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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 should the meningococcal vaccine be given and to which group?
When they are > 40 lbs and still less then 5'
1300 mg/day
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

2. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One time abdominal X-ray for all MALES who ever SMOKES

3. What kind of polio vaccine is preferred?
1000 IU/day
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
65 (earlier if have increased risk factors)

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

5. What are the guidelines for colon cancer screening?
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 up to 7 yo and < 5' should be placed in a booster seat.
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

6. What type of illnesses does Hib vaccine prevent?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
Exercise - Environmental hazard reduction - Close monitoring of medication
Meningitis and Epiglottitis

7. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
When they are > 40 lbs and still less then 5'
4 mg/day
Adults > 60

8. Who are at increased risk for adverse effect catching a flu?
Starts at 20 for both M and W
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

9. In which group of patients should aspirin be given as primary prevention for MI?
Breast CA - thromboembolic event - stroke and CAD
One time abdominal X-ray for all MALES who ever SMOKES
Men 45 - 79 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

10. What is the USPSTF guideline for chlamydial screening?
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
When they are > 40 lbs and still less then 5'
In all W < 24 who are sexually active - In W > 24 with increased risk

11. When is intensive individualized home-based intervention recommended?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ 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
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

12. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
65 (earlier if have increased risk factors)
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

13. Who should get shingles vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
BP - Height - Weight
Adults > 60
In all W < 24 who are sexually active - In W > 24 with increased risk

14. What is the schedule for Hep B vaccine?
When they are > 40 lbs and still less then 5'
One dose at 12-15 mod - Booster at least 4-weeks after
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. When should chest X-ray be used for screening?
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
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
Women 55 - 79 yo
NEVER

16. 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
BP - Height - Weight

17. How much vit D should adults > 50 take?
In adults with sustained BP > 135/80 mmHg
Women 55 - 79 yo
1000 IU/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...

18. What can decrease fall in the elderly?
2mo - 4 mo - 6mo and 12-15 mo
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

19. At what age should women have DEXA scan?
> 2 yo and less than 40 lbs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
65 (earlier if have increased risk factors)
1300 mg/day

20. Who should get Tdap vaccine and how often?
0.4 mg/day
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
Forearm

21. How much vit D should adults < 50 take?
800 IU/ day
Rear facing
Femoral neck
Breast CA - thromboembolic event - stroke and CAD

22. 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
Starts at 20 for both M and W
Total cholesterol - FOBT

23. How much folate should all women of child bearing age take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Smoking - Alcoholism
0.4 mg/day
Forearm

24. What are the guidelines for visual screening?
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
1200 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 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

25. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
1000 mg/day

26. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
HISTORY
Femoral neck
Children up to 7 yo and < 5' should be placed in a booster seat.

27. What 3 things should always be done in an office visit?
To get IgA protection
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
Rear facing

28. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
When they are > 40 lbs and still less then 5'
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

29. What kind of car seat should children < 2 yo be placed in?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Every 5 years
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES

30. What are some RFs for DMT2?
HISTORY
Exercise - Environmental hazard reduction - Close monitoring of medication
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)

31. What are the guidelines for pap smear?
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
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)
Meningitis and Epiglottitis

32. What is the schedule for DTap vaccine?
To get IgA protection
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

33. What are the USPSTF guidelines for mammogram?
Starts at 20 for both M and W
Femoral neck
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 50 (recommends against starting at 40) and every 2 years

34. How much flouride should non military children in the state of HI be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

35. When is area of induration > 15 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)
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

36. Which children should use a semi-upright/forward facing carseat?
65 (earlier if have increased risk factors)
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
> 2 yo and less than 40 lbs

37. Some contraindications for aspirin
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

38. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Starts at 20 for both M and W
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

39. When can children sit in a booster seat?

40. What is the schedule for polio vaccine?
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
One dose at 12-15 mod - Booster at least 4-weeks after
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

41. What is the schedule for Gardasil?
1000 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

42. When is area of induration > 10 mm considered TB positive?
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
When they are > 40 lbs and still less then 5'
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

43. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Exercise or physical therapy and vit D for patients > 65
Starts at 20 for both M and W
Persons with no known risk factors

44. What is USPSTF guideline for abdominal aortic aneurysm screening?
To get IgA protection
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
One time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs

45. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)
1300 mg/day
Femoral neck

46. What is the USPSTF guideline for DMT2 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
1000 mg/day
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

47. What is the ADA guideline for DMT2 screening?
Every 5 years
One time abdominal X-ray for all MALES who ever SMOKES
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

48. What is HI law for booster seat?

49. What is the schedule for varicella vaccine?
1300 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

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