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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 can decrease fall in the elderly?
During 2nd - 3rd trimester
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)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Exercise - Environmental hazard reduction - Close monitoring of medication

2. What are the guidelines for pap smear?
1300 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
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)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

3. In which group of patients should aspirin be given as primary prevention for MI?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
During 2nd - 3rd trimester
Men 45 - 79 yo

4. When should pregnant women get a flu shot?
800 IU/ day
1200 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
During 2nd - 3rd trimester

5. What kind of sunscreen SPF is recommended for sun protection?
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
Femoral neck
More than 15

6. What is the USPSTF guideline for chlamydial screening?
HISTORY
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis

7. 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
2mo - 4 mo - 6mo and 12-15 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs

8. What is the schedule for Hep A vaccine?
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
Meningitis and Epiglottitis
0.4 - 0.8 mg/day for 1 month prior to conception

9. How much calcium should adults (19 - 50) take?
When they are > 40 lbs and still less then 5'
NEVER
1000 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

10. What type of illnesses does Hib vaccine prevent?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Meningitis and Epiglottitis
Stroke and DVT

11. What is the schedule for varicella vaccine?
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

12. Who should get shingles vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
More than 15
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Adults > 60

13. What are some risk factors for CAD?
In all W < 24 who are sexually active - In W > 24 with increased risk
Smoking - Alcoholism
HISTORY
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

14. What is the NCEP III guideline for cholesterol screening?
One dose at 12-15 mod - Booster at least 4-weeks after
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
When they are > 40 lbs and still less then 5'
Start at 20 for all M and W regardless of RFs

15. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
> 2 yo and less than 40 lbs
Stroke and DVT
Rear facing

16. What are the risks of combination HRT?
More than 15
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
HISTORY

17. What 3 things should always be done in an office visit?
BP - Height - Weight
1200 mg/day
1000 mg/day
Persons with no known risk factors

18. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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 20 for both M and W
Adults > 60
When they are > 40 lbs and still less then 5'

19. How much calcium should adolescents (9 -18) take?
Rear facing
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
1300 mg/day

20. How much fluoride should military children in HI be given?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Meningitis and Epiglottitis
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

21. When can children sit in a booster seat?

22. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
1000 IU/day
BP - Height - Weight
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

23. How much folate should all women of child bearing age take?
1000 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)
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 mg/day

24. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
65 (earlier if have increased risk factors)
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
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

25. When is area of induration > 15 mm considered TB positive?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors

26. How often do asplenic patients receive pneumococcal vaccine?
Women 55 - 79 yo
Every 5 years
65 (earlier if have increased risk factors)
Persons with no known risk factors

27. What are some RFs for DMT2?
> 2 yo and less than 40 lbs
NEVER
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 45 - 79 yo

28. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Stroke and DVT
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
Forearm
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

29. What is the schedule for Gardasil?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 - 0.8 mg/day for 1 month prior to conception

30. What is the schedule for Hep B vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT

31. When is area of induration > 10 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)
Start at 20 for all M and W regardless of RFs
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

32. When should Gardasil be given and for what purposes?
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 - 6mo and 12-15 mo
Breast CA - thromboembolic event - stroke and CAD
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

33. 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
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
2mo - 4 mo - 6mo and 12-15 mo

34. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
4 mg/day

35. Some contraindications for aspirin
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
Start at 20 for all M and W regardless of RFs
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

36. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day

37. What are the USPSTF guidelines for mammogram?
To get IgA protection
Rear facing
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo - 6mo and 12-15 mo

38. When is area of induration > 5mm considered TB positive?
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
When they are > 40 lbs and still less then 5'
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

39. How much calcium should women > 50 take?
Every 5 years
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
1200 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after

40. What are the guidelines for visual screening?
800 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)
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Every 5 years

41. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT
Men 45 - 79 yo

42. What kind of polio vaccine is preferred?
Stroke and DVT
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2mo - 4mo - 6-18 mo and 4-6 yrs
BP - Height - Weight

43. In which group of patients should aspirin be given as primary prevention for stroke?
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
Women 55 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Total cholesterol - FOBT

44. What is the ADA guideline for DMT2 screening?
HISTORY
NEVER
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Smoking - Alcoholism

45. What are the guidelines for colon cancer screening?
More than 15
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
Every 5 years
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

46. What is the most important way to screen for CAD in an asymptomatic patients?
To get IgA protection
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
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY

47. What is the USPSTF guideline for fall prevention in the elderly?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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...
Exercise or physical therapy and vit D for patients > 65

48. When should the meningococcal vaccine be given and to which group?
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

49. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY
0.4 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

50. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
During 2nd - 3rd trimester
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise or physical therapy and vit D for patients > 65