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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. How much vit D should adults > 50 take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 IU/day

2. How much folate and for How long should a woman take for planned pregnancy?
65 (earlier if have increased risk factors)
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65

3. How much calcium should adults (19 - 50) take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 mg/day
Rear facing
4 mg/day

4. What is the USPSTF guideline for fall prevention in the elderly?
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
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT

5. When is intensive individualized home-based intervention recommended?
2mo - 4 mo - 6mo and 12-15 mo
0.4 - 0.8 mg/day for 1 month prior to conception
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

6. When should pregnant women get a flu shot?
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
More than 15
12 - 23 mo - 2 doses are to be given 6 mo apart

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

8. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
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
1000 IU/day

9. What is the ADA guideline for DMT2 screening?
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)
1000 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

10. What are the guidelines for colon cancer screening?
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Women 55 - 79 yo

11. How much calcium should adolescents (9 -18) take?
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
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day

12. 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
4 mg/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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

13. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
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

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

15. When should Gardasil be given and for what purposes?
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)
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
800 IU/ day

16. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One dose at 12-15 mod - Booster at least 4-weeks after
Total cholesterol - FOBT

17. What kind of polio vaccine is preferred?
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
Adults > 60
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

18. How often do asplenic patients receive pneumococcal vaccine?
BP - Height - Weight
Women 55 - 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
Every 5 years

19. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
HISTORY

20. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60

21. 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
Men 45 - 79 yo
1200 mg/day
Starts at 20 for both M and W

22. What is the USPSTF guideline for chlamydial screening?
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
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

23. Who should get Tdap vaccine and how often?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)
0.4 - 0.8 mg/day for 1 month prior to conception
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

24. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

25. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

26. What is HI law for booster seat?

27. What is the schedule for DTap vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT

28. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

29. What are some RFs for DMT2?
More than 15
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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 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...
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
Start at 20 for all M and W regardless of RFs
2mo - 4 mo - 6mo and 12-15 mo

31. When is area of induration > 15 mm considered TB positive?
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
Rear facing
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

32. How much fluoride should military children in HI be given?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Smoking - Alcoholism

33. What kind of sunscreen SPF is recommended for sun protection?
Every 5 years
Meningitis and Epiglottitis
HISTORY
More than 15

34. When is area of induration > 10 mm considered TB positive?
Stroke and DVT
One time abdominal X-ray for all MALES who ever SMOKES
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 up to 7 yo and < 5' should be placed in a booster seat.

35. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk
Men 45 - 79 yo
Exercise or physical therapy and vit D for patients > 65

36. If traveling to endemic areas - Why should one get a dose of live vaccine?
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
To get IgA protection

37. 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
Stroke and DVT
Start at 20 for all M and W regardless of RFs
Rear facing

38. What kind of car seat should children < 2 yo be placed in?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Rear facing
Forearm

39. What are the risks of combination HRT?
800 IU/ day
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
0.4 mg/day

40. What are the USPSTF guidelines for mammogram?
Forearm
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

41. What is the schedule for rotavirus vaccine?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12 - 23 mo - 2 doses are to be given 6 mo apart

42. What is the NCEP III guideline for cholesterol screening?
Every 5 years
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'
> 2 yo and less than 40 lbs

43. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Every 5 years
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

44. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
800 IU/ day
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

45. What is the schedule for Hep B vaccine?
Persons with no known risk factors
When they are > 40 lbs and still less then 5'
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight

46. In which group of patients should aspirin be given as primary prevention for stroke?
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
65 (earlier if have increased risk factors)
Women 55 - 79 yo

47. What is the schedule for Gardasil?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1300 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk

48. What type of illnesses does Hib vaccine prevent?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
NEVER

49. 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
Start at 20 for all M and W regardless of RFs
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

50. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Persons with no known risk factors
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
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