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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. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 mg/day
Stroke and DVT
Forearm

2. If traveling to endemic areas - Why should one get a dose of live vaccine?
1000 IU/day
To get IgA protection
In adults with sustained BP > 135/80 mmHg
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

3. What is the USPSTF guideline for DMT2 screening?
Exercise or physical therapy and vit D for patients > 65
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
In adults with sustained BP > 135/80 mmHg

4. When should the meningococcal vaccine be given and to which group?
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)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

5. 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)
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

6. What are 2 conditions that have been proven to be beneficial to screened for?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism

7. How much vit D should adults > 50 take?
When they are > 40 lbs and still less then 5'
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day

8. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Femoral neck
NEVER
1000 IU/day

9. What is the schedule for rotavirus vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

10. What are the USPSTF guidelines for mammogram?
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
1200 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 50 (recommends against starting at 40) and every 2 years

11. In which group of patients should aspirin be given as primary prevention for stroke?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise or physical therapy and vit D for patients > 65
Women 55 - 79 yo

12. What are some safety issues you should counsel parents with young children?
65 (earlier if have increased risk factors)
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...
1000 mg/day
Stroke and DVT

13. 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
To get IgA protection
HISTORY
Women 55 - 79 yo

14. When is area of induration > 10 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4mo - 6-18 mo and 4-6 yrs

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)
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
Men 45 - 79 yo
> 2 yo and less than 40 lbs

16. What is the schedule for Hib vaccine?
BP - Height - Weight
2mo - 4mo - 6-18 mo and 4-6 yrs
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65

17. Which children should use a semi-upright/forward facing carseat?
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
During 2nd - 3rd trimester
> 2 yo and less than 40 lbs

18. When should chest X-ray be used for screening?
1000 mg/day
NEVER
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

19. What are the guidelines for pap smear?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

20. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years
Persons with no known risk factors

21. What is the schedule for Gardasil?
Women 55 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

22. Unopposed estrogen increases risks for what conditions?
1000 IU/day
Stroke and DVT
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

23. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester

24. What is the USPSTF guideline for chlamydial screening?
Femoral neck
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

25. How much vit D should adults < 50 take?
Women 55 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception
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
800 IU/ day

26. What 3 things should always be done in an office visit?
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
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
During 2nd - 3rd trimester
BP - Height - Weight

27. How much calcium should women > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2mo - 4mo - 6-18 mo and 4-6 yrs
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

28. What kind of sunscreen SPF is recommended for sun protection?
Starts at 50 (recommends against starting at 40) and every 2 years
Meningitis and Epiglottitis
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

29. 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
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
Exercise or physical therapy and vit D for patients > 65

30. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
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. What is the most important way to screen for CAD in an asymptomatic patients?
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
HISTORY

32. What type of illnesses does Hib vaccine prevent?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis
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
1300 mg/day

33. How much folate should all women of child bearing age take?
1000 mg/day
0.4 mg/day
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

34. When should tetanus immunoglobulin be given?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
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 the USPSTF guidelines for cholesterol screening in people with normal risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 IU/day
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

36. How much folate and for How long should a woman take for planned pregnancy?
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart

37. What is the schedule for MMR vaccine?
800 IU/ day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

38. Who should get shingles vaccine?
Forearm
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Rear facing

39. What is the schedule for polio vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
Women 55 - 79 yo
Meningitis and Epiglottitis

41. What is the USPSTF guideline for fall prevention in the elderly?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
Adults > 60
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...

42. Some contraindications for aspirin
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

43. When is intensive individualized home-based intervention recommended?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

44. When is area of induration > 15 mm considered TB positive?
When they are > 40 lbs and still less then 5'
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
Persons with no known risk factors
Meningitis and Epiglottitis

45. How much fluoride should military children in HI be given?
0.4 mg/day
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
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

46. At what age should women have DEXA scan?
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

47. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
BP - Height - Weight
1300 mg/day
4 mg/day
1000 IU/day

48. What are the guidelines for colon cancer screening?
When they are > 40 lbs and still less then 5'
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
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)

49. What is USPSTF guideline for abdominal aortic aneurysm screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
NEVER
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 yo

50. How often do asplenic patients receive pneumococcal vaccine?
More than 15
Every 5 years
65 (earlier if have increased risk factors)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose