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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 DTap 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
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism
One time abdominal X-ray for all MALES who ever SMOKES

3. What are 2 conditions that have been proven to be beneficial to screened for?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism
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
Adults > 60

4. What are the risks of combination HRT?
Women 55 - 79 yo
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
Breast CA - thromboembolic event - stroke and CAD
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 calcium should adolescents (9 -18) take?
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

6. Measurement of which anatomic structure is best predictor for hip fracture?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck
During 2nd - 3rd trimester

7. What is the USPSTF guideline for fall prevention in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs

8. How much vit D should adults < 50 take?
800 IU/ day
1200 mg/day
To get IgA protection
HISTORY

9. When is area of induration > 10 mm considered TB positive?
0.4 mg/day
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
2mo - 4mo - 6-18 mo and 4-6 yrs

10. What is the USPSTF guideline for DMT2 screening?
To get IgA protection
Starts at 20 for both M and W
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors

11. In which group of patients should aspirin be given as primary prevention for MI?
1200 mg/day
1300 mg/day
0.4 mg/day
Men 45 - 79 yo

12. What are some risk factors for CAD?
1000 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after

13. What type of illnesses does Hib vaccine prevent?
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Meningitis and Epiglottitis

14. What is the schedule for Hib vaccine?
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

15. What is HI law for booster seat?

16. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
4 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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

17. How much flouride should non military children in the state of HI be given?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Women 55 - 79 yo

18. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

19. What are the guidelines for pap smear?
HISTORY
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
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)

20. Who are at increased risk for adverse effect catching a flu?
Femoral neck
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
4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

21. If traveling to endemic areas - Why should one get a dose of live vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
More than 15
To get IgA protection

22. What is the schedule for varicella vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after

23. What is the USPSTF guideline for chlamydial screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk
Stroke and DVT
HISTORY

24. What kind of sunscreen SPF is recommended for sun protection?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
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

25. How much calcium should women > 50 take?
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

26. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Stroke and DVT
Exercise or physical therapy and vit D for patients > 65
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

27. What is the schedule for Hep A vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
More than 15
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

28. 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
1200 mg/day
Smoking - Alcoholism
65 (earlier if have increased risk factors)

29. How much vit D should adults > 50 take?
1000 IU/day
1200 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk

30. What can decrease fall in the elderly?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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)
Exercise - Environmental hazard reduction - Close monitoring of medication
Exercise or physical therapy and vit D for patients > 65

31. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
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

32. What are the USPSTF guidelines for mammogram?
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years

33. What is the schedule for polio vaccine?
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 - 4mo - 6-18 mo and 4-6 yrs
Every 5 years
Women 55 - 79 yo

34. 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
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

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

36. What kind of car seat should children < 2 yo be placed in?
Rear facing
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
> 2 yo and less than 40 lbs
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

37. 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Femoral neck
In all W < 24 who are sexually active - In W > 24 with increased risk

38. What tests are appropriate to order in an asymptomatic 57 yo male?
Starts at 20 for both M and W
Total cholesterol - FOBT
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

39. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

40. When should chest X-ray be used for screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
NEVER
Rear facing
HISTORY

41. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Every 5 years
Exercise or physical therapy and vit D for patients > 65
Starts at 20 for both M and W

42. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Meningitis and Epiglottitis
Forearm
1000 mg/day
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

43. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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.
Femoral neck

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

45. Some contraindications for aspirin
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

46. What is the schedule for MMR vaccine?
Every 5 years
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

47. What is the schedule for Hep B vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD

48. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

49. What kind of polio vaccine is preferred?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One time abdominal X-ray for all MALES who ever SMOKES
Every 5 years

50. What is the schedule for rotavirus vaccine?
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age