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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?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
Smoking - Alcoholism
4 mg/day

2. How much flouride should non military children in the state of HI be given?
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Smoking - Alcoholism

3. How much calcium should adults (19 - 50) take?
Meningitis and Epiglottitis
1000 mg/day
800 IU/ 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...

4. What are some safety issues you should counsel parents with young children?
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
To get IgA protection

5. When can children sit in a booster seat?

6. 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
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
Persons with no known risk factors
65 (earlier if have increased risk factors)

7. What kind of polio vaccine is preferred?
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years
Start at 20 for all M and W regardless of RFs

8. Measurement of which anatomic structure is best predictor for hip fracture?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Men 45 - 79 yo
Femoral neck

9. What tests are appropriate to order in an asymptomatic 57 yo male?
Meningitis and Epiglottitis
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
One time abdominal X-ray for all MALES who ever SMOKES

10. What is the NCEP III guideline for cholesterol screening?
More than 15
2mo - 4 mo - 6mo and 12-15 mo
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester

11. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day

12. What kind of sunscreen SPF is recommended for sun protection?
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years

13. When is area of induration > 10 mm considered TB positive?
Women 55 - 79 yo
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
Total cholesterol - FOBT
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

14. How much fluoride should military children in HI be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
To get IgA protection

15. 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)
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 dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W

16. How much vit D should adults < 50 take?
Every 5 years
Start at 20 for all M and W regardless of RFs
0.4 mg/day
800 IU/ day

17. In which group of patients should aspirin be given as primary prevention for stroke?
BP - Height - Weight
Women 55 - 79 yo
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...

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

19. Some contraindications for aspirin
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. How often do asplenic patients receive pneumococcal vaccine?
Stroke and DVT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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...
Every 5 years

21. When should tetanus immunoglobulin be given?
Forearm
Every 5 years
In adults with sustained BP > 135/80 mmHg
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

22. How much folate should all women of child bearing age take?
In adults with sustained BP > 135/80 mmHg
4 mg/day
0.4 mg/day
Women 55 - 79 yo

23. What are the USPSTF guidelines for mammogram?
Total cholesterol - FOBT
Stroke and DVT
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years

24. What is the ADA guideline for DMT2 screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

25. 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
Breast CA - thromboembolic event - stroke and CAD
More than 15
> 2 yo and less than 40 lbs

26. What is the schedule for Gardasil?
Persons with no known risk factors
Smoking - Alcoholism
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

27. What can decrease fall in the elderly?
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
Every 5 years

28. What is the USPSTF guideline for chlamydial screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In all W < 24 who are sexually active - In W > 24 with increased risk

29. When is area of induration > 5mm considered TB positive?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

30. What is the schedule for varicella vaccine?
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after

31. How much vit D should adults > 50 take?
1000 IU/day
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
Rear facing

32. What kind of car seat should children < 2 yo be placed in?
Rear facing
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD

33. Which children should use a semi-upright/forward facing carseat?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
> 2 yo and less than 40 lbs
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

34. What is the USPSTF guideline for DMT2 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 mg/day
In adults with sustained BP > 135/80 mmHg

35. What is the schedule for MMR vaccine?
In adults with sustained BP > 135/80 mmHg
NEVER
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

36. What is the most important way to screen for CAD in an asymptomatic patients?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
HISTORY
Meningitis and Epiglottitis
Exercise or physical therapy and vit D for patients > 65

37. When is area of induration > 15 mm considered TB positive?
Adults > 60
Persons with no known risk factors
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

38. What is the schedule for polio vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs
> 2 yo and less than 40 lbs
More than 15

39. Who should get shingles vaccine?
Adults > 60
1200 mg/day
Stroke and DVT
NEVER

40. What is the schedule for Hep A vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

41. Unopposed estrogen increases risks for what conditions?
Meningitis and Epiglottitis
Men 45 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT

42. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

43. What is HI law for booster seat?

44. What type of illnesses does Hib vaccine prevent?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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)
Meningitis and Epiglottitis

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
During 2nd - 3rd trimester
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)

46. What are the risks of combination HRT?
Stroke and DVT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
Adults > 60

47. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

48. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Persons with no known risk factors
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

49. What are 2 conditions that have been proven to be beneficial to screened for?
Children up to 7 yo and < 5' should be placed in a booster seat.
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years
1000 mg/day

50. What is the schedule for rotavirus vaccine?
Women 55 - 79 yo
800 IU/ day
Start at 20 for all M and W regardless of RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age