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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 HI law for booster seat?

2. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Breast CA - thromboembolic event - stroke and CAD
1200 mg/day
Persons with no known risk factors

3. What is the schedule for Gardasil?
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.
In adults with sustained BP > 135/80 mmHg

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

5. What is the schedule for Hep B vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY

6. What tests are appropriate to order in an asymptomatic 57 yo male?
Women 55 - 79 yo
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Total cholesterol - FOBT

7. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
65 (earlier if have increased risk factors)
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

8. What are the guidelines for pap smear?
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)
Adults > 60
In adults with sustained BP > 135/80 mmHg

9. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Adults > 60
Starts at 20 for both M and W
Men 45 - 79 yo
1300 mg/day

10. What are 2 conditions that have been proven to be beneficial to screened for?
Children up to 7 yo and < 5' should be placed in a booster seat.
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism
Persons with no known risk factors

11. What is USPSTF guideline for abdominal aortic aneurysm screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65

12. What is the schedule for DTap vaccine?
Start at 20 for all M and W regardless of RFs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT

13. When should tetanus immunoglobulin be given?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 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

14. What is the USPSTF guideline for chlamydial screening?
Adults > 60
To get IgA protection
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day

15. How much calcium should adolescents (9 -18) take?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

16. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Exercise or physical therapy and vit D for patients > 65

17. What is the schedule for rotavirus vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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)
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

18. When should pregnant women get a flu shot?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
During 2nd - 3rd trimester
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Persons with no known risk factors

19. How much flouride should non military children in the state of HI be given?
Smoking - Alcoholism
HISTORY
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

20. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
4 mg/day
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

21. When can children sit in a booster seat?

22. What type of illnesses does Hib vaccine prevent?
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
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
During 2nd - 3rd trimester
Meningitis and Epiglottitis

23. 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
During 2nd - 3rd trimester
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

24. What is the schedule for Hib vaccine?
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
1300 mg/day
2mo - 4 mo - 6mo and 12-15 mo

25. What can decrease fall in the elderly?
Stroke and DVT
4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication

26. Who should get shingles vaccine?
Adults > 60
Meningitis and Epiglottitis
NEVER
> 2 yo and less than 40 lbs

27. What are the risks of combination HRT?
Femoral neck
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD

28. 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
Adults > 60
Women 55 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

29. If traveling to endemic areas - Why should one get a dose of live vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
To get IgA protection
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

30. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

31. How much calcium should women > 50 take?
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
One dose at 12-15 mod - Booster at least 4-weeks after

32. What kind of polio vaccine is preferred?
Adults > 60
1300 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

33. Unopposed estrogen increases risks for what conditions?
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
Adults > 60
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

34. 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
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
Adults > 60

35. What is the schedule for Hep A vaccine?
NEVER
2mo - 4 mo - 6mo and 12-15 mo
During 2nd - 3rd trimester
12 - 23 mo - 2 doses are to be given 6 mo apart

36. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
800 IU/ 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
Starts at 50 (recommends against starting at 40) and every 2 years

37. Who should get Tdap vaccine and how often?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

38. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
1000 mg/day
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

39. What is the ADA guideline for DMT2 screening?
1000 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
In all W < 24 who are sexually active - In W > 24 with increased risk
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

40. What is the schedule for varicella vaccine?
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
During 2nd - 3rd trimester
Children up to 7 yo and < 5' should be placed in a booster seat.

41. How much vit D should adults > 50 take?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 mg/day

42. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing

43. What is the NCEP III guideline for cholesterol screening?
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'
1300 mg/day

44. Measurement of which anatomic structure is best predictor for hip fracture?
65 (earlier if have increased risk factors)
Femoral neck
More than 15
Persons with no known risk factors

45. What are the guidelines for colon cancer screening?
Every 5 years
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
Persons with no known risk factors
Women 55 - 79 yo

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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
4 mg/day

47. What is the USPSTF guideline for DMT2 screening?
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
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
In all W < 24 who are sexually active - In W > 24 with increased risk

48. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Preschool children : 3-4 yo - Elderly patients: > 65 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm

49. When is area of induration > 5mm considered TB positive?
HISTORY
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Stroke and DVT
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

50. In which group of patients should aspirin be given as primary prevention for stroke?
In adults with sustained BP > 135/80 mmHg
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
Women 55 - 79 yo