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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 vit D should adults < 50 take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In adults with sustained BP > 135/80 mmHg
800 IU/ day
Smoking - Alcoholism

2. Unopposed estrogen increases risks for what conditions?
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
BP - Height - Weight
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

3. What is the USPSTF guideline for chlamydial 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...
In all W < 24 who are sexually active - In W > 24 with increased risk
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

4. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 mg/day

5. What are the guidelines for pap smear?
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 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)
> 2 yo and less than 40 lbs
1300 mg/day

6. Which children should use a semi-upright/forward facing carseat?
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES
Persons with no known risk factors
> 2 yo and less than 40 lbs

7. What is the schedule for Gardasil?
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W

8. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs

9. What is the schedule for rotavirus vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day

10. What is the schedule for polio vaccine?
4 mg/day
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 yrs
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

11. What 3 things should always be done in an office visit?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
BP - Height - Weight
HISTORY
Total cholesterol - FOBT

12. What are the risks of combination HRT?
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years
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

13. What is the schedule for Hib vaccine?
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT

14. What are some RFs for DMT2?
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
4 mg/day
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...

15. What is the schedule for varicella vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo
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

16. 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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
HISTORY
One time abdominal X-ray for all MALES who ever SMOKES

17. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
One time abdominal X-ray for all MALES who ever SMOKES
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

18. When should Gardasil be given and for what purposes?
65 (earlier if have increased risk factors)
NEVER
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
> 2 yo and less than 40 lbs

19. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 yo
Starts at 20 for both M and W

20. Measurement of which anatomic structure is best predictor for hip fracture?
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
Femoral neck
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

21. What tests are appropriate to order in an asymptomatic 57 yo male?
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W
Total cholesterol - FOBT

22. What are the USPSTF guidelines for mammogram?
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
4 mg/day
Forearm
Starts at 50 (recommends against starting at 40) and every 2 years

23. Who are at increased risk for adverse effect catching a flu?
When they are > 40 lbs and still less then 5'
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism
One dose at 12-15 mod - Booster at least 4-weeks after

24. How much folate should all women of child bearing age take?
65 (earlier if have increased risk factors)
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

25. 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...
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

26. When should the meningococcal vaccine be given and to which group?
65 (earlier if have increased risk factors)
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

27. What is the USPSTF guideline for DMT2 screening?
When they are > 40 lbs and still less then 5'
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg

28. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children up to 7 yo and < 5' should be placed in a booster seat.

29. What kind of car seat should children < 2 yo be placed in?
1300 mg/day
1000 IU/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Rear facing

30. How much vit D should adults > 50 take?
1000 IU/day
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Rear facing

31. How much calcium should women > 50 take?
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
To get IgA protection
Rear facing
1200 mg/day

32. If traveling to endemic areas - Why should one get a dose of live vaccine?
NEVER
To get IgA protection
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

33. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years

34. What is the ADA guideline for DMT2 screening?
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

35. What type of illnesses does Hib vaccine prevent?
4 mg/day
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
Meningitis and Epiglottitis

36. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

37. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

38. 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
0.4 mg/day
Starts at 20 for both M and W
1200 mg/day

39. When is area of induration > 15 mm considered TB positive?
Total cholesterol - FOBT
Persons with no known risk factors
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...
To get IgA protection

40. What are some risk factors for CAD?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

41. What are the guidelines for colon cancer screening?
During 2nd - 3rd trimester
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 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day

42. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
In adults with sustained BP > 135/80 mmHg
Starts at 20 for both M and W
Women 55 - 79 yo

43. 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
To get IgA protection
Starts at 20 for both M and W
Total cholesterol - FOBT

44. 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
During 2nd - 3rd trimester
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

45. When can children sit in a booster seat?

46. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

47. What is USPSTF guideline for abdominal aortic aneurysm screening?
1200 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

48. How much fluoride should military children in HI be given?
65 (earlier if have increased risk factors)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

49. What are the guidelines for visual screening?
Smoking - Alcoholism
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

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