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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 the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo

2. When is area of induration > 5mm considered TB positive?
More than 15
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
2mo - 4 mo - 6mo and 12-15 mo
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...

3. When is area of induration > 15 mm considered TB positive?
Total cholesterol - FOBT
Persons with no known risk factors
Preschool children : 3-4 yo - Elderly patients: > 65 yo
When they are > 40 lbs and still less then 5'

4. What tests are appropriate to order in an asymptomatic 57 yo male?
2mo - 4mo - 6-18 mo and 4-6 yrs
Total cholesterol - FOBT
Starts at 50 (recommends against starting at 40) and every 2 years
Children up to 7 yo and < 5' should be placed in a booster seat.

5. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
1200 mg/day
Starts at 20 for both M and W
1000 IU/day
Femoral neck

6. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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...
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

7. How much calcium should adolescents (9 -18) take?
Forearm
1300 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In all W < 24 who are sexually active - In W > 24 with increased risk

8. What can decrease fall in the elderly?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

9. What is the ADA guideline for DMT2 screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

10. What is the schedule for MMR vaccine?
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

11. How much vit D should adults < 50 take?
Every 5 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
Children up to 7 yo and < 5' should be placed in a booster seat.
800 IU/ day

12. Measurement of which anatomic structure is best predictor for hip fracture?
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
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
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES

13. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Women 55 - 79 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
BP - Height - Weight

14. Who should get Tdap vaccine and how often?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing

15. In which group of patients should aspirin be given as primary prevention for stroke?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
800 IU/ day
Women 55 - 79 yo

16. What is the USPSTF guideline for fall prevention in the elderly?
To get IgA protection
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 IU/day
Exercise or physical therapy and vit D for patients > 65

17. Some contraindications for aspirin
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60

18. What are some safety issues you should counsel parents with young children?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
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...
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

19. When should the meningococcal vaccine be given and to which group?
Every 5 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

20. How often do asplenic patients receive pneumococcal vaccine?
In adults with sustained BP > 135/80 mmHg
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Every 5 years

21. What are the guidelines for visual screening?
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
0.4 mg/day

22. What is USPSTF guideline for abdominal aortic aneurysm screening?
One dose at 12-15 mod - Booster at least 4-weeks after
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
Every 5 years

23. When should tetanus immunoglobulin be given?
More than 15
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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. How much vit D should adults > 50 take?
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1000 IU/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

25. What kind of polio vaccine is preferred?
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
Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

26. Which children should use a semi-upright/forward facing carseat?
Femoral neck
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs

27. Who should get shingles vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

28. Unopposed estrogen increases risks for what conditions?
1000 IU/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Stroke and DVT

29. What is the most important way to screen for CAD in an asymptomatic patients?
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Starts at 50 (recommends against starting at 40) and every 2 years
HISTORY

30. How much calcium should women > 50 take?
Every 5 years
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

31. What 3 things should always be done in an office visit?
In all W < 24 who are sexually active - In W > 24 with increased risk
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Starts at 50 (recommends against starting at 40) and every 2 years

32. What is the schedule for Hep A vaccine?
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

33. What are 2 conditions that have been proven to be beneficial to screened for?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Smoking - Alcoholism
During 2nd - 3rd trimester
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

34. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES

35. If traveling to endemic areas - Why should one get a dose of live vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
To get IgA protection
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

36. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
1000 mg/day

37. How much calcium should adults (19 - 50) take?
1300 mg/day
1000 mg/day
NEVER
Starts at 20 for both M and W

38. When can children sit in a booster seat?

39. What kind of sunscreen SPF is recommended for sun protection?
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

40. When is intensive individualized home-based intervention recommended?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Adults > 60
Stroke and DVT
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

41. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
More than 15
Meningitis and Epiglottitis
To get IgA protection

42. What is the USPSTF guideline for chlamydial screening?
65 (earlier if have increased risk factors)
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
In all W < 24 who are sexually active - In W > 24 with increased risk

43. What is the schedule for rotavirus vaccine?
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
More than 15
Men 45 - 79 yo

44. How much flouride should non military children in the state of HI be given?
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

45. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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
HISTORY

46. Who are at increased risk for adverse effect catching a flu?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1200 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

47. What are the risks of combination HRT?
NEVER
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
Breast CA - thromboembolic event - stroke and CAD

48. How much folate and for How long should a woman take for planned pregnancy?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight

49. How much folate should all women of child bearing age take?
0.4 mg/day
1200 mg/day
When they are > 40 lbs and still less then 5'
4 mg/day

50. What are the USPSTF guidelines for mammogram?
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
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
Starts at 50 (recommends against starting at 40) and every 2 years