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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. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Femoral neck
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Women 55 - 79 yo

2. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

3. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Forearm
One time abdominal X-ray for all MALES who ever SMOKES

4. What are some risk factors for CAD?
Forearm
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
To get IgA protection

5. How much folate should all women of child bearing age take?
0.4 mg/day
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 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

6. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Total cholesterol - FOBT
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

7. What are the guidelines for colon cancer screening?
4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

8. Who should get shingles vaccine?
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 mg/day
Men 45 - 79 yo
Adults > 60

9. What kind of polio vaccine is preferred?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 20 for both M and W
Smoking - Alcoholism

10. What can decrease fall in the elderly?
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
When they are > 40 lbs and still less then 5'
Exercise - Environmental hazard reduction - Close monitoring of medication

11. What is the USPSTF guideline for fall prevention in the elderly?
Total cholesterol - FOBT
Exercise or physical therapy and vit D for patients > 65
0.4 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years

12. How much flouride should non military children in the state of HI be given?
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

13. When is area of induration > 5mm considered TB positive?
Children up to 7 yo and < 5' should be placed in a booster seat.
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
1200 mg/day

14. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT
Meningitis and Epiglottitis
To get IgA protection

15. What is the ADA guideline for DMT2 screening?
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...
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
65 (earlier if have increased risk factors)
2mo - 4 mo - 6mo and 12-15 mo

16. What are the guidelines for pap smear?
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
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)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

17. What is the schedule for MMR vaccine?
Smoking - Alcoholism
To get IgA protection
HISTORY
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

18. How much folate and for How long should a woman take for planned pregnancy?
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
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

19. What are some RFs for DMT2?
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
1300 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

20. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Women 55 - 79 yo
More than 15
HISTORY

21. What is the USPSTF guideline for DMT2 screening?
1300 mg/day
In adults with sustained BP > 135/80 mmHg
Forearm
To get IgA protection

22. When is intensive individualized home-based intervention recommended?
4 mg/day
Every 5 years
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
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

23. How much calcium should adults (19 - 50) take?
When they are > 40 lbs and still less then 5'
Every 5 years
1000 mg/day
During 2nd - 3rd trimester

24. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

25. Unopposed estrogen increases risks for what conditions?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Stroke and DVT
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...
Rear facing

26. What are the USPSTF guidelines for mammogram?
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
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

27. Measurement of which anatomic structure is best predictor for hip fracture?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Femoral neck
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
One time abdominal X-ray for all MALES who ever SMOKES

28. Who should get Tdap vaccine and how often?
12 - 23 mo - 2 doses are to be given 6 mo apart
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

29. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

30. What 3 things should always be done in an office visit?
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
BP - Height - Weight
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

31. What is the schedule for Hep A vaccine?
Smoking - Alcoholism
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart
One time abdominal X-ray for all MALES who ever SMOKES

32. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
Breast CA - thromboembolic event - stroke and CAD
During 2nd - 3rd trimester
1300 mg/day

33. When should chest X-ray be used for screening?
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart
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
During 2nd - 3rd trimester

34. What are 2 conditions that have been proven to be beneficial to screened for?
Femoral neck
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Smoking - Alcoholism
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

35. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

36. What are the risks of combination HRT?
In adults with sustained BP > 135/80 mmHg
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
Breast CA - thromboembolic event - stroke and CAD

37. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

38. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Every 5 years
Meningitis and Epiglottitis
Starts at 20 for both M and W
Adults > 60

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

40. How much calcium should women > 50 take?
0.4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day

41. How much vit D should adults > 50 take?
When they are > 40 lbs and still less then 5'
More than 15
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo

42. At what age should women have DEXA scan?
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
65 (earlier if have increased risk factors)
Starts at 50 (recommends against starting at 40) and every 2 years

43. When should Gardasil be given and for what purposes?
More than 15
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

44. In which group of patients should aspirin be given as primary prevention for stroke?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
During 2nd - 3rd trimester
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo

45. How much fluoride should military children in HI be given?
Persons with no known risk factors
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
0.4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

46. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

47. If traveling to endemic areas - Why should one get a dose of live vaccine?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
To get IgA protection
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

48. When is area of induration > 10 mm considered TB positive?
Exercise or physical therapy and vit D for patients > 65
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Forearm
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

49. When should the meningococcal vaccine be given and to which group?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
65 (earlier if have increased risk factors)
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

50. What is the USPSTF guideline for chlamydial screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing
0.4 mg/day