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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. How much folate should all women of child bearing age take?
0.4 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
1000 IU/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

2. When should chest X-ray be used for screening?
Start at 20 for all M and W regardless of RFs
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
NEVER
800 IU/ day

3. How much vit D should adults > 50 take?
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
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day

4. What is the schedule for varicella 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
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

5. How much calcium should adults (19 - 50) take?
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
1000 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo

6. When is intensive individualized home-based intervention recommended?
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
Smoking - Alcoholism
More than 15

7. 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
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. What are the risks of combination HRT?
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

9. What are some RFs for DMT2?
NEVER
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
When they are > 40 lbs and still less then 5'
> 2 yo and less than 40 lbs

10. Some contraindications for aspirin
To get IgA protection
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
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...
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

11. What is the schedule for Gardasil?
Meningitis and Epiglottitis
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart

12. What kind of polio vaccine is preferred?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

13. What kind of sunscreen SPF is recommended for sun protection?
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
More than 15
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

14. 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...
Starts at 20 for both M and W
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

15. How often do asplenic patients receive pneumococcal vaccine?
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
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)

16. When should tetanus immunoglobulin be given?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo - 6mo and 12-15 mo

17. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs

18. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Forearm
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs

19. What is HI law for booster seat?

20. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

21. What are the USPSTF guidelines for mammogram?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

22. In which group of patients should aspirin be given as primary prevention for stroke?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
4 mg/day
Women 55 - 79 yo

23. Who are at increased risk for adverse effect catching a flu?
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise or physical therapy and vit D for patients > 65
Women 55 - 79 yo

24. What are some risk factors for CAD?
0.4 - 0.8 mg/day for 1 month prior to conception
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
800 IU/ day

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Men 45 - 79 yo
Starts at 20 for both M and W
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

26. What are the guidelines for colon cancer screening?
Rear facing
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In all W < 24 who are sexually active - In W > 24 with increased risk

27. How much folate and for How long should a woman take for planned pregnancy?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism
0.4 - 0.8 mg/day for 1 month prior to conception
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

28. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
1300 mg/day
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

29. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

30. When is area of induration > 5mm considered TB positive?
1200 mg/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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

31. What is the schedule for Hep A vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
12 - 23 mo - 2 doses are to be given 6 mo apart

32. What type of illnesses does Hib vaccine prevent?
Rear facing
Femoral neck
Meningitis and Epiglottitis
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

33. What is USPSTF guideline for abdominal aortic aneurysm screening?
Exercise or physical therapy and vit D for patients > 65
One time abdominal X-ray for all MALES who ever SMOKES
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

34. 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
Femoral neck
Stroke and DVT
Starts at 50 (recommends against starting at 40) and every 2 years

35. When should the meningococcal vaccine be given and to which group?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

36. Which children should use a semi-upright/forward facing carseat?
1200 mg/day
> 2 yo and less than 40 lbs
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

37. What is the USPSTF guideline for fall prevention in the elderly?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Exercise or physical therapy and vit D for patients > 65
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs

38. What is the schedule for MMR 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...
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15

39. At what age should women have DEXA scan?
When they are > 40 lbs and still less then 5'
Smoking - Alcoholism
65 (earlier if have increased risk factors)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

40. When is area of induration > 15 mm considered TB positive?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Persons with no known risk factors
Smoking - Alcoholism
Men 45 - 79 yo

41. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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...
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

42. Who should get shingles 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)
Adults > 60
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

43. What is the schedule for DTap vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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)

44. What is the NCEP III guideline for cholesterol screening?
1200 mg/day
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
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. Unopposed estrogen increases risks for what conditions?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Stroke and DVT

46. What is the most important way to screen for CAD in an asymptomatic patients?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
HISTORY
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 schedule for Hib vaccine?
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD
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
2mo - 4 mo - 6mo and 12-15 mo

48. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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 mg/day
Stroke and DVT
Forearm

49. What is the schedule for polio vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
One dose at 12-15 mod - Booster at least 4-weeks after

50. In which group of patients should aspirin be given as primary prevention for MI?
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)