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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 are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 mg/day
When they are > 40 lbs and still less then 5'
Rear facing

2. Who are at increased risk for adverse effect catching a flu?
1000 IU/day
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

3. What is the schedule for varicella vaccine?
1000 IU/day
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg
One dose at 12-15 mod - Booster at least 4-weeks after

4. Unopposed estrogen increases risks for what conditions?
65 (earlier if have increased risk factors)
Stroke and DVT
HISTORY
Smoking - Alcoholism

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

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6. When should tetanus immunoglobulin be given?
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
1300 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

7. What is the USPSTF guideline for DMT2 screening?
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

8. What 3 things should always be done in an office visit?
> 2 yo and less than 40 lbs
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Total cholesterol - FOBT

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

10. 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
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
12 - 23 mo - 2 doses are to be given 6 mo apart

11. What is the schedule for MMR vaccine?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
During 2nd - 3rd trimester

12. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Adults > 60
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Meningitis and Epiglottitis

13. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
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
During 2nd - 3rd trimester

14. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day
More than 15

15. What tests are appropriate to order in an asymptomatic 57 yo male?
65 (earlier if have increased risk factors)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
Total cholesterol - FOBT

16. What is the schedule for polio vaccine?
1200 mg/day
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4mo - 6-18 mo and 4-6 yrs

17. How much calcium should adolescents (9 -18) take?
Rear facing
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1300 mg/day

18. 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
4 mg/day
1300 mg/day

19. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)
More than 15
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. When can children sit in a booster seat?

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21. Who should get shingles vaccine?
Adults > 60
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
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years

22. What type of illnesses does Hib vaccine prevent?
Adults > 60
Smoking - Alcoholism
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Meningitis and Epiglottitis

23. When is area of induration > 5mm considered TB positive?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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

24. Which children should use a semi-upright/forward facing carseat?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
> 2 yo and less than 40 lbs
One dose at 12-15 mod - Booster at least 4-weeks after
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

25. How much vit D should adults > 50 take?
0.4 - 0.8 mg/day for 1 month prior to conception
0.4 mg/day
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.

26. At what age should women have DEXA scan?
When they are > 40 lbs and still less then 5'
Rear facing
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

27. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
To get IgA protection
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism

28. How much fluoride should military children in HI be given?
NEVER
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 IU/day

29. When should chest X-ray be used for screening?
NEVER
Rear facing
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...
> 2 yo and less than 40 lbs

30. What are some risk factors for CAD?
Start at 20 for all M and W regardless of RFs
0.4 - 0.8 mg/day for 1 month prior to conception
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis

31. What is the most important way to screen for CAD in an asymptomatic patients?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
Adults > 60
HISTORY

32. 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
Women 55 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs

33. When should Gardasil be given and for what purposes?
Femoral neck
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
Breast CA - thromboembolic event - stroke and CAD
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

34. How much calcium should women > 50 take?
1200 mg/day
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication

35. How often do asplenic patients receive pneumococcal vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
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
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

36. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Exercise - Environmental hazard reduction - Close monitoring of medication

37. What is the USPSTF guideline for chlamydial screening?
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
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

38. What is HI law for booster seat?

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39. 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
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

40. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester
NEVER

41. What can decrease fall in the elderly?
800 IU/ day
BP - Height - Weight
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT

42. In which group of patients should aspirin be given as primary prevention for stroke?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

43. What are 2 conditions that have been proven to be beneficial to screened for?
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism

44. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
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

45. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
4 mg/day
Starts at 20 for both M and W
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

46. What are the guidelines for pap smear?
Children up to 7 yo and < 5' should be placed in a booster seat.
BP - Height - Weight
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

47. What is the NCEP III guideline for cholesterol screening?
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 20 for both M and W
Start at 20 for all M and W regardless of RFs
0.4 - 0.8 mg/day for 1 month prior to conception

48. Measurement of which anatomic structure is best predictor for hip fracture?
When they are > 40 lbs and still less then 5'
Femoral neck
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

49. How much flouride should non military children in the state of HI be given?
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...
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In adults with sustained BP > 135/80 mmHg

50. How much calcium should adults (19 - 50) take?
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day