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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 visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
Meningitis and Epiglottitis
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

2. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 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
One dose at 12-15 mod - Booster at least 4-weeks after

3. What is the USPSTF guideline for chlamydial 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
Persons with no known risk factors
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk

4. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Men 45 - 79 yo
1200 mg/day
Breast CA - thromboembolic event - stroke and CAD

5. What is the NCEP III guideline for cholesterol screening?
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
Start at 20 for all M and W regardless of RFs
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

6. What are some safety issues you should counsel parents with young children?
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
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...
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

7. What are the USPSTF guidelines for mammogram?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)

8. What are the risks of combination HRT?
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD
Rear facing

9. Which children should use a semi-upright/forward facing carseat?
Children up to 7 yo and < 5' should be placed in a booster seat.
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
Women 55 - 79 yo

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

11. In which group of patients should aspirin be given as primary prevention for MI?
65 (earlier if have increased risk factors)
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

12. What can decrease fall in the elderly?
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

13. If traveling to endemic areas - Why should one get a dose of live 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
To get IgA protection

14. What is the schedule for MMR vaccine?
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

15. Who should get Tdap vaccine and how often?
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
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

16. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
800 IU/ 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

17. What kind of polio vaccine is preferred?
More than 15
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...
Breast CA - thromboembolic event - stroke and CAD

18. What are some RFs for DMT2?
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
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
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

19. When should pregnant women get a flu shot?
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
During 2nd - 3rd trimester
Every 5 years

20. How much calcium should women > 50 take?
1200 mg/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
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

21. When is area of induration > 10 mm considered TB positive?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after
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. What is the USPSTF guideline for fall prevention in the elderly?
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
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
Exercise or physical therapy and vit D for patients > 65

23. How much folate should all women of child bearing age take?
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
1200 mg/day

24. Measurement of which anatomic structure is best predictor for hip fracture?
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
One dose at 12-15 mod - Booster at least 4-weeks after

25. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Meningitis and Epiglottitis

26. How much folate and for How long should a woman take for planned pregnancy?
Every 5 years
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
0.4 - 0.8 mg/day for 1 month prior to conception

27. What kind of car seat should children < 2 yo be placed in?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
Men 45 - 79 yo
Rear facing

28. When can children sit in a booster seat?

29. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

30. What are the guidelines for pap smear?
1300 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)
In all W < 24 who are sexually active - In W > 24 with increased risk
BP - Height - Weight

31. At what age should women have DEXA scan?
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day
65 (earlier if have increased risk factors)
Children up to 7 yo and < 5' should be placed in a booster seat.

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
Forearm

33. How much flouride should non military children in the state of HI be given?
During 2nd - 3rd trimester
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo

34. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Start at 20 for all M and W regardless of RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight

35. What kind of sunscreen SPF is recommended for sun protection?
1000 IU/day
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
More than 15
Starts at 20 for both M and W

36. When should chest X-ray be used for screening?
NEVER
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
One time abdominal X-ray for all MALES who ever SMOKES

37. 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
Rear facing
Women 55 - 79 yo
Stroke and DVT

38. How often do asplenic patients receive pneumococcal vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
NEVER
Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. What are 2 conditions that have been proven to be beneficial to screened for?
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
Femoral neck
Smoking - Alcoholism
1300 mg/day

40. How much calcium should adults (19 - 50) take?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
Femoral neck
1000 mg/day

41. When should Gardasil be given and for what purposes?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
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
4 mg/day

42. What is the most important way to screen for CAD in an asymptomatic patients?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day

43. How much vit D should adults > 50 take?
Adults > 60
1000 IU/day
0.4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

44. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

45. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65

46. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
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)

47. What is HI law for booster seat?

48. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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)
800 IU/ day
Stroke and DVT

49. What is USPSTF guideline for abdominal aortic aneurysm screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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)
One time abdominal X-ray for all MALES who ever SMOKES
Femoral neck

50. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
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