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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 Hep A vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65
12 - 23 mo - 2 doses are to be given 6 mo apart

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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise - Environmental hazard reduction - Close monitoring of medication

3. What are the guidelines for pap smear?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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)
HISTORY
Starts at 20 for both M and W

4. When should chest X-ray be used for screening?
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
One time abdominal X-ray for all MALES who ever SMOKES
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)
NEVER

5. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
0.4 mg/day
Stroke and DVT

6. What kind of car seat should children < 2 yo be placed in?
Rear facing
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
In all W < 24 who are sexually active - In W > 24 with increased risk
Preschool children : 3-4 yo - Elderly patients: > 65 yo

7. Which children should use a semi-upright/forward facing carseat?
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Persons with no known risk factors
> 2 yo and less than 40 lbs

8. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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 overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
NEVER

9. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
During 2nd - 3rd trimester
HISTORY

10. What are some safety issues you should counsel parents with young children?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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...

11. What are some risk factors for CAD?
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
NEVER

12. Who should get Tdap vaccine and how often?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
During 2nd - 3rd trimester

13. How much flouride should non military children in the state of HI be given?
Smoking - Alcoholism
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

14. What is the schedule for DTap vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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...
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

15. What is the schedule for Hep B vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

16. When can children sit in a booster seat?

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

18. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

19. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Adults > 60
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

20. How much calcium should adolescents (9 -18) take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day
Forearm
Meningitis and Epiglottitis

21. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of 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

22. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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
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
4 mg/day

23. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Exercise or physical therapy and vit D for patients > 65
HISTORY
Forearm

24. What is USPSTF guideline for abdominal aortic aneurysm screening?
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
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...
Rear facing

25. When is area of induration > 15 mm considered TB positive?
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...
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Persons with no known risk factors
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

26. How often do asplenic patients receive pneumococcal vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
NEVER

27. What is the NCEP III guideline for cholesterol 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
Start at 20 for all M and W regardless of 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
BP - Height - Weight

28. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES

29. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men 45 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
One time abdominal X-ray for all MALES who ever SMOKES

30. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES

31. What is the USPSTF guideline for fall prevention in the elderly?
BP - Height - Weight
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)
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo

32. How much fluoride should military children in HI be given?
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
During 2nd - 3rd trimester

33. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
Men 45 - 79 yo
1300 mg/day

34. When is intensive individualized home-based intervention recommended?
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
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
Exercise or physical therapy and vit D for patients > 65

35. How much vit D should adults < 50 take?
Persons with no known risk factors
Adults > 60
In adults with sustained BP > 135/80 mmHg
800 IU/ day

36. What is the USPSTF guideline for DMT2 screening?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In adults with sustained BP > 135/80 mmHg

37. What is the USPSTF guideline for chlamydial screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
In all W < 24 who are sexually active - In W > 24 with increased risk
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

38. What are the risks of combination HRT?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
Rear facing
Forearm

39. How much calcium should adults (19 - 50) take?
1200 mg/day
1000 mg/day
Adults > 60
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

40. 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
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
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...

41. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Starts at 20 for both M and W
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES

42. What are the guidelines for visual screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children up to 7 yo and < 5' should be placed in a booster seat.

43. What is the schedule for varicella vaccine?
Meningitis and Epiglottitis
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In adults with sustained BP > 135/80 mmHg
One dose at 12-15 mod - Booster at least 4-weeks after

44. How much folate and for How long should a woman take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception

45. What is HI law for booster seat?

46. What is the schedule for MMR vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Smoking - Alcoholism

47. When is area of induration > 10 mm considered TB positive?
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
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

48. What is the schedule for polio vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs

49. What are some RFs for DMT2?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Start at 20 for all M and W regardless of RFs

50. What are the USPSTF guidelines for mammogram?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Women 55 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years