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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 most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
One dose at 12-15 mod - Booster at least 4-weeks after
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)

2. 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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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...

3. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
BP - Height - Weight

4. What is the schedule for DTap vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

5. What kind of car seat should children < 2 yo be placed in?
During 2nd - 3rd trimester
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing

6. 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)
In adults with sustained BP > 135/80 mmHg
NEVER
65 (earlier if have increased risk factors)

7. Which children should use a semi-upright/forward facing carseat?
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
> 2 yo and less than 40 lbs
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)

8. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 50 (recommends against starting at 40) and every 2 years
Every 5 years
Starts at 20 for both M and W
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

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

10. What kind of sunscreen SPF is recommended for sun protection?
Men 45 - 79 yo
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY

11. When can children sit in a booster seat?

12. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
12 - 23 mo - 2 doses are to be given 6 mo apart

13. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Every 5 years
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

14. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Persons with no known risk factors
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication

16. When is area of induration > 10 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Adults > 60

17. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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)
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

18. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

19. Some contraindications for aspirin
> 2 yo and less than 40 lbs
0.4 mg/day
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. What type of illnesses does Hib vaccine prevent?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1300 mg/day
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)

21. How much vit D should adults > 50 take?
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
1000 IU/day
1300 mg/day

22. What is HI law for booster seat?

23. What are the guidelines for visual screening?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo

24. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
When they are > 40 lbs and still less then 5'
0.4 - 0.8 mg/day for 1 month prior to conception
Forearm
Femoral neck

25. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children up to 7 yo and < 5' should be placed in a booster seat.

26. What is USPSTF guideline for abdominal aortic aneurysm screening?
Meningitis and Epiglottitis
Starts at 20 for both M and W
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES

27. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Persons with no known risk factors
One time abdominal X-ray for all MALES who ever SMOKES

28. In which group of patients should aspirin be given as primary prevention for MI?
Children up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day
Men 45 - 79 yo
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

29. What 3 things should always be done in an office visit?
Starts at 50 (recommends against starting at 40) and every 2 years
BP - Height - Weight
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

30. Who should get shingles vaccine?
Adults > 60
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

31. At what age should women have DEXA scan?
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
65 (earlier if have increased risk factors)
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

32. What are the risks of combination HRT?
Starts at 20 for both M and W
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

33. How much fluoride should military children in HI be given?
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

34. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65
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

35. Unopposed estrogen increases risks for what conditions?
During 2nd - 3rd trimester
4 mg/day
Stroke and DVT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

36. When should Gardasil be given and for what purposes?
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
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

37. How much calcium should adults (19 - 50) take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
1000 mg/day

38. How often do asplenic patients receive pneumococcal vaccine?
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
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)
Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. When should tetanus immunoglobulin be given?
Starts at 20 for both M and W
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
Children up to 7 yo and < 5' should be placed in a booster seat.

40. When is area of induration > 5mm considered TB positive?
Forearm
Starts at 50 (recommends against starting at 40) and every 2 years
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

41. Who should get Tdap vaccine and how often?
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
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
Forearm
Total cholesterol - FOBT

42. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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
0.4 - 0.8 mg/day for 1 month prior to conception
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...

43. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

44. How much folate should all women of child bearing age take?
0.4 mg/day
800 IU/ day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years

45. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1000 mg/day

46. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo - 6mo and 12-15 mo

47. What tests are appropriate to order in an asymptomatic 57 yo male?
NEVER
Total cholesterol - FOBT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

48. What kind of polio vaccine is preferred?
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)
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

49. How much calcium should women > 50 take?
When they are > 40 lbs and still less then 5'
1200 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing

50. How much calcium should adolescents (9 -18) take?
Children up to 7 yo and < 5' should be placed in a booster seat.
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day