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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 are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
In all W < 24 who are sexually active - In W > 24 with increased risk

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
During 2nd - 3rd trimester
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 age 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years

3. Who are at increased risk for adverse effect catching a flu?
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
BP - Height - Weight

4. Which children should use a semi-upright/forward facing carseat?
Smoking - Alcoholism
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs
2mo - 4 mo - 6mo and 12-15 mo

5. What is the schedule for Hep A vaccine?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

6. What are the guidelines for colon cancer screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

7. When is area of induration > 5mm considered TB positive?
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
In adults with sustained BP > 135/80 mmHg
Start at 20 for all M and W regardless of RFs
BP - Height - Weight

8. What is the USPSTF guideline for chlamydial screening?
1000 IU/day
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk

9. What kind of car seat should children < 2 yo be placed in?
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4mo - 6-18 mo and 4-6 yrs
When they are > 40 lbs and still less then 5'

10. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Femoral neck
One dose at 12-15 mod - Booster at least 4-weeks after
Rear facing

11. When should the meningococcal vaccine be given and to which group?
Total cholesterol - FOBT
65 (earlier if have increased risk factors)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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. When is area of induration > 10 mm considered TB positive?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and 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
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

13. How much calcium should women > 50 take?
1200 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
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
Stroke and DVT

14. Measurement of which anatomic structure is best predictor for hip fracture?
HISTORY
Femoral neck
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD

15. What are the guidelines for pap smear?
Exercise or physical therapy and vit D for patients > 65
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)
Rear facing

16. What is the NCEP III guideline for cholesterol screening?
1000 mg/day
Start at 20 for all M and W regardless of RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
Persons with no known risk factors

17. What is the schedule for varicella vaccine?
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)
One dose at 12-15 mod - Booster at least 4-weeks after
Preschool children : 3-4 yo - Elderly patients: > 65 yo
During 2nd - 3rd trimester

18. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

19. How much calcium should adolescents (9 -18) take?
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
1300 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Starts at 20 for both M and W

20. What kind of polio vaccine is preferred?
1300 mg/day
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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

21. Who should get shingles vaccine?
Persons with no known risk factors
Women 55 - 79 yo
Adults > 60
When they are > 40 lbs and still less then 5'

22. What is the ADA guideline for DMT2 screening?
Rear facing
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)
One dose at 12-15 mod - Booster at least 4-weeks after

23. How much vit D should adults > 50 take?
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo - 6mo and 12-15 mo
BP - Height - Weight

24. How much calcium should adults (19 - 50) take?
65 (earlier if have increased risk factors)
1000 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Preschool children : 3-4 yo - Elderly patients: > 65 yo

25. When can children sit in a booster seat?

26. What kind of sunscreen SPF is recommended for sun protection?
More than 15
1200 mg/day
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

27. When is intensive individualized home-based intervention recommended?
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
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

28. Who should get Tdap vaccine and how often?
Adults > 60
Smoking - Alcoholism
Meningitis and Epiglottitis
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. When should chest X-ray be used for screening?
1000 IU/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
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs

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

31. What are the risks of combination HRT?
Stroke and DVT
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
NEVER

32. What are some safety issues you should counsel parents with young children?
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
When they are > 40 lbs and still less then 5'
One dose at 12-15 mod - Booster at least 4-weeks after
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...

33. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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. How much vit D should adults < 50 take?
NEVER
Breast CA - thromboembolic event - stroke and CAD
800 IU/ day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

35. At what age should women have DEXA scan?
Rear facing
65 (earlier if have increased risk factors)
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

36. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

37. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart

38. What is HI law for booster seat?

39. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Meningitis and Epiglottitis
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
Breast CA - thromboembolic event - stroke and CAD

40. What is the schedule for MMR vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4mo - 6-18 mo and 4-6 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Breast CA - thromboembolic event - stroke and CAD

41. What is the schedule for polio vaccine?
When they are > 40 lbs and still less then 5'
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
1200 mg/day

42. What are some risk factors for CAD?
Exercise or physical therapy and vit D for patients > 65
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15
Breast CA - thromboembolic event - stroke and CAD

43. When is area of induration > 15 mm considered TB positive?
65 (earlier if have increased risk factors)
Persons with no known risk factors
1000 IU/day
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

44. What is the schedule for DTap vaccine?
Every 5 years
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 45 - 79 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

45. 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
Women 55 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise - Environmental hazard reduction - Close monitoring of medication

46. Unopposed estrogen increases risks for what conditions?
Exercise or physical therapy and vit D for patients > 65
Stroke and DVT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism

47. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
4 mg/day

48. What is the USPSTF guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

49. If traveling to endemic areas - Why should one get a dose of live vaccine?
HISTORY
Every 5 years
NEVER
To get IgA protection

50. How often do asplenic patients receive pneumococcal vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Every 5 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound