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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. If traveling to endemic areas - Why should one get a dose of live vaccine?
Women 55 - 79 yo
Meningitis and Epiglottitis
To get IgA protection
Starts at 20 for both M and W

2. What is HI law for booster seat?

3. 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)
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)
Men 45 - 79 yo

4. How much fluoride should military children in HI be given?
Total cholesterol - FOBT
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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. How much folate should all women of child bearing age take?
Men 45 - 79 yo
0.4 mg/day
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. How much folate and for How long should a woman take for planned pregnancy?
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

7. At what age should women have DEXA scan?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
During 2nd - 3rd trimester
Total cholesterol - FOBT

8. What are 2 conditions that have been proven to be beneficial to screened for?
1200 mg/day
Smoking - Alcoholism
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

9. 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
In all W < 24 who are sexually active - In W > 24 with increased risk
Total cholesterol - FOBT
1200 mg/day

10. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

11. What is USPSTF guideline for abdominal aortic aneurysm screening?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
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

12. What is the schedule for polio vaccine?
4 mg/day
Stroke and DVT
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs

13. What are some RFs for DMT2?
Starts at 50 (recommends against starting at 40) and every 2 years
When they are > 40 lbs and still less then 5'
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
800 IU/ day

14. What is the schedule for varicella vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after

15. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
In adults with sustained BP > 135/80 mmHg
Forearm
Start at 20 for all M and W regardless of RFs

16. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day
Starts at 20 for both M and W

17. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication
Start at 20 for all M and W regardless of RFs
Total cholesterol - FOBT

18. Who should get Tdap vaccine and how often?
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
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

19. When should the meningococcal vaccine be given and to which group?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of 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)
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

20. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
More than 15
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

21. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester

22. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

23. What is the most important way to screen for CAD in an asymptomatic patients?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
One dose at 12-15 mod - Booster at least 4-weeks after

24. What tests are appropriate to order in an asymptomatic 57 yo male?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Total cholesterol - FOBT
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

25. When should Gardasil be given and for what purposes?
Forearm
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
800 IU/ day
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

26. When should pregnant women get a flu shot?
800 IU/ day
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

27. How much vit D should adults > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day

28. In which group of patients should aspirin be given as primary prevention for stroke?
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
Men 45 - 79 yo
Women 55 - 79 yo

29. What kind of sunscreen SPF is recommended for sun protection?
Women 55 - 79 yo
More than 15
Meningitis and Epiglottitis
BP - Height - Weight

30. When is area of induration > 5mm considered TB positive?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
To get IgA protection
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

31. In which group of patients should aspirin be given as primary prevention for MI?
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
Forearm
More than 15
Men 45 - 79 yo

32. How much calcium should adults (19 - 50) take?
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
1000 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
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

33. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Every 5 years
Forearm
HISTORY

34. What are some safety issues you should counsel parents with young children?
Every 5 years
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
Meningitis and Epiglottitis

35. What is the schedule for Hep A vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
12 - 23 mo - 2 doses are to be given 6 mo apart
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection

36. Who are at increased risk for adverse effect catching a flu?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Femoral neck
Preschool children : 3-4 yo - Elderly patients: > 65 yo

37. What kind of polio vaccine is preferred?
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)
Femoral neck
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)

38. When can children sit in a booster seat?

39. What is the schedule for Hib vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

40. Some contraindications for aspirin
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

41. How much flouride should non military children in the state of HI be given?
0.4 - 0.8 mg/day for 1 month prior to conception
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

42. When should chest X-ray be used for screening?
NEVER
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
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors

43. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
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)
NEVER

44. How often do asplenic patients receive pneumococcal vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
1300 mg/day
Every 5 years

45. How much calcium should adolescents (9 -18) take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One time abdominal X-ray for all MALES who ever SMOKES
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1300 mg/day

46. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
HISTORY
More than 15

47. How much calcium should women > 50 take?
1200 mg/day
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
Children up to 7 yo and < 5' should be placed in a booster seat.

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

49. How much vit D should adults < 50 take?
800 IU/ day
0.4 - 0.8 mg/day for 1 month prior to conception
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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

50. When is area of induration > 10 mm considered TB positive?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman