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. When should chest X-ray be used for screening?
Men 45 - 79 yo
Starts at 20 for both M and W
Smoking - Alcoholism
NEVER

2. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
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)
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

3. What 3 things should always be done in an office visit?
BP - Height - Weight
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
Stroke and DVT
12 - 23 mo - 2 doses are to be given 6 mo apart

4. How much folate and for How long should a woman take for planned pregnancy?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'
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 - 0.8 mg/day for 1 month prior to conception

5. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
> 2 yo and less than 40 lbs
65 (earlier if have increased risk factors)

6. How much flouride should non military children in the state of HI be given?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
In all W < 24 who are sexually active - In W > 24 with increased risk

7. How much calcium should adults (19 - 50) take?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
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

8. What is the schedule for rotavirus vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

9. 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
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

10. Some contraindications for aspirin
Meningitis and Epiglottitis
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 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

11. When can children sit in a booster seat?

12. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

13. How much folate should all women of child bearing age take?
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after

14. What is the schedule for varicella vaccine?
HISTORY
Meningitis and Epiglottitis
One dose at 12-15 mod - Booster at least 4-weeks after
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. At what age should women have DEXA scan?
Rear facing
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
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

16. What are some safety issues you should counsel parents with young children?
One dose at 12-15 mod - Booster at least 4-weeks after
Preschool children : 3-4 yo - Elderly patients: > 65 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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...

17. What is the schedule for Hib vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

18. What kind of sunscreen SPF is recommended for sun protection?
Start at 20 for all M and W regardless of RFs
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
4 mg/day
More than 15

19. When should pregnant women get a flu shot?
Exercise - Environmental hazard reduction - Close monitoring of medication
During 2nd - 3rd trimester
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

20. 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
BP - Height - Weight
NEVER
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

21. What type of illnesses does Hib vaccine prevent?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Meningitis and Epiglottitis
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men 45 - 79 yo

22. What is the most important way to screen for CAD in an asymptomatic patients?
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)
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

23. What are the guidelines for visual screening?
800 IU/ 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)
Exercise or physical therapy and vit D for patients > 65
Preschool children : 3-4 yo - Elderly patients: > 65 yo

24. What is the schedule for Gardasil?
Rear facing
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Total cholesterol - FOBT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

26. How often do asplenic patients receive pneumococcal vaccine?
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)
When they are > 40 lbs and still less then 5'
> 2 yo and less than 40 lbs
Every 5 years

27. 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
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 dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

28. How much calcium should women > 50 take?
Start at 20 for all M and W regardless of RFs
1200 mg/day
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo

29. When is area of induration > 5mm considered TB positive?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
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

30. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Forearm
Breast CA - thromboembolic event - stroke and CAD

31. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
HISTORY
In adults with sustained BP > 135/80 mmHg
Femoral neck
Forearm

32. What is HI law for booster seat?

33. When should the meningococcal vaccine be given and to which group?
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs

34. When should Gardasil be given and for what purposes?
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
Total cholesterol - FOBT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

35. Measurement of which anatomic structure is best predictor for hip fracture?
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
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...
Femoral neck
When they are > 40 lbs and still less then 5'

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

37. What is the schedule for MMR vaccine?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

38. What are some RFs for DMT2?
2mo - 4mo - 6-18 mo and 4-6 yrs
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 degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
65 (earlier if have increased risk factors)

39. When is intensive individualized home-based intervention recommended?
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
Men 45 - 79 yo
BP - Height - Weight

40. In which group of patients should aspirin be given as primary prevention for MI?
Adults > 60
HISTORY
Men 45 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

41. In which group of patients should aspirin be given as primary prevention for stroke?
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo

42. Who should get shingles vaccine?
Adults > 60
Stroke and DVT
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

43. What are 2 conditions that have been proven to be beneficial to screened for?
Adults > 60
Smoking - Alcoholism
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 mg/day

44. What are the guidelines for colon cancer screening?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
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

45. What kind of polio vaccine is preferred?
Rear facing
More than 15
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT

46. How much calcium should adolescents (9 -18) take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
1300 mg/day
In adults with sustained BP > 135/80 mmHg

47. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day
To get IgA protection

48. What is the USPSTF guideline for chlamydial screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs

49. What can decrease fall in the elderly?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
65 (earlier if have increased risk factors)
4 mg/day

50. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1300 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
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo