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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. When is area of induration > 15 mm considered TB positive?
One dose at 12-15 mod - Booster at least 4-weeks after
Persons with no known risk factors
4 mg/day
When they are > 40 lbs and still less then 5'

2. When should Gardasil be given and for what purposes?
Women 55 - 79 yo
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
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

3. Measurement of which anatomic structure is best predictor for hip fracture?
Every 5 years
Meningitis and Epiglottitis
Femoral neck
1000 mg/day

4. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
> 2 yo and less than 40 lbs
1000 IU/day
4 mg/day
0.4 mg/day

5. How much calcium should women > 50 take?
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
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

6. What is the most important way to screen for CAD in an asymptomatic patients?
BP - Height - Weight
65 (earlier if have increased risk factors)
HISTORY
Adults > 60

7. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

8. How much folate should all women of child bearing age take?
0.4 mg/day
NEVER
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

9. What kind of polio vaccine is preferred?
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs

10. When is area of induration > 5mm considered TB positive?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. What is the USPSTF guideline for chlamydial screening?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
In all W < 24 who are sexually active - In W > 24 with increased risk

12. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors

13. How much vit D should adults > 50 take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day
When they are > 40 lbs and still less then 5'
In all W < 24 who are sexually active - In W > 24 with increased risk

14. What kind of sunscreen SPF is recommended for sun protection?
More than 15
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Every 5 years

15. What are the guidelines for visual 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

16. What is the schedule for varicella vaccine?
0.4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One dose at 12-15 mod - Booster at least 4-weeks after
65 (earlier if have increased risk factors)

17. What type of illnesses does Hib vaccine prevent?
BP - Height - Weight
Meningitis and Epiglottitis
Every 5 years
To get IgA protection

18. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Persons with no known risk factors
Starts at 20 for both M and W

19. When is area of induration > 10 mm considered TB positive?
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)
1300 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
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

20. Which children should use a semi-upright/forward facing carseat?
0.4 - 0.8 mg/day for 1 month prior to conception
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
Total cholesterol - FOBT
> 2 yo and less than 40 lbs

21. What is the USPSTF guideline for fall prevention in the elderly?
Femoral neck
Exercise or physical therapy and vit D for patients > 65
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...
Stroke and DVT

22. When should tetanus immunoglobulin be given?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
4 mg/day

23. What is the schedule for rotavirus vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
When they are > 40 lbs and still less then 5'
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

24. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
> 2 yo and less than 40 lbs
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

25. When is intensive individualized home-based intervention recommended?
1000 IU/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 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

26. What 3 things should always be done in an office visit?
1000 IU/day
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
BP - Height - Weight

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

28. What is the ADA guideline for DMT2 screening?
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 time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

29. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

30. How much calcium should adults (19 - 50) take?
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...
Total cholesterol - FOBT
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

31. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Rear facing
Every 5 years

32. 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 20 for both M and W
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Start at 20 for all M and W regardless of RFs

33. Who should get Tdap vaccine and how often?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
4 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

34. What can decrease fall in the elderly?
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT
More than 15

35. Who should get shingles vaccine?
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day
Smoking - Alcoholism

36. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

37. In which group of patients should aspirin be given as primary prevention for stroke?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Women 55 - 79 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
BP - Height - Weight

38. How much vit D should adults < 50 take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Smoking - Alcoholism

39. What is the NCEP III guideline for cholesterol screening?
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs
1000 IU/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

40. When can children sit in a booster seat?

41. What are the guidelines for colon cancer screening?
Every 5 years
1200 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. What is the schedule for MMR vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

43. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise - Environmental hazard reduction - Close monitoring of medication
When they are > 40 lbs and still less then 5'
Rear facing

44. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

45. How often do asplenic patients receive pneumococcal vaccine?
Stroke and DVT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Every 5 years

46. What are some RFs for DMT2?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
Adults > 60
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

47. What are 2 conditions that have been proven to be beneficial to screened for?
> 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
Smoking - Alcoholism
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

48. Unopposed estrogen increases risks for what conditions?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
Stroke and DVT

49. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

50. Some contraindications for aspirin
Starts at 20 for both M and W
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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