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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 45 - 79 yo
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
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo - 6mo and 12-15 mo
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES

3. What is the schedule for Hep A vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
12 - 23 mo - 2 doses are to be given 6 mo apart
BP - Height - Weight

4. What type of illnesses does Hib vaccine prevent?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'
12 - 23 mo - 2 doses are to be given 6 mo apart

5. When should pregnant women get a flu shot?
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...
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day

6. How much fluoride should military children in HI be given?
Femoral neck
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
To get IgA protection

7. If traveling to endemic areas - Why should one get a dose of live vaccine?
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
Persons with no known risk factors
To get IgA protection

8. What is the schedule for varicella vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
One dose at 12-15 mod - Booster at least 4-weeks after
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

9. What 3 things should always be done in an office visit?
Stroke and DVT
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
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
BP - Height - Weight

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

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11. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
800 IU/ day
Start at 20 for all M and W regardless of RFs
Rear facing

12. What kind of sunscreen SPF is recommended for sun protection?
1000 IU/day
One dose at 12-15 mod - Booster at least 4-weeks after
Stroke and DVT
More than 15

13. What are the USPSTF guidelines for cholesterol screening in 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)
Breast CA - thromboembolic event - stroke and CAD
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 20 for both M and W

14. How much calcium should adults (19 - 50) take?
Adults > 60
Women 55 - 79 yo
1000 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

15. How much folate and for How long should a woman take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

16. How much vit D should adults > 50 take?
1000 IU/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
Rear facing
In adults with sustained BP > 135/80 mmHg

17. What are the guidelines for pap smear?
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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day

18. When should tetanus immunoglobulin be given?
More than 15
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES

19. How much calcium should adolescents (9 -18) take?
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

20. What are some risk factors for CAD?
2mo - 4 mo - 6mo and 12-15 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
> 2 yo and less than 40 lbs

21. What is the USPSTF guideline for chlamydial screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg

22. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1000 IU/day
NEVER
Women 55 - 79 yo

23. When is area of induration > 10 mm considered TB positive?
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

24. When should the meningococcal vaccine be given and to which group?
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
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

25. What are the guidelines for visual screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Total cholesterol - FOBT

26. What are some safety issues you should counsel parents with young children?
One dose at 12-15 mod - Booster at least 4-weeks after
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...
2mo - 4mo - 6-18 mo and 4-6 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

27. Measurement of which anatomic structure is best predictor for hip fracture?
Children up to 7 yo and < 5' should be placed in a booster seat.
Femoral neck
Meningitis and Epiglottitis
Starts at 20 for both M and W

28. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
1200 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
In adults with sustained BP > 135/80 mmHg

29. Some contraindications for aspirin
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One time abdominal X-ray for all MALES who ever SMOKES
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

30. What are the risks of combination HRT?
0.4 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)
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

31. Who should get Tdap vaccine and how often?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

32. What is the schedule for DTap vaccine?
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

33. What is the schedule for polio vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4mo - 6-18 mo and 4-6 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
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. What kind of polio vaccine is preferred?
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
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

35. What tests are appropriate to order in an asymptomatic 57 yo male?
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 degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after

36. How much vit D should adults < 50 take?
2mo - 4mo - 6-18 mo and 4-6 yrs
Women 55 - 79 yo
Persons with no known risk factors
800 IU/ day

37. 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
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
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

38. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

39. What kind of car seat should children < 2 yo be placed in?
Rear facing
More than 15
800 IU/ day
12 - 23 mo - 2 doses are to be given 6 mo apart

40. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs

41. In which group of patients should aspirin be given as primary prevention for MI?
Persons with no known risk factors
Men 45 - 79 yo
During 2nd - 3rd trimester
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

42. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception
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

43. What is the ADA guideline for DMT2 screening?
Femoral neck
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In adults with sustained BP > 135/80 mmHg
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

44. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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. When is intensive individualized home-based intervention recommended?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

46. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
1000 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

47. When should chest X-ray be used for screening?
NEVER
Preschool children : 3-4 yo - Elderly patients: > 65 yo
4 mg/day
Exercise or physical therapy and vit D for patients > 65

48. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Women 55 - 79 yo
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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

49. What are 2 conditions that have been proven to be beneficial to screened for?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism
Adults > 60

50. Which children should use a semi-upright/forward facing carseat?
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
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
Femoral neck