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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 kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
HISTORY
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo

2. What is the USPSTF guideline for chlamydial screening?
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
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

3. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
NEVER
> 2 yo and less than 40 lbs
4 mg/day

4. What are 2 conditions that have been proven to be beneficial to screened for?
When they are > 40 lbs and still less then 5'
1300 mg/day
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years

5. Who should get shingles vaccine?
1300 mg/day
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...
Adults > 60
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

6. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk
Men 45 - 79 yo

7. What is the NCEP III guideline for cholesterol screening?
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs

8. What is the schedule for varicella vaccine?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
One time abdominal X-ray for all MALES who ever SMOKES
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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)
Persons with no known risk factors
Forearm

10. What kind of car seat should children < 2 yo be placed in?
Starts at 20 for both M and W
Rear facing
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. Which children should use a semi-upright/forward facing carseat?
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1300 mg/day
> 2 yo and less than 40 lbs

12. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day

13. What is the schedule for Hib vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4mo - 6-18 mo and 4-6 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo - 6mo and 12-15 mo

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
During 2nd - 3rd trimester
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...
Start at 20 for all M and W regardless of RFs

15. What is the schedule for rotavirus vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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...

16. What is USPSTF guideline for abdominal aortic aneurysm screening?
Starts at 20 for both M and W
1000 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
2mo - 4mo - 6-18 mo and 4-6 yrs

17. How much calcium should adults (19 - 50) take?
Stroke and DVT
4 mg/day
1000 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

18. If traveling to endemic areas - Why should one get a dose of live vaccine?
Every 5 years
More than 15
Women 55 - 79 yo
To get IgA protection

19. In which group of patients should aspirin be given as primary prevention for MI?
> 2 yo and less than 40 lbs
Men 45 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo

20. When is intensive individualized home-based intervention recommended?
0.4 - 0.8 mg/day for 1 month prior to conception
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 all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day

21. What are the guidelines for visual screening?
0.4 mg/day
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm

22. When can children sit in a booster seat?

23. What is HI law for booster seat?

24. What is the schedule for Hep B vaccine?
During 2nd - 3rd trimester
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day

25. When should tetanus immunoglobulin be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

26. What is the schedule for MMR vaccine?
1300 mg/day
Starts at 20 for both M and W
> 2 yo and less than 40 lbs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

27. How much folate should all women of child bearing age take?
1300 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 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

28. When should pregnant women get a flu shot?
When they are > 40 lbs and still less then 5'
During 2nd - 3rd trimester
More than 15
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

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

30. How much calcium should women > 50 take?
1200 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
Starts at 20 for both M and W
Meningitis and Epiglottitis

31. What are some risk factors for CAD?
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 IU/day

32. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
65 (earlier if have increased risk factors)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck

33. What is the ADA guideline for DMT2 screening?
0.4 mg/day
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

34. What is the schedule for DTap 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
BP - Height - Weight
0.4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

35. What 3 things should always be done in an office visit?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight
Smoking - Alcoholism
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

36. At what age should women have DEXA scan?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Adults > 60
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)

37. When is area of induration > 15 mm considered TB positive?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Men 45 - 79 yo
Persons with no known risk factors

38. What are some safety issues you should counsel parents with young children?
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...
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Stroke and DVT
1200 mg/day

39. 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
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo - 6mo and 12-15 mo

40. How much vit D should adults > 50 take?
1200 mg/day
1000 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day

41. What is the schedule for Hep A vaccine?
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...
Children up to 7 yo and < 5' should be placed in a booster seat.
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo

42. What are the risks of combination HRT?
800 IU/ day
1000 IU/day
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD

43. When should chest X-ray be used for screening?
NEVER
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

44. Who are at increased risk for adverse effect catching a flu?
Women 55 - 79 yo
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...
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

45. When is area of induration > 5mm considered TB positive?
NEVER
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

46. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
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
NEVER

47. Some contraindications for aspirin
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In all W < 24 who are sexually active - In W > 24 with increased risk

48. When is area of induration > 10 mm considered TB positive?
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
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
Every 5 years

49. What is the most important way to screen for CAD in an asymptomatic patients?
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
HISTORY
4 mg/day
1000 mg/day

50. How often do asplenic patients receive pneumococcal vaccine?
To get IgA protection
In adults with sustained BP > 135/80 mmHg
Every 5 years
Adults > 60