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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 USPSTF guideline for DMT2 screening?
1200 mg/day
In adults with sustained BP > 135/80 mmHg
0.4 mg/day
> 2 yo and less than 40 lbs

2. What is the USPSTF guideline for fall prevention in the elderly?
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...
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

3. How much calcium should adolescents (9 -18) take?
One dose at 12-15 mod - Booster at least 4-weeks after
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD
4 mg/day

4. What is the schedule for Gardasil?
Persons with no known risk factors
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

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

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6. When should tetanus immunoglobulin be given?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
When they are > 40 lbs and still less then 5'
Femoral neck

7. When is intensive individualized home-based intervention recommended?
1200 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
Children up to 7 yo and < 5' should be placed in a booster seat.
In all W < 24 who are sexually active - In W > 24 with increased risk

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

9. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Stroke and DVT
HISTORY
1300 mg/day
4 mg/day

10. What is the schedule for rotavirus vaccine?
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
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

11. What is the USPSTF guideline for chlamydial screening?
4 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
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk

12. In which group of patients should aspirin be given as primary prevention for stroke?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
Preschool children : 3-4 yo - Elderly patients: > 65 yo

13. What are the USPSTF guidelines for mammogram?
Starts at 20 for both M and W
Starts at 50 (recommends against starting at 40) and every 2 years
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
4 mg/day

14. What is USPSTF guideline for abdominal aortic aneurysm screening?
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
One time abdominal X-ray for all MALES who ever SMOKES
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)
BP - Height - Weight

15. What are the guidelines for colon cancer screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
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
1000 IU/day

16. What kind of sunscreen SPF is recommended for sun protection?
In all W < 24 who are sexually active - In W > 24 with increased risk
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
More than 15

17. At what age should women have DEXA scan?
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
65 (earlier if have increased risk factors)
1200 mg/day

18. When should pregnant women get a flu shot?
4 mg/day
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
During 2nd - 3rd trimester

19. Unopposed estrogen increases risks for what conditions?
Breast CA - thromboembolic event - stroke and CAD
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
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. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Femoral neck
1300 mg/day
Stroke and DVT

21. 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)
NEVER
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

22. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
During 2nd - 3rd trimester
Persons with no known risk factors

23. When is area of induration > 5mm considered TB positive?
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
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
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

24. What is the schedule for varicella vaccine?
Rear facing
Persons with no known risk factors
One dose at 12-15 mod - Booster at least 4-weeks after
In all W < 24 who are sexually active - In W > 24 with increased risk

25. When should Gardasil be given and for what purposes?
Total cholesterol - FOBT
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 < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs

26. What 3 things should always be done in an office visit?
BP - Height - Weight
Femoral neck
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

27. When is area of induration > 10 mm considered TB positive?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

28. What can decrease fall in the elderly?
To get IgA protection
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
Start at 20 for all M and W regardless of RFs
Exercise - Environmental hazard reduction - Close monitoring of medication

29. What are the guidelines for visual screening?
Starts at 50 (recommends against starting at 40) and every 2 years
Persons with no known risk factors
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

30. 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
65 (earlier if have increased risk factors)
Exercise - Environmental hazard reduction - Close monitoring of medication
In adults with sustained BP > 135/80 mmHg

31. What are some safety issues you should counsel parents with young children?
12 - 23 mo - 2 doses are to be given 6 mo apart
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...
Every 5 years
0.4 mg/day

32. What is the schedule for polio vaccine?
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
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

33. How much vit D should adults > 50 take?
To get IgA protection
1000 IU/day
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 45 - 79 yo

34. How much calcium should adults (19 - 50) take?
1000 mg/day
More than 15
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)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

35. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
> 2 yo and less than 40 lbs

36. 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
Every 5 years
> 2 yo and less than 40 lbs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

37. Who should get shingles vaccine?
4 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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Adults > 60

38. How much flouride should non military children in the state of HI be given?
Adults > 60
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Smoking - Alcoholism
In adults with sustained BP > 135/80 mmHg

39. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Rear facing
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day

40. Which children should use a semi-upright/forward facing carseat?
Meningitis and Epiglottitis
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
In adults with sustained BP > 135/80 mmHg

41. What type of illnesses does Hib vaccine prevent?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Adults > 60

42. What is HI law for booster seat?

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43. What is the most important way to screen for CAD in an asymptomatic patients?
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
1200 mg/day
HISTORY

44. How often do asplenic patients receive pneumococcal 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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years

45. When should the meningococcal vaccine be given and to which group?
Persons with no known risk factors
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise - Environmental hazard reduction - Close monitoring of medication
Start at 20 for all M and W regardless of RFs

46. What is the NCEP III guideline for cholesterol screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
4 mg/day
Breast CA - thromboembolic event - stroke and CAD

47. How much vit D should adults < 50 take?
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
Total cholesterol - FOBT
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

48. What kind of car seat should children < 2 yo be placed in?
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)
Rear facing
Men 45 - 79 yo
Forearm

49. How much folate should all women of child bearing age take?
1200 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 mg/day
Men 45 - 79 yo

50. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
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