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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 and for How long should a woman with hx of NTD take for planned pregnancy?
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
Persons with no known risk factors
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

2. What is the USPSTF guideline for fall prevention in the elderly?
Men 45 - 79 yo
More than 15
Exercise or physical therapy and vit D for patients > 65
1000 mg/day

3. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

4. What is the schedule for Hep B vaccine?
2mo - 4 mo - 6mo and 12-15 mo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Rear facing

5. How much vit D should adults > 50 take?
1000 IU/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
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

6. Who are at increased risk for adverse effect catching a flu?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo - 6mo and 12-15 mo

7. When should the meningococcal vaccine be given and to which group?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Adults > 60

8. What can decrease fall in the elderly?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1200 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Children up to 7 yo and < 5' should be placed in a booster seat.

9. What is the schedule for Gardasil?
Total cholesterol - FOBT
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
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

10. What is the schedule for Hib vaccine?
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors

11. How much calcium should adults (19 - 50) take?
1000 mg/day
Women 55 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
12 - 23 mo - 2 doses are to be given 6 mo apart

12. What is the schedule for DTap vaccine?
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
1200 mg/day
65 (earlier if have increased risk factors)

13. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

14. 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
In adults with sustained BP > 135/80 mmHg
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
65 (earlier if have increased risk factors)

15. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

16. What is the most important way to screen for CAD in an asymptomatic patients?
During 2nd - 3rd trimester
Stroke and DVT
HISTORY
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...

17. How much folate should all women of child bearing age take?
One dose at 12-15 mod - Booster at least 4-weeks after
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day

18. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
4 mg/day
Persons with no known risk factors
Total cholesterol - FOBT

19. What is the USPSTF guideline for chlamydial screening?
Rear facing
Start at 20 for all M and W regardless of 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
In all W < 24 who are sexually active - In W > 24 with increased risk

20. When can children sit in a booster seat?

21. When is area of induration > 10 mm considered TB positive?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Every 5 years
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
Femoral neck

22. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
4 mg/day
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk

23. Who should get shingles vaccine?
NEVER
Femoral neck
Men 45 - 79 yo
Adults > 60

24. Who should get Tdap vaccine and how often?
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known 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
Women 55 - 79 yo

25. How much calcium should adolescents (9 -18) take?
Stroke and DVT
1300 mg/day
> 2 yo and less than 40 lbs
1000 mg/day

26. How much calcium should women > 50 take?
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
1300 mg/day

27. At what age should women have DEXA scan?
Forearm
Men 45 - 79 yo
65 (earlier if have increased risk factors)
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 kind of polio vaccine is preferred?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. What is the USPSTF guideline for DMT2 screening?
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 - 23 mo - 2 doses are to be given 6 mo apart
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
In adults with sustained BP > 135/80 mmHg

30. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk

31. How often do asplenic patients receive pneumococcal vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
Women 55 - 79 yo

32. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
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
Women 55 - 79 yo

33. What are some safety issues you should counsel parents with young children?
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.
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...
When they are > 40 lbs and still less then 5'

34. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
1000 mg/day

35. What are 2 conditions that have been proven to be beneficial to screened for?
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W
Smoking - Alcoholism
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

36. What is the schedule for varicella vaccine?
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

37. What is USPSTF guideline for abdominal aortic aneurysm screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
Adults > 60
One time abdominal X-ray for all MALES who ever SMOKES

38. What are the risks of combination HRT?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD

39. How much folate and for How long should a woman take for planned pregnancy?
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)
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight

40. What 3 things should always be done in an office visit?
BP - Height - Weight
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
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs

41. What are the guidelines for pap smear?
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

42. When should chest X-ray be used for screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60

43. What is the NCEP III guideline for cholesterol screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
Persons with no known risk factors
4 mg/day
Start at 20 for all M and W regardless of RFs

44. 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
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 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise or physical therapy and vit D for patients > 65

46. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
To get IgA protection
800 IU/ day
0.4 mg/day

47. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

48. How much vit D should adults < 50 take?
During 2nd - 3rd trimester
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
800 IU/ day

49. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Breast CA - thromboembolic event - stroke and CAD
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

50. What are the guidelines for colon cancer screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs
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 - 4mo - 6-18 mo and 4-6 yrs