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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 Hib vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Persons with no known risk factors

2. How much vit D should adults < 50 take?
Smoking - Alcoholism
800 IU/ day
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)

3. When should the meningococcal vaccine be given and to which group?
Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 IU/day

4. What is the NCEP III guideline for cholesterol screening?
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
4 mg/day

5. Who should get Tdap vaccine and how often?
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 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
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. What can decrease fall in the elderly?
Stroke and DVT
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
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

7. When is intensive individualized home-based intervention recommended?
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
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
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day

8. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day
Total cholesterol - FOBT

9. How much folate should all women of child bearing age take?
Women 55 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
0.4 mg/day

10. What is the USPSTF guideline for DMT2 screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Every 5 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...
In adults with sustained BP > 135/80 mmHg

11. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 20 for both M and W
4 mg/day

12. In which group of patients should aspirin be given as primary prevention for MI?
1300 mg/day
Men 45 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day

13. How much vit D should adults > 50 take?
In adults with sustained BP > 135/80 mmHg
Stroke and DVT
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
1000 IU/day

14. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Every 5 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
HISTORY

15. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT
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 20 for both M and W

16. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm
Total cholesterol - FOBT
0.4 mg/day

17. In which group of patients should aspirin be given as primary prevention for stroke?
Forearm
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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

18. How much flouride should non military children in the state of HI be given?
Stroke and DVT
Forearm
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

19. What kind of car seat should children < 2 yo be placed in?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day

20. What kind of polio vaccine is preferred?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 IU/day
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

21. What is the schedule for Hep B vaccine?
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

22. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day
Forearm

23. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 yrs

24. What is the most important way to screen for CAD in an asymptomatic patients?
More than 15
65 (earlier if have increased risk factors)
HISTORY
4 mg/day

25. When should chest X-ray be used for screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Start at 20 for all M and W regardless of RFs
NEVER

26. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
In adults with sustained BP > 135/80 mmHg

27. 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
Every 5 years
Femoral neck
Persons with no known risk factors

28. How much calcium should adults (19 - 50) take?
1200 mg/day
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...
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day

29. What is the schedule for varicella vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

30. What kind of sunscreen SPF is recommended for sun protection?
800 IU/ day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
More than 15
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

31. How much folate and for How long should a woman take for planned pregnancy?
Total cholesterol - FOBT
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
800 IU/ day

32. How often do asplenic patients receive pneumococcal vaccine?
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo

33. How much calcium should women > 50 take?
1200 mg/day
To get IgA protection
Stroke and DVT
2mo - 4mo - 6-18 mo and 4-6 yrs

34. What is the ADA guideline for DMT2 screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise or physical therapy and vit D for patients > 65

35. What are the USPSTF guidelines for mammogram?
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

36. What is the schedule for DTap vaccine?
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
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

37. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

38. Which children should use a semi-upright/forward facing carseat?
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. What is the schedule for rotavirus vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
BP - Height - Weight

40. When should pregnant women get a flu shot?
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
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

41. Some contraindications for aspirin
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
During 2nd - 3rd trimester
In adults with sustained BP > 135/80 mmHg

42. 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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One dose at 12-15 mod - Booster at least 4-weeks after

43. How much calcium should adolescents (9 -18) take?
1300 mg/day
> 2 yo and less than 40 lbs
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 - Environmental hazard reduction - Close monitoring of medication

44. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after

45. When can children sit in a booster seat?

46. What are some risk factors for CAD?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

47. Who should get shingles vaccine?
Adults > 60
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
More than 15

48. What is HI law for booster seat?

49. What are the guidelines for pap smear?
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
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
HISTORY

50. What are some safety issues you should counsel parents with young children?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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...
4 mg/day