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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 HI law for booster seat?

2. What are the guidelines for colon cancer screening?
0.4 - 0.8 mg/day for 1 month prior to conception
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
HISTORY

3. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 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

4. Who are at increased risk for adverse effect catching a flu?
Exercise - Environmental hazard reduction - Close monitoring of medication
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

5. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
1000 IU/day
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs

6. When is area of induration > 10 mm considered TB positive?
> 2 yo and less than 40 lbs
Total cholesterol - FOBT
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

7. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Adults > 60
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

8. What 3 things should always be done in an office visit?
Forearm
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after
BP - Height - Weight

9. How much vit D should adults < 50 take?
Men 45 - 79 yo
Start at 20 for all M and W regardless of RFs
800 IU/ 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

10. Unopposed estrogen increases risks for what conditions?
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1200 mg/day
Stroke and DVT

11. Measurement of which anatomic structure is best predictor for hip fracture?
Every 5 years
When they are > 40 lbs and still less then 5'
0.4 - 0.8 mg/day for 1 month prior to conception
Femoral neck

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

13. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

14. What is the schedule for polio vaccine?
BP - Height - Weight
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
In adults with sustained BP > 135/80 mmHg

15. When should tetanus immunoglobulin be given?
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester
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

16. When should the meningococcal vaccine be given and to which group?
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
Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception

17. What are the guidelines for visual screening?
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

18. What are some safety issues you should counsel parents with young children?
HISTORY
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

19. In which group of patients should aspirin be given as primary prevention for MI?
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
More than 15
NEVER

20. What are some risk factors for CAD?
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

21. Some contraindications for aspirin
Stroke and DVT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day
HISTORY

22. 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
Stroke and DVT
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
Children up to 7 yo and < 5' should be placed in a booster seat.

23. When should chest X-ray be used for screening?
NEVER
Stroke and DVT
1000 IU/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

24. What are the risks of combination HRT?
To get IgA protection
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

25. What can decrease fall in the elderly?
1300 mg/day
In adults with sustained BP > 135/80 mmHg
Exercise - Environmental hazard reduction - Close monitoring of medication
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

26. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Persons with no known risk factors
Rear facing

27. If traveling to endemic areas - Why should one get a dose of live vaccine?
Men 45 - 79 yo
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD
To get IgA protection

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

29. What are 2 conditions that have been proven to be beneficial to screened for?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
In adults with sustained BP > 135/80 mmHg
Smoking - Alcoholism

30. At what age should women have DEXA scan?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis

31. What is the schedule for rotavirus vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
4 mg/day

32. What kind of sunscreen SPF is recommended for sun protection?
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
NEVER

33. What kind of polio vaccine is preferred?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
During 2nd - 3rd trimester

34. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm

35. How much folate should all women of child bearing age take?
0.4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Meningitis and Epiglottitis
Femoral neck

36. What is the schedule for Hep A vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart

37. When can children sit in a booster seat?

38. How much calcium should adolescents (9 -18) take?
Starts at 50 (recommends against starting at 40) and every 2 years
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1300 mg/day

39. What is the USPSTF guideline for fall prevention in the elderly?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise or physical therapy and vit D for patients > 65
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
Starts at 20 for both M and W

40. What is the USPSTF 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)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In adults with sustained BP > 135/80 mmHg

41. What are some RFs for DMT2?
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 adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after

42. 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
Start at 20 for all M and W regardless of RFs
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

43. Who should get shingles vaccine?
Adults > 60
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES

44. How much flouride should non military children in the state of HI be given?
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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...
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

45. What are the guidelines for pap smear?
800 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
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)
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

46. What is the NCEP III guideline for cholesterol screening?
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
Persons with no known risk factors
Start at 20 for all M and W regardless of RFs

47. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
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
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

48. When should Gardasil be given and for what purposes?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
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

49. What is the schedule for Hep B vaccine?
Men 45 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

50. When is intensive individualized home-based intervention recommended?
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
800 IU/ day
Forearm
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