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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. If traveling to endemic areas - Why should one get a dose of live vaccine?
1200 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

2. What kind of sunscreen SPF is recommended for sun protection?
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Total cholesterol - FOBT

3. When should chest X-ray be used for screening?
> 2 yo and less than 40 lbs
2mo - 4 mo - 6mo and 12-15 mo
NEVER
Men 45 - 79 yo

4. What kind of polio vaccine is preferred?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

5. 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
65 (earlier if have increased risk factors)

6. How much calcium should adolescents (9 -18) take?
Rear facing
1200 mg/day
Smoking - Alcoholism
1300 mg/day

7. How much fluoride should military children in HI be given?
0.4 mg/day
1000 IU/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

8. What is the schedule for rotavirus vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors

9. When should Gardasil be given and for what purposes?
0.4 - 0.8 mg/day for 1 month prior to conception
Adults > 60
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

10. How much folate and for How long should a woman take for planned pregnancy?
Femoral neck
Start at 20 for all M and W regardless of RFs
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

11. Unopposed estrogen increases risks for what conditions?
> 2 yo and less than 40 lbs
Stroke and DVT
Smoking - Alcoholism
To get IgA protection

12. When should tetanus immunoglobulin be given?
0.4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Every 5 years

13. What are the risks of combination HRT?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
0.4 - 0.8 mg/day for 1 month prior to conception
Forearm
1000 mg/day
0.4 mg/day

15. In which group of patients should aspirin be given as primary prevention for MI?
> 2 yo and less than 40 lbs
Men 45 - 79 yo
Women 55 - 79 yo
Every 5 years

16. How much folate should all women of child bearing age take?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Stroke and DVT
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

17. How much calcium should women > 50 take?
1300 mg/day
1200 mg/day
65 (earlier if have increased risk factors)
When they are > 40 lbs and still less then 5'

18. When is intensive individualized home-based intervention recommended?
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck
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

19. 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
Total cholesterol - FOBT
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

20. What are 2 conditions that have been proven to be beneficial to screened for?
Men 45 - 79 yo
Femoral neck
Smoking - Alcoholism
One dose at 12-15 mod - Booster at least 4-weeks after

21. What is the USPSTF guideline for DMT2 screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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 adults with sustained BP > 135/80 mmHg
More than 15

22. Who should get shingles vaccine?
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
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
Adults > 60

23. Who are at increased risk for adverse effect catching a flu?
2mo - 4 mo - 6mo and 12-15 mo
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
1000 mg/day

24. What tests are appropriate to order in an asymptomatic 57 yo male?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT

25. What are some RFs for DMT2?
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

26. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

27. What are some risk factors for CAD?
In all W < 24 who are sexually active - In W > 24 with increased risk
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60
When they are > 40 lbs and still less then 5'

28. What are the guidelines for visual screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk
Preschool children : 3-4 yo - Elderly patients: > 65 yo

29. What is the schedule for MMR vaccine?
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

30. What 3 things should always be done in an office visit?
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'

31. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 50 (recommends against starting at 40) and every 2 years
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
To get IgA protection

32. When should pregnant women get a flu shot?
Start at 20 for all M and W regardless of 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
During 2nd - 3rd trimester
Rear facing

33. What are the guidelines for pap smear?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)

34. What can decrease fall in the elderly?
Every 5 years
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception
Stroke and DVT

35. At what age should women have DEXA scan?
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...
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
HISTORY
65 (earlier if have increased risk factors)

36. How much calcium should adults (19 - 50) take?
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 - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day

37. How much vit D should adults > 50 take?
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Meningitis and Epiglottitis
Adults > 60

38. What is the schedule for Hib vaccine?
To get IgA protection
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years

39. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
800 IU/ 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...
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

40. What is HI law for booster seat?

41. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
4 mg/day
> 2 yo and less than 40 lbs
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

42. In which group of patients should aspirin be given as primary prevention for stroke?
Persons with no known risk factors
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
Children up to 7 yo and < 5' should be placed in a booster seat.

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

44. When can children sit in a booster seat?

45. What type of illnesses does Hib vaccine prevent?
Smoking - Alcoholism
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

46. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Women 55 - 79 yo
1000 IU/day
Starts at 50 (recommends against starting at 40) and every 2 years

47. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Starts at 50 (recommends against starting at 40) and every 2 years

48. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

49. What is the most important way to screen for CAD in an asymptomatic patients?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
Exercise - Environmental hazard reduction - Close monitoring of medication
HISTORY

50. What is the USPSTF guideline for fall prevention in the elderly?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg