patients should aspirin be given as primary prevention for MI?
Women 55 - 79 yo
4 mg/day
Men 45 - 79 yo
1000 IU/day

49. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Preschool children : 3-4 yo - Elderly patients: > 65 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W

50. When should tetanus immunoglobulin be given?
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Total cholesterol - FOBT