Test your basic knowledge |

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 risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
One dose at 12-15 mod - Booster at least 4-weeks after
HISTORY

2. When can children sit in a booster seat?

3. When should chest X-ray be used for screening?
NEVER
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
Women 55 - 79 yo
Starts at 20 for both M and W

4. When should the meningococcal vaccine be given and to which group?
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
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

5. When should pregnant women get a flu shot?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
During 2nd - 3rd trimester

6. What are some RFs for DMT2?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
BP - Height - Weight
Total cholesterol - FOBT

7. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

8. What is the ADA guideline for DMT2 screening?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day

9. How much folate should all women of child bearing age take?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
NEVER

10. What is the schedule for rotavirus vaccine?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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...

11. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and 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
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

12. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
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

13. When is intensive individualized home-based intervention recommended?
Adults > 60
Femoral neck
Children up to 7 yo and < 5' should be placed in a booster seat.
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

14. What is the schedule for polio vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
Rear facing
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo

15. Measurement of which anatomic structure is best predictor for hip fracture?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1300 mg/day
1000 mg/day
Femoral neck

16. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Breast CA - thromboembolic event - stroke and CAD
NEVER
Forearm
More than 15

17. What is the NCEP III guideline for cholesterol screening?
Exercise or physical therapy and vit D for patients > 65
800 IU/ day
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

18. How often do asplenic patients receive pneumococcal vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 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)

19. In which group of patients should aspirin be given as primary prevention for stroke?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
More than 15
1000 mg/day

20. What are the USPSTF guidelines for mammogram?
Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

21. Some contraindications for aspirin
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

22. Who are at increased risk for adverse effect catching a flu?
1000 IU/day
> 2 yo and less than 40 lbs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

23. What is the USPSTF guideline for chlamydial screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

24. What kind of sunscreen SPF is recommended for sun protection?
Starts at 20 for both M and W
More than 15
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

25. What is the schedule for Hep A vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

26. Which children should use a semi-upright/forward facing carseat?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

27. How much flouride should non military children in the state of HI be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
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 20 for both M and W

28. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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 45 - 79 yo
Total cholesterol - FOBT

29. What are 2 conditions that have been proven to be beneficial to screened for?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
When they are > 40 lbs and still less then 5'

30. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
65 (earlier if have increased risk factors)
12 - 23 mo - 2 doses are to be given 6 mo apart
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

31. How much folate and for How long should a woman take for planned pregnancy?
12 - 23 mo - 2 doses are to be given 6 mo apart
When they are > 40 lbs and still less then 5'
Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception

32. What is the schedule for Hib vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

33. What are the guidelines for colon cancer screening?
Femoral neck
HISTORY
Starts at 20 for both M and W
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

34. What is the schedule for Gardasil?
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)
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 50 (recommends against starting at 40) and every 2 years

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

36. What is the schedule for Hep B vaccine?
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

37. How much calcium should adults (19 - 50) take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise or physical therapy and vit D for patients > 65
1000 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

38. When is area of induration > 15 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
Starts at 20 for both M and W
Persons with no known risk factors
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

39. Who should get Tdap vaccine and how often?
Femoral neck
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
Persons with no known risk factors
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What are the guidelines for visual screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Forearm
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo

41. What is the USPSTF guideline for fall prevention in the elderly?
1300 mg/day
Rear facing
Exercise or physical therapy and vit D for patients > 65
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

42. Who should get shingles vaccine?
BP - Height - Weight
Adults > 60
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. What is the schedule for DTap vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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 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

44. What is HI law for booster seat?

45. Unopposed estrogen increases risks for what conditions?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Stroke and DVT
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65

46. 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
1200 mg/day
1300 mg/day
Rear facing

47. How much calcium should women > 50 take?
Stroke and DVT
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1200 mg/day

48. If traveling to endemic areas - Why should one get a dose of live vaccine?
1300 mg/day
To get IgA protection
Rear facing
In adults with sustained BP > 135/80 mmHg

49. In which group of patients should aspirin be given as primary prevention for MI?
Stroke and DVT
Men 45 - 79 yo
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

50. What are some risk factors for CAD?
Children up to 7 yo and < 5' should be placed in a booster seat.
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
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