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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 are the guidelines for pap smear?
0.4 - 0.8 mg/day for 1 month prior to conception
1200 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)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

2. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
1000 mg/day
In adults with sustained BP > 135/80 mmHg
Forearm

3. Who should get shingles vaccine?
Adults > 60
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'

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

5. In which group of patients should aspirin be given as primary prevention for stroke?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Women 55 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
1300 mg/day

6. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1300 mg/day

7. What is the USPSTF guideline for chlamydial screening?
When they are > 40 lbs and still less then 5'
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
Stroke and DVT

8. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Meningitis and Epiglottitis
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

9. When should tetanus immunoglobulin be given?
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
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

10. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
When they are > 40 lbs and still less then 5'
Femoral neck

11. 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...
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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. When should Gardasil be given and for what purposes?
1000 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
Forearm
Children up to 7 yo and < 5' should be placed in a booster seat.

13. Measurement of which anatomic structure is best predictor for hip fracture?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day
> 2 yo and less than 40 lbs
Femoral neck

14. What is the schedule for polio vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
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

15. Some contraindications for aspirin
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. How much vit D should adults > 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Persons with no known risk factors

17. What is the schedule for rotavirus vaccine?
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day

18. How much folate and for How long should a woman take for planned pregnancy?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
4 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

19. What is the NCEP III guideline for cholesterol screening?
Rear facing
Women 55 - 79 yo
Start at 20 for all M and W regardless of RFs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

20. What are some risk factors for CAD?
Breast CA - thromboembolic event - stroke and CAD
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

21. Unopposed estrogen increases risks for what conditions?
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
Stroke and DVT
Forearm
When they are > 40 lbs and still less then 5'

22. Who should get Tdap vaccine and how often?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

23. At what age should women have DEXA scan?
Rear facing
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
65 (earlier if have increased risk factors)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

24. What is the ADA guideline for DMT2 screening?
Men 45 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Meningitis and Epiglottitis
2mo - 4mo - 6-18 mo and 4-6 yrs

25. How much fluoride should military children in HI be given?
1300 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

26. What are the risks of combination HRT?
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

27. What is the schedule for Hep B vaccine?
In adults with sustained BP > 135/80 mmHg
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...
Meningitis and Epiglottitis
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

28. If traveling to endemic areas - Why should one get a dose of live vaccine?
Start at 20 for all M and W regardless of RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart
To get IgA protection

29. What 3 things should always be done in an office visit?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

30. What is HI law for booster seat?

31. How much calcium should adolescents (9 -18) take?
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
Adults > 60

32. How much flouride should non military children in the state of HI be given?
> 2 yo and less than 40 lbs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

33. 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
More than 15
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
Stroke and DVT

34. How much calcium should adults (19 - 50) take?
Men 45 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
1000 mg/day

35. What kind of polio vaccine is preferred?
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'
One dose at 12-15 mod - Booster at least 4-weeks after
Every 5 years

36. What kind of sunscreen SPF is recommended for sun protection?
BP - Height - Weight
Men 45 - 79 yo
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
More than 15

37. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
During 2nd - 3rd trimester
Men 45 - 79 yo

38. What is the schedule for DTap vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

40. What is the most important way to screen for CAD in an asymptomatic patients?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

41. What is the schedule for Hep A vaccine?
800 IU/ day
Stroke and DVT
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo

42. What is the schedule for MMR vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
When they are > 40 lbs and still less then 5'

43. What type of illnesses does Hib vaccine prevent?
When they are > 40 lbs and still less then 5'
Smoking - Alcoholism
Meningitis and Epiglottitis
Femoral neck

44. Which children should use a semi-upright/forward facing carseat?
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
Every 5 years
To get IgA protection
> 2 yo and less than 40 lbs

45. In which group of patients should aspirin be given as primary prevention for MI?
Stroke and DVT
Men 45 - 79 yo
1300 mg/day
More than 15

46. When should pregnant women get a flu shot?
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.

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

48. What is the USPSTF guideline for DMT2 screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In adults with sustained BP > 135/80 mmHg
1200 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

49. When should chest X-ray be used for screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
NEVER
1000 IU/day
4 mg/day

50. What are the guidelines for colon cancer screening?
Total cholesterol - FOBT
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 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 45 - 79 yo