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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. How much folate should all women of child bearing age take?
0.4 mg/day
NEVER
Rear facing
During 2nd - 3rd trimester

2. 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
Women 55 - 79 yo
HISTORY
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

3. How much vit D should adults > 50 take?
1000 IU/day
Every 5 years
Stroke and DVT
800 IU/ day

4. How much flouride should non military children in the state of HI be given?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
1300 mg/day

5. What tests are appropriate to order in an asymptomatic 57 yo male?
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT

6. What are some safety issues you should counsel parents with young children?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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...
65 (earlier if have increased risk factors)

7. 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
Forearm
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

8. Measurement of which anatomic structure is best predictor for hip fracture?
Stroke and DVT
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
Exercise or physical therapy and vit D for patients > 65
Femoral neck

9. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Stroke and DVT
Starts at 20 for both M and W

10. How much fluoride should military children in HI be given?
1000 IU/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
0.4 - 0.8 mg/day for 1 month prior to conception
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

11. What are the risks of combination HRT?
Persons with no known risk factors
Adults > 60
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo

12. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

13. How often do asplenic patients receive pneumococcal vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
Every 5 years
Adults > 60

14. What is the schedule for varicella vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
4 mg/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)
One dose at 12-15 mod - Booster at least 4-weeks after

15. When should Gardasil be given and for what purposes?
NEVER
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
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

16. When should pregnant women get a flu shot?
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
During 2nd - 3rd trimester

17. What is the schedule for Hep B vaccine?
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
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

18. When should the meningococcal vaccine be given and to which group?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Every 5 years
Adults > 60

19. How much calcium should adolescents (9 -18) take?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day

20. What are 2 conditions that have been proven to be beneficial to screened for?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism

21. What are the guidelines for visual screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

22. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day

23. Who should get Tdap vaccine and how often?
4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
During 2nd - 3rd trimester
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

24. What is HI law for booster seat?

25. What is the ADA guideline for DMT2 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day

26. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
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)
Starts at 50 (recommends against starting at 40) and every 2 years
Every 5 years

27. What is the schedule for Hib vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo - 6mo and 12-15 mo
Men 45 - 79 yo

28. What is the schedule for rotavirus 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
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

29. What is the USPSTF guideline for chlamydial screening?
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES
Forearm

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

31. What are the guidelines for colon cancer screening?
Total cholesterol - FOBT
Meningitis and Epiglottitis
Women 55 - 79 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

32. What are the USPSTF guidelines for mammogram?
BP - Height - Weight
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 years
HISTORY

33. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

34. Who should get shingles vaccine?
Adults > 60
More than 15
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
HISTORY

35. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Total cholesterol - FOBT
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

36. In which group of patients should aspirin be given as primary prevention for stroke?
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

37. What are the guidelines for pap smear?
4 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)
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...
HISTORY

38. How much calcium should adults (19 - 50) take?
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
Starts at 20 for both M and W
1000 mg/day

39. What is the schedule for Hep A vaccine?
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs
In adults with sustained BP > 135/80 mmHg
12 - 23 mo - 2 doses are to be given 6 mo apart

40. What is the schedule for polio vaccine?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Persons with no known risk factors
BP - Height - Weight

41. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
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
Adults > 60
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)

42. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
One time abdominal X-ray for all MALES who ever SMOKES
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
4 mg/day

43. What is the most important way to screen for CAD in an asymptomatic patients?
Smoking - Alcoholism
HISTORY
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

44. 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
Stroke and DVT
One time abdominal X-ray for all MALES who ever SMOKES
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

45. Who are at increased risk for adverse effect catching a flu?
When they are > 40 lbs and still less then 5'
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Smoking - Alcoholism

46. When should chest X-ray be used for screening?
One time abdominal X-ray for all MALES who ever SMOKES
NEVER
0.4 mg/day
Persons with no known risk factors

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

48. Unopposed estrogen increases risks for what conditions?
Adults > 60
Stroke and DVT
Smoking - Alcoholism
65 (earlier if have increased risk factors)

49. What kind of sunscreen SPF is recommended for sun protection?
More than 15
0.4 mg/day
1000 mg/day
Smoking - Alcoholism

50. When should tetanus immunoglobulin be given?
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo