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Test your basic knowledge |
Family Medicine Health Maintenance
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Subjects
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health-sciences
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family-medicine
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
Men 45 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Femoral neck
2. Who should get shingles vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
NEVER
Adults > 60
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
3. When should chest X-ray be used for screening?
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
NEVER
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
4. How much vit D should adults > 50 take?
Adults > 60
Persons with no known risk factors
1000 IU/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)
5. What are some risk factors for CAD?
Starts at 50 (recommends against starting at 40) and every 2 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise - Environmental hazard reduction - Close monitoring of medication
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
6. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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 20 for both M and W
Femoral neck
7. What is the USPSTF guideline for chlamydial screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
8. When is area of induration > 5mm considered TB positive?
1300 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
65 (earlier if have increased risk factors)
Women 55 - 79 yo
9. What is the schedule for MMR vaccine?
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
10. How much vit D should adults < 50 take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart
800 IU/ day
11. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 - 0.8 mg/day for 1 month prior to conception
800 IU/ day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
One time abdominal X-ray for all MALES who ever SMOKES
12. What are the guidelines for colon cancer screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 20 for both M and W
13. What kind of car seat should children < 2 yo be placed in?
More than 15
Rear facing
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Men 45 - 79 yo
14. When can children sit in a booster seat?
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15. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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)
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
16. 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
Meningitis and Epiglottitis
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
1300 mg/day
17. What are some RFs for DMT2?
When they are > 40 lbs and still less then 5'
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)
18. What kind of polio vaccine is preferred?
During 2nd - 3rd trimester
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
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...
19. How much fluoride should military children in HI be given?
Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1300 mg/day
20. When should Gardasil be given and for what purposes?
Meningitis and Epiglottitis
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
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
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
21. Measurement of which anatomic structure is best predictor for hip fracture?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Femoral neck
Breast CA - thromboembolic event - stroke and 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
22. What is the schedule for rotavirus vaccine?
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)
HISTORY
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
23. What are the 4 main groups of people who are candidates for pneumococcal vaccine?
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24. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 yo
25. What is the schedule for Gardasil?
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
26. When should pregnant women get a flu shot?
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day
During 2nd - 3rd trimester
65 (earlier if have increased risk factors)
27. How much folate and for How long should a woman take for planned pregnancy?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Women 55 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
28. What is the schedule for varicella vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
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
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
29. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
30. What can decrease fall in the elderly?
Every 5 years
To get IgA protection
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
31. In which group of patients should aspirin be given as primary prevention for MI?
Smoking - Alcoholism
Men 45 - 79 yo
Starts at 20 for both M and W
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
32. Who are at increased risk for adverse effect catching a flu?
Women 55 - 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
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
33. What is HI law for booster seat?
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34. What is the schedule for DTap vaccine?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
35. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
36. What is the NCEP III guideline for cholesterol screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
2mo - 4mo - 6-18 mo and 4-6 yrs
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs
37. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
38. What is the schedule for Hep A vaccine?
1300 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
39. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 20 for both M and W
HISTORY
40. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
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
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise - Environmental hazard reduction - Close monitoring of medication
41. Which children should use a semi-upright/forward facing carseat?
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
Persons with no known risk factors
> 2 yo and less than 40 lbs
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
42. When is area of induration > 10 mm considered TB positive?
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
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
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
> 2 yo and less than 40 lbs
43. 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
Starts at 50 (recommends against starting at 40) and every 2 years
During 2nd - 3rd trimester
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
44. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Adults > 60
Persons with no known risk factors
1000 IU/day
45. If traveling to endemic areas - Why should one get a dose of live vaccine?
Total cholesterol - FOBT
To get IgA protection
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
46. What are some safety issues you should counsel parents with young children?
When they are > 40 lbs and still less then 5'
Total cholesterol - FOBT
> 2 yo and less than 40 lbs
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...
47. What 3 things should always be done in an office visit?
BP - Height - Weight
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4mo - 6-18 mo and 4-6 yrs
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
48. What is the schedule for Hib vaccine?
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo
49. What are the guidelines for pap smear?
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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)
50. How much folate should all women of child bearing age take?
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...
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Breast CA - thromboembolic event - stroke and CAD
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