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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. When can children sit in a booster seat?

2. In which group of patients should aspirin be given as primary prevention for MI?
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
One dose at 12-15 mod - Booster at least 4-weeks after
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

3. What are the guidelines for colon cancer 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
Start at 20 for all M and W regardless of 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
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. How much vit D should adults < 50 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
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
Total cholesterol - FOBT

5. What is the most important way to screen for CAD in an asymptomatic patients?
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
Starts at 20 for both M and W
BP - Height - Weight

6. What is the schedule for Gardasil?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
More than 15
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

7. When is intensive individualized home-based intervention recommended?
2mo - 4mo - 6-18 mo and 4-6 yrs
More than 15
One time abdominal X-ray for all MALES who ever SMOKES
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

8. 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
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
When they are > 40 lbs and still less then 5'
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Meningitis and Epiglottitis

10. What is the schedule for varicella vaccine?
Smoking - Alcoholism
Femoral neck
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day

11. What is the schedule for rotavirus vaccine?
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Starts at 20 for both M and W
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

12. In which group of patients should aspirin be given as primary prevention for stroke?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo
1200 mg/day

13. How much calcium should women > 50 take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 IU/day
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

14. When is area of induration > 15 mm considered TB positive?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs
Persons with no known risk factors
Total cholesterol - FOBT

15. When should pregnant women get a flu shot?
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
> 2 yo and less than 40 lbs
Smoking - Alcoholism

16. What are some RFs for DMT2?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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 50 (recommends against starting at 40) and every 2 years

17. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
4 mg/day
Meningitis and Epiglottitis
Total cholesterol - FOBT

18. Which children should use a semi-upright/forward facing carseat?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs
Meningitis and Epiglottitis

19. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Women 55 - 79 yo
Meningitis and Epiglottitis

20. How much folate should all women of child bearing age take?
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 starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day

21. What are some safety issues you should counsel parents with young children?
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)
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...
Exercise - Environmental hazard reduction - Close monitoring of medication

22. When should the meningococcal vaccine be given and to which group?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

23. When is area of induration > 5mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
1000 IU/day
0.4 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

24. What kind of car seat should children < 2 yo be placed in?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Rear facing
1300 mg/day
65 (earlier if have increased risk factors)

25. What is the schedule for polio vaccine?
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester
0.4 - 0.8 mg/day for 1 month prior to conception

26. What is the schedule for Hep B vaccine?
Men 45 - 79 yo
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
2mo - 4mo - 6-18 mo and 4-6 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

27. What are the guidelines for visual screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

28. 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
Starts at 20 for both M and W
Forearm
Women 55 - 79 yo

29. How much flouride should non military children in the state of HI 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
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 mg/day
800 IU/ day

30. What is the schedule for Hep A vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
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 4 main groups of people who are candidates for pneumococcal vaccine?

32. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
0.4 - 0.8 mg/day for 1 month prior to conception
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

33. What are 2 conditions that have been proven to be beneficial to screened for?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
More than 15

34. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
One time abdominal X-ray for all MALES who ever SMOKES
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

35. What are some risk factors for CAD?
NEVER
800 IU/ day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Every 5 years

36. What is the USPSTF guideline for chlamydial screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
More than 15
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 all W < 24 who are sexually active - In W > 24 with increased risk

37. Who are at increased risk for adverse effect catching a flu?
0.4 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

38. How often do asplenic patients receive pneumococcal vaccine?
4 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
65 (earlier if have increased risk factors)
Every 5 years

39. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day

40. What kind of polio vaccine is preferred?
Femoral neck
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'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

41. Who should get Tdap vaccine and how often?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Breast CA - thromboembolic event - stroke and CAD
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

42. How much calcium should adults (19 - 50) 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
1000 mg/day
Exercise or physical therapy and vit D for patients > 65
Femoral neck

43. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
During 2nd - 3rd trimester

44. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
1300 mg/day
Meningitis and Epiglottitis
More than 15

45. What are the guidelines for pap smear?
2mo - 4 mo - 6mo and 12-15 mo
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
0.4 - 0.8 mg/day for 1 month prior to conception

46. When should chest X-ray be used for screening?
65 (earlier if have increased risk factors)
In adults with sustained BP > 135/80 mmHg
Forearm
NEVER

47. 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
Every 5 years
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD

48. Some contraindications for aspirin
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day

49. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Smoking - Alcoholism
800 IU/ day
Women 55 - 79 yo

50. What is the USPSTF guideline for fall prevention in the elderly?
HISTORY
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Forearm