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. In which group of patients should aspirin be given as primary prevention for MI?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
To get IgA protection

2. If traveling to endemic areas - Why should one get a dose of live 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
800 IU/ day
To get IgA protection

3. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

4. What are 2 conditions that have been proven to be beneficial to screened for?
1000 IU/day
Smoking - Alcoholism
12 - 23 mo - 2 doses are to be given 6 mo apart
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

5. What are the USPSTF guidelines for mammogram?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 50 (recommends against starting at 40) and every 2 years

6. When should Gardasil be given and for what purposes?
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 45 - 79 yo
1200 mg/day
Forearm

7. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased 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
Smoking - Alcoholism

8. When is intensive individualized home-based intervention recommended?
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

9. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication

10. In which group of patients should aspirin be given as primary prevention for stroke?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
Women 55 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. What is the USPSTF guideline for chlamydial screening?
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
Men 45 - 79 yo

12. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Every 5 years
1000 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day

13. What is the schedule for Hep A vaccine?
Men 45 - 79 yo
4 mg/day
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
12 - 23 mo - 2 doses are to be given 6 mo apart

14. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Forearm
1200 mg/day
> 2 yo and less than 40 lbs

15. 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)
Adults > 60
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight

16. What are some safety issues you should counsel parents with young children?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT

17. How much calcium should women > 50 take?
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

18. 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
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Total cholesterol - FOBT

19. What are the guidelines for visual screening?
Forearm
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children up to 7 yo and < 5' should be placed in a booster seat.
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

20. What tests are appropriate to order in an asymptomatic 57 yo male?
Smoking - Alcoholism
Starts at 20 for both M and W
Total cholesterol - FOBT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

21. What are the risks of combination HRT?
One time abdominal X-ray for all MALES who ever SMOKES
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Breast CA - thromboembolic event - stroke and CAD
More than 15

22. How much vit D should adults > 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
1000 IU/day

23. What are some risk factors for CAD?
One time abdominal X-ray for all MALES who ever SMOKES
1300 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

24. What is HI law for booster seat?

25. How much folate should all women of child bearing age take?
0.4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after

26. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
Men 45 - 79 yo

27. How much vit D should adults < 50 take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

28. When is area of induration > 10 mm considered TB positive?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

29. What is USPSTF guideline for abdominal aortic aneurysm screening?
Stroke and DVT
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg
One time abdominal X-ray for all MALES who ever SMOKES

30. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
During 2nd - 3rd trimester
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
Persons with no known risk factors

31. How much calcium should adults (19 - 50) take?
1000 mg/day
Femoral neck
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years

32. What is the NCEP III guideline for cholesterol screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 - 0.8 mg/day for 1 month prior to conception
Start at 20 for all M and W regardless of RFs
1000 mg/day

33. How much calcium should adolescents (9 -18) take?
1300 mg/day
Adults > 60
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

34. When should pregnant women get a flu shot?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
During 2nd - 3rd trimester
More than 15
Children up to 7 yo and < 5' should be placed in a booster seat.

35. Unopposed estrogen increases risks for what conditions?
Total cholesterol - FOBT
Women 55 - 79 yo
Stroke and DVT
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)

36. How much folate and for How long should a woman take for planned pregnancy?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men 45 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

37. At what age should women have DEXA scan?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
Starts at 20 for both M and W

38. Who should get shingles vaccine?
Adults > 60
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65

39. 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)
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

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

41. What are the guidelines for colon cancer 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
Preschool children : 3-4 yo - Elderly patients: > 65 yo

42. What is the schedule for polio vaccine?
1000 IU/day
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester
BP - Height - Weight

43. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
When they are > 40 lbs and still less then 5'
Forearm

44. How often do asplenic patients receive pneumococcal vaccine?
1300 mg/day
65 (earlier if have increased risk factors)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Every 5 years

45. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
To get IgA protection
Adults > 60
When they are > 40 lbs and still less then 5'

46. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs

47. 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
In adults with sustained BP > 135/80 mmHg
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

48. Which children should use a semi-upright/forward facing carseat?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
> 2 yo and less than 40 lbs
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
1000 IU/day

49. Who should get Tdap vaccine and how often?
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
0.4 - 0.8 mg/day for 1 month prior to conception
Breast CA - thromboembolic event - stroke and CAD

50. What is the ADA guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 20 for both M and W
Smoking - Alcoholism