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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. Which children should use a semi-upright/forward facing carseat?
Smoking - Alcoholism
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs

2. Measurement of which anatomic structure is best predictor for hip fracture?
During 2nd - 3rd trimester
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

3. What is the schedule for Hep A vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 20 for both M and W

4. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

5. What kind of car seat should children < 2 yo be placed in?
4 mg/day
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing

6. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Exercise - Environmental hazard reduction - Close monitoring of medication
Exercise or physical therapy and vit D for patients > 65
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

7. How much flouride should non military children in the state of HI be given?
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
To get IgA protection
Preschool children : 3-4 yo - Elderly patients: > 65 yo

8. What are 2 conditions that have been proven to be beneficial to screened for?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Smoking - Alcoholism

9. In which group of patients should aspirin be given as primary prevention for MI?
1000 IU/day
Men 45 - 79 yo
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

10. When is intensive individualized home-based intervention recommended?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
Exercise - Environmental hazard reduction - Close monitoring of medication
Rear facing

11. How much calcium should women > 50 take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
1200 mg/day

12. How much vit D should adults < 50 take?
800 IU/ 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
Persons with no known risk factors
Meningitis and Epiglottitis

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

14. 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
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
Children up to 7 yo and < 5' should be placed in a booster seat.

15. In which group of patients should aspirin be given as primary prevention for stroke?
1200 mg/day
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo

16. When should tetanus immunoglobulin be given?
Meningitis and Epiglottitis
BP - Height - Weight
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing

17. How much vit D should adults > 50 take?
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
HISTORY
More than 15
1000 IU/day

18. What is the schedule for MMR vaccine?
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1200 mg/day
Exercise or physical therapy and vit D for patients > 65

19. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 years
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after

20. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day
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)

21. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Exercise - Environmental hazard reduction - Close monitoring of medication

22. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1300 mg/day

23. What are some safety issues you should counsel parents with young children?
When they are > 40 lbs and still less then 5'
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...
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

24. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY

25. When is area of induration > 10 mm considered TB positive?
Start at 20 for all M and W regardless of RFs
800 IU/ day
To get IgA protection
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

26. When can children sit in a booster seat?

27. If traveling to endemic areas - Why should one get a dose of live vaccine?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Meningitis and Epiglottitis
12 - 23 mo - 2 doses are to be given 6 mo apart
To get IgA protection

28. Who are at increased risk for adverse effect catching a flu?
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
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection

29. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

30. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
800 IU/ day
1200 mg/day
HISTORY

31. When is area of induration > 15 mm considered TB positive?
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
4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Persons with no known risk factors

32. What 3 things should always be done in an office visit?
In adults with sustained BP > 135/80 mmHg
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...
Femoral neck
BP - Height - Weight

33. What can decrease fall in the elderly?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise - Environmental hazard reduction - Close monitoring of medication
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

34. What is the schedule for polio vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4mo - 6-18 mo and 4-6 yrs
1200 mg/day

35. How much folate should all women of child bearing age take?
0.4 mg/day
Total cholesterol - FOBT
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...
2mo - 4mo - 6-18 mo and 4-6 yrs

36. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

37. What are some RFs for DMT2?
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

38. 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
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
12 - 23 mo - 2 doses are to be given 6 mo apart
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

39. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
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
0.4 - 0.8 mg/day for 1 month prior to conception

40. 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)
More than 15
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day

41. What is the schedule for Hib vaccine?
Women 55 - 79 yo
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4 mo - 6mo and 12-15 mo

42. What is the most important way to screen for CAD in an asymptomatic patients?
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart

43. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD
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
Stroke and DVT

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

45. How often do asplenic patients receive pneumococcal vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism
Every 5 years
1000 IU/day

46. Unopposed estrogen increases risks for what conditions?
800 IU/ day
One time abdominal X-ray for all MALES who ever SMOKES
Stroke and DVT
2mo - 4 mo - 6mo and 12-15 mo

47. What is the schedule for DTap vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men 45 - 79 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

48. When should chest X-ray be used for screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Every 5 years
1000 mg/day
NEVER

49. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
When they are > 40 lbs and still less then 5'
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

50. What kind of sunscreen SPF is recommended for sun protection?
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...
More than 15
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Femoral neck