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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. At what age should women have DEXA scan?
0.4 mg/day
Forearm
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...

2. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
To get IgA protection
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo - 6mo and 12-15 mo

3. What is the schedule for varicella vaccine?
BP - Height - Weight
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W

4. What are some safety issues you should counsel parents with young children?
1000 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 mg/day
Every 5 years

5. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
One dose at 12-15 mod - Booster at least 4-weeks after
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. What are the risks of combination HRT?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
Children up to 7 yo and < 5' should be placed in a booster seat.

7. How much calcium should adults (19 - 50) take?
12 - 23 mo - 2 doses are to be given 6 mo apart
Persons with no known risk factors
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

8. What are 2 conditions that have been proven to be beneficial to screened for?
Stroke and DVT
1300 mg/day
Every 5 years
Smoking - Alcoholism

9. What is the schedule for Hib vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
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
2mo - 4 mo - 6mo and 12-15 mo
Children up to 7 yo and < 5' should be placed in a booster seat.

10. Unopposed estrogen increases risks for what conditions?
Smoking - Alcoholism
To get IgA protection
Meningitis and Epiglottitis
Stroke and DVT

11. What is the schedule for Hep B vaccine?
Femoral neck
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

12. When should Gardasil be given and for what purposes?
2mo - 4 mo - 6mo and 12-15 mo
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
NEVER
Starts at 20 for both M and W

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

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14. In which group of patients should aspirin be given as primary prevention for MI?
More than 15
Smoking - Alcoholism
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

15. What kind of sunscreen SPF is recommended for sun protection?
Starts at 20 for both M and W
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
More than 15

16. What are the guidelines for colon cancer screening?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise or physical therapy and vit D for patients > 65
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

17. How much calcium should women > 50 take?
Meningitis and Epiglottitis
1200 mg/day
Persons with no known risk factors
NEVER

18. When is area of induration > 10 mm considered TB positive?
Forearm
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)
Adults > 60
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

19. What is the ADA guideline for DMT2 screening?
To get IgA protection
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Start at 20 for all M and W regardless of RFs
Adults > 60

20. Measurement of which anatomic structure is best predictor for hip fracture?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
One time abdominal X-ray for all MALES who ever SMOKES

21. When can children sit in a booster seat?

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22. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk
12 - 23 mo - 2 doses are to be given 6 mo apart

23. What tests are appropriate to order in an asymptomatic 57 yo male?
Men 45 - 79 yo
HISTORY
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

24. What is the schedule for MMR vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo

25. What are the USPSTF guidelines for mammogram?
1000 IU/day
Starts at 50 (recommends against starting at 40) and every 2 years
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)
Breast CA - thromboembolic event - stroke and CAD

26. What is the USPSTF guideline for DMT2 screening?
HISTORY
In adults with sustained BP > 135/80 mmHg
Rear facing
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

27. 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
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

28. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65
Women 55 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

29. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart

30. How much folate should all women of child bearing age take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 mg/day
65 (earlier if have increased risk factors)
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

31. How much flouride should non military children in the state of HI be given?
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

32. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
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
Smoking - Alcoholism
During 2nd - 3rd trimester

33. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

34. What are some RFs for DMT2?
Adults > 60
Starts at 50 (recommends against starting at 40) and every 2 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

35. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 50 (recommends against starting at 40) and every 2 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...
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
Starts at 20 for both M and W

36. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

37. 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)
Smoking - Alcoholism
Forearm
800 IU/ day

38. What is the NCEP III guideline for cholesterol screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise - Environmental hazard reduction - Close monitoring of medication
Start at 20 for all M and W regardless of RFs
Femoral neck

39. What kind of polio vaccine is preferred?
To get IgA protection
During 2nd - 3rd trimester
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

40. When should chest X-ray be used for 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
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
NEVER

41. How much calcium should adolescents (9 -18) take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
Women 55 - 79 yo

42. How much vit D should adults > 50 take?
Rear facing
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Meningitis and Epiglottitis
1000 IU/day

43. What is the schedule for DTap vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day
1200 mg/day

44. When is area of induration > 15 mm considered TB positive?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs
Persons with no known risk factors

45. What can decrease fall in the elderly?
1300 mg/day
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
Exercise - Environmental hazard reduction - Close monitoring of medication
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

46. What is the schedule for polio vaccine?
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
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4mo - 6-18 mo and 4-6 yrs

47. When should the meningococcal vaccine be given and to which group?
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Every 5 years
Adults > 60
Forearm
1000 mg/day

49. Who should get shingles vaccine?
Stroke and DVT
1300 mg/day
Adults > 60
Meningitis and Epiglottitis

50. How much folate and for How long should a woman take for planned pregnancy?
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 50 (recommends against starting at 40) and every 2 years
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 - 0.8 mg/day for 1 month prior to conception