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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 can decrease fall in the elderly?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication

2. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
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
Rear facing

3. When should tetanus immunoglobulin be given?
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

4. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors
NEVER
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

5. What is HI law for booster seat?

6. How much calcium should adolescents (9 -18) take?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
More than 15
1300 mg/day
1200 mg/day

7. What is the schedule for DTap vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception
NEVER
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

8. How much vit D should adults < 50 take?
In adults with sustained BP > 135/80 mmHg
800 IU/ day
65 (earlier if have increased risk factors)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

9. What is the ADA guideline for DMT2 screening?
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

10. When is area of induration > 5mm considered TB positive?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT
0.4 - 0.8 mg/day for 1 month prior to conception

11. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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 - 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
Children up to 7 yo and < 5' should be placed in a booster seat.

12. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

13. What is the schedule for Hep A vaccine?
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
1200 mg/day

14. Who should get shingles vaccine?
Adults > 60
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
1000 IU/day

15. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Stroke and DVT
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

16. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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 adults with sustained BP > 135/80 mmHg
2mo - 4 mo - 6mo and 12-15 mo

17. At what age should women have DEXA scan?
800 IU/ day
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
Adults > 60

18. What are some safety issues you should counsel parents with young children?
800 IU/ day
In adults with sustained BP > 135/80 mmHg
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...

19. What is the USPSTF guideline for fall prevention in the elderly?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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)
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65

20. How much fluoride should military children in HI be given?
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

21. How much vit D should adults > 50 take?
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 IU/day

22. What is the NCEP III guideline for cholesterol screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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)
Start at 20 for all M and W regardless of RFs

23. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
When they are > 40 lbs and still less then 5'
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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...

24. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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)
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

25. What kind of polio vaccine is preferred?
0.4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

26. What is the schedule for Gardasil?
One time abdominal X-ray for all MALES who ever SMOKES
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
More than 15

27. What are the USPSTF guidelines for mammogram?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 50 (recommends against starting at 40) and every 2 years

28. How much folate should all women of child bearing age take?
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after

29. Measurement of which anatomic structure is best predictor for hip fracture?
0.4 - 0.8 mg/day for 1 month prior to conception
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo

30. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One dose at 12-15 mod - Booster at least 4-weeks after
Children up to 7 yo and < 5' should be placed in a booster seat.

31. How often do asplenic patients receive pneumococcal vaccine?
> 2 yo and less than 40 lbs
In adults with sustained BP > 135/80 mmHg
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)
Every 5 years

32. Which children should use a semi-upright/forward facing carseat?
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs

33. How much calcium should adults (19 - 50) take?
Women 55 - 79 yo
1000 mg/day
Exercise or physical therapy and vit D for patients > 65
HISTORY

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

35. What is the schedule for varicella vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
One dose at 12-15 mod - Booster at least 4-weeks after

36. What are the guidelines for pap smear?
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
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 dose at 12-15 mod - Booster at least 4-weeks after

37. What is the schedule for Hep B vaccine?
Start at 20 for all M and W regardless of RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In all W < 24 who are sexually active - In W > 24 with increased risk

38. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs
Total cholesterol - FOBT
Start at 20 for all M and W regardless of RFs

39. What are some risk factors for CAD?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
During 2nd - 3rd trimester
1200 mg/day

40. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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...
One dose at 12-15 mod - Booster at least 4-weeks after

41. What is the most important way to screen for CAD in an asymptomatic patients?
Start at 20 for all M and W regardless of RFs
HISTORY
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 20 for both M and W

42. When can children sit in a booster seat?

43. 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
Total cholesterol - FOBT
Women 55 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception

44. What is the schedule for polio vaccine?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
One time abdominal X-ray for all MALES who ever SMOKES
Women 55 - 79 yo

45. What are the guidelines for colon cancer screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
One dose at 12-15 mod - Booster at least 4-weeks after
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

46. How much flouride should non military children in the state of HI be given?
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 dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

47. What kind of car seat should children < 2 yo be placed in?
0.4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

48. What are some RFs for DMT2?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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)
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

49. When is area of induration > 10 mm considered TB positive?
Femoral neck
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
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
4 mg/day

50. When is intensive individualized home-based intervention recommended?
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
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
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