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Family Medicine Health Maintenance

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 30 minutes. 2 minutes extra for reading the instructions.
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 is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
1300 mg/day
1200 mg/day

2. How much folate should all women of child bearing age take?
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...
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Stroke and DVT
0.4 mg/day

3. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
1200 mg/day

4. What is the schedule for Gardasil?
1200 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

5. What are some safety issues you should counsel parents with young children?
1200 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...
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

6. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
HISTORY
When they are > 40 lbs and still less then 5'
Persons with no known risk factors

7. When is intensive individualized home-based intervention recommended?
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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 - 23 mo - 2 doses are to be given 6 mo apart

8. 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...
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Total cholesterol - FOBT

9. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
800 IU/ day
Femoral neck

10. What is the schedule for Hep A vaccine?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES

11. Some contraindications for aspirin
One dose at 12-15 mod - Booster at least 4-weeks after
When they are > 40 lbs and still less then 5'
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

12. Who should get shingles vaccine?
> 2 yo and less than 40 lbs
Adults > 60
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

13. What is the schedule for Hep B vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

14. When is area of induration > 15 mm considered TB positive?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
Persons with no known 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

15. Unopposed estrogen increases risks for what conditions?
1000 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo

16. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
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
1000 IU/day
Adults > 60

17. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
1000 mg/day
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

18. 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
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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

19. If traveling to endemic areas - Why should one get a dose of live vaccine?
Meningitis and Epiglottitis
Stroke and DVT
To get IgA protection
Adults > 60

20. What is HI law for booster seat?

21. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
In adults with sustained BP > 135/80 mmHg
Women 55 - 79 yo
Forearm
Persons with no known risk factors

22. What kind of sunscreen SPF is recommended for sun protection?
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester

23. What is the schedule for MMR vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
1000 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

24. How much calcium should adults (19 - 50) take?
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 mg/day

25. When is area of induration > 10 mm considered TB positive?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

26. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
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)

27. What kind of car seat should children < 2 yo be placed in?
BP - Height - Weight
Exercise or physical therapy and vit D for patients > 65
65 (earlier if have increased risk factors)
Rear facing

28. What is the NCEP III guideline for cholesterol screening?
Adults > 60
Start at 20 for all M and W regardless of RFs
Women 55 - 79 yo
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

29. What is the schedule for Hib vaccine?
During 2nd - 3rd trimester
Meningitis and Epiglottitis
2mo - 4 mo - 6mo and 12-15 mo
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

30. What can decrease fall in the elderly?
During 2nd - 3rd trimester
Exercise - Environmental hazard reduction - Close monitoring of medication
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
BP - Height - Weight

31. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 mg/day

32. What is the schedule for polio vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck
4 mg/day

33. What is the USPSTF guideline for fall prevention in the elderly?
800 IU/ day
When they are > 40 lbs and still less then 5'
Exercise or physical therapy and vit D for patients > 65
0.4 - 0.8 mg/day for 1 month prior to conception

34. 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
When they are > 40 lbs and still less then 5'
Stroke and DVT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

35. When should chest X-ray be used for screening?
In adults with sustained BP > 135/80 mmHg
NEVER
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

36. When should tetanus immunoglobulin be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children up to 7 yo and < 5' should be placed in a booster seat.
Meningitis and Epiglottitis

37. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Stroke and DVT
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

38. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Adults > 60
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 20 for both M and W

39. What are the guidelines for visual screening?
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
1000 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

40. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
800 IU/ day
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

41. What is the USPSTF guideline for DMT2 screening?
4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
In adults with sustained BP > 135/80 mmHg
1000 IU/day

42. How much folate and for How long should a woman take for planned pregnancy?
More than 15
In adults with sustained BP > 135/80 mmHg
0.4 - 0.8 mg/day for 1 month prior to conception
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...

43. When should pregnant women get a flu shot?
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day
During 2nd - 3rd trimester
Smoking - Alcoholism

44. What is the most important way to screen for CAD in an asymptomatic patients?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

45. Who should get Tdap vaccine and how often?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
2mo - 4 mo - 6mo and 12-15 mo
More than 15

46. When can children sit in a booster seat?

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

48. What are the guidelines for colon cancer screening?
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 - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY
Persons with no known risk factors

49. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
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
HISTORY

50. What kind of polio vaccine is preferred?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Femoral neck