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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?
Start at 20 for all M and W regardless of RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

2. What are some risk factors for CAD?
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

3. What is the NCEP III guideline for cholesterol screening?
Meningitis and Epiglottitis
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
Forearm

4. What is the schedule for Hib vaccine?
Forearm
2mo - 4 mo - 6mo and 12-15 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after

5. When should chest X-ray be used for screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
NEVER
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1300 mg/day

6. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
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 starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Rear facing

7. What is HI law for booster seat?

8. How much vit D should adults > 50 take?
12 - 23 mo - 2 doses are to be given 6 mo apart
Adults > 60
Men 45 - 79 yo
1000 IU/day

9. What tests are appropriate to order in an asymptomatic 57 yo male?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Total cholesterol - FOBT
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
Femoral neck

10. What is the schedule for Hep A vaccine?
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
1300 mg/day
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart

11. 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
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

12. Unopposed estrogen increases risks for what conditions?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES
Stroke and DVT

13. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES

14. How much folate should all women of child bearing age take?
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
Women 55 - 79 yo
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...

15. Who should get Tdap vaccine and how often?
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
Femoral neck
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...
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

16. What are the guidelines for visual screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

17. What is the USPSTF guideline for DMT2 screening?
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection
In adults with sustained BP > 135/80 mmHg
Children up to 7 yo and < 5' should be placed in a booster seat.

18. What is the most important way to screen for CAD in an asymptomatic patients?
0.4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
HISTORY
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

19. What are the guidelines for colon cancer screening?
One dose at 12-15 mod - Booster at least 4-weeks after
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
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
Stroke and DVT

20. In which group of patients should aspirin be given as primary prevention for stroke?
Total cholesterol - FOBT
When they are > 40 lbs and still less then 5'
Women 55 - 79 yo
65 (earlier if have increased risk factors)

21. What kind of car seat should children < 2 yo be placed in?
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
Persons with no known risk factors
Rear facing

22. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In adults with sustained BP > 135/80 mmHg
Persons with no known risk factors

23. How often do asplenic patients receive pneumococcal vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

24. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

25. How much vit D should adults < 50 take?
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)
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day

26. When should pregnant women get a flu shot?
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
During 2nd - 3rd trimester
Smoking - Alcoholism

27. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day
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
Exercise or physical therapy and vit D for patients > 65

28. What is the schedule for MMR vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 20 for both M and W
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
4 mg/day

29. What are the guidelines for pap smear?
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)

30. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4mo - 6-18 mo and 4-6 yrs

31. When should the meningococcal vaccine be given and to which group?
Forearm
1000 IU/day
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

32. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
Total cholesterol - FOBT
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

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

34. How much fluoride should military children in HI be given?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day

35. How much calcium should women > 50 take?
65 (earlier if have increased risk factors)
More than 15
1200 mg/day
Adults > 60

36. At what age should women have DEXA scan?
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 - 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
65 (earlier if have increased risk factors)
HISTORY

37. In which group of patients should aspirin be given as primary prevention for MI?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
65 (earlier if have increased risk factors)
Men 45 - 79 yo

38. What is the schedule for rotavirus 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
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 and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
To get IgA protection

39. What is the schedule for DTap vaccine?
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

40. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

41. What is the schedule for varicella vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
One dose at 12-15 mod - Booster at least 4-weeks after
Total cholesterol - FOBT
More than 15

42. What are some safety issues you should counsel parents with young children?
1300 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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...
65 (earlier if have increased risk factors)

43. When can children sit in a booster seat?

44. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60

45. What type of illnesses does Hib vaccine prevent?
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after

46. Who should get shingles vaccine?
Adults > 60
Persons with no known risk factors
When they are > 40 lbs and still less then 5'
800 IU/ day

47. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1200 mg/day
1000 IU/day
4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

48. How much folate and for How long should a woman take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Children up to 7 yo and < 5' should be placed in a booster seat.

49. What kind of polio vaccine is preferred?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One dose at 12-15 mod - Booster at least 4-weeks after

50. Some contraindications for aspirin
Every 5 years
1000 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)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy