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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 is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 IU/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day

2. What is the schedule for DTap vaccine?
Breast CA - thromboembolic event - stroke and CAD
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known risk factors

3. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise or physical therapy and vit D for patients > 65
Men 45 - 79 yo
Starts at 20 for both M and W

4. What is the USPSTF guideline for chlamydial screening?
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
In all W < 24 who are sexually active - In W > 24 with increased risk

5. What is USPSTF guideline for abdominal aortic aneurysm screening?
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)
When they are > 40 lbs and still less then 5'
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

6. 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
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
BP - Height - Weight

7. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
1000 mg/day
Stroke and DVT
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

8. How often do asplenic patients receive pneumococcal vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
In all W < 24 who are sexually active - In W > 24 with increased risk

9. 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
0.4 - 0.8 mg/day for 1 month prior to conception
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'

10. What 3 things should always be done in an office visit?
Forearm
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
More than 15
BP - Height - Weight

11. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Persons with no known risk factors
Starts at 50 (recommends against starting at 40) and every 2 years
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. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
In all W < 24 who are sexually active - In W > 24 with increased risk

13. At what age should women have DEXA scan?
1000 mg/day
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

14. How much flouride should non military children in the state of HI be given?
1200 mg/day
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Meningitis and Epiglottitis

15. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Rear facing
Children up to 7 yo and < 5' should be placed in a booster seat.

16. Measurement of which anatomic structure is best predictor for hip fracture?
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck
Rear facing
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

17. What is the schedule for polio vaccine?
Smoking - Alcoholism
Rear facing
2mo - 4mo - 6-18 mo and 4-6 yrs
Femoral neck

18. What is the most important way to screen for CAD in an asymptomatic patients?
Start at 20 for all M and W regardless of RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
HISTORY
Femoral neck

19. How much folate should all women of child bearing age take?
0.4 mg/day
Femoral neck
To get IgA protection
Women 55 - 79 yo

20. Who should get shingles vaccine?
Rear facing
Adults > 60
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors

21. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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
65 (earlier if have increased risk factors)
Forearm

22. What are some safety issues you should counsel parents with young children?
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...
Rear facing
Starts at 20 for both M and W
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

23. Some contraindications for aspirin
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
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)

24. When should pregnant women get a flu shot?
Smoking - Alcoholism
During 2nd - 3rd trimester
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
2mo - 4 mo - 6mo and 12-15 mo

25. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
0.4 - 0.8 mg/day for 1 month prior to conception
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

26. When is area of induration > 15 mm considered TB positive?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication
Persons with no known risk factors

27. What is HI law for booster seat?

28. What kind of sunscreen SPF is recommended for sun protection?
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15
During 2nd - 3rd trimester

29. What is the schedule for Hep B vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
To get IgA protection

30. What is the schedule for varicella vaccine?
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)
One dose at 12-15 mod - Booster at least 4-weeks after
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

31. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 IU/day
1000 mg/day
Starts at 20 for both M and W

32. If traveling to endemic areas - Why should one get a dose of live vaccine?
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
To get IgA protection

33. When should chest X-ray be used for screening?
Adults > 60
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs
BP - Height - Weight

34. When is area of induration > 5mm considered TB positive?
Total cholesterol - FOBT
Rear facing
HISTORY
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

35. What are 2 conditions that have been proven to be beneficial to screened for?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Smoking - Alcoholism
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors

36. What are the guidelines for visual screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo

37. How much calcium should adults (19 - 50) take?
1000 mg/day
1200 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication

38. 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
HISTORY
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo

39. When is area of induration > 10 mm considered TB positive?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
NEVER
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

40. What are the risks of combination HRT?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo - 6mo and 12-15 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
Breast CA - thromboembolic event - stroke and CAD

41. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Forearm
2mo - 4 mo - 6mo and 12-15 mo
More than 15

42. When should the meningococcal vaccine be given and to which group?
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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)

43. What type of illnesses does Hib vaccine prevent?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Start at 20 for all M and W regardless of RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Meningitis and Epiglottitis

44. How much calcium should adolescents (9 -18) take?
BP - Height - Weight
More than 15
1200 mg/day
1300 mg/day

45. What is the USPSTF guideline for DMT2 screening?
1000 IU/day
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

46. How much calcium should women > 50 take?
Adults > 60
Total cholesterol - FOBT
Femoral neck
1200 mg/day

47. In which group of patients should aspirin be given as primary prevention for MI?
When they are > 40 lbs and still less then 5'
Men 45 - 79 yo
1200 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

48. What are some RFs for DMT2?
Rear facing
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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...

49. How much folate and for How long should a woman take for planned pregnancy?
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)

50. What are the USPSTF guidelines for mammogram?
Total cholesterol - FOBT
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 years