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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 are the guidelines for visual screening?
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo

2. When should Gardasil be given and for what purposes?
1000 mg/day
Exercise or physical therapy and vit D for patients > 65
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
12 - 23 mo - 2 doses are to be given 6 mo apart

3. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
800 IU/ 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

4. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis

5. 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
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
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo

6. When can children sit in a booster seat?

7. When is area of induration > 10 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

8. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
Exercise or physical therapy and vit D for patients > 65

9. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
Men 45 - 79 yo
Women 55 - 79 yo

10. What are some safety issues you should counsel parents with young children?
1300 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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...
Total cholesterol - FOBT

11. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis
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)

12. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Femoral neck
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

13. What is the schedule for Hib vaccine?
NEVER
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 - 6mo and 12-15 mo

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
0.4 mg/day
Forearm
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

15. What is the schedule for Gardasil?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

16. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism
Forearm
Persons with no known risk factors

17. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
To get IgA protection
Starts at 50 (recommends against starting at 40) and every 2 years
In adults with sustained BP > 135/80 mmHg

18. How much folate and for How long should a woman take for planned pregnancy?
One dose at 12-15 mod - Booster at least 4-weeks after
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
0.4 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

19. What is the schedule for DTap vaccine?
4 mg/day
During 2nd - 3rd trimester
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs

20. What kind of sunscreen SPF is recommended for sun protection?
0.4 - 0.8 mg/day for 1 month prior to conception
In adults with sustained BP > 135/80 mmHg
More than 15
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

21. How much vit D should adults > 50 take?
1000 IU/day
Every 5 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
BP - Height - Weight

22. How much calcium should adolescents (9 -18) take?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day
When they are > 40 lbs and still less then 5'
1000 IU/day

23. When is area of induration > 15 mm considered TB positive?
Start at 20 for all M and W regardless of RFs
Persons with no known risk factors
0.4 - 0.8 mg/day for 1 month prior to conception
Men 45 - 79 yo

24. How much calcium should adults (19 - 50) take?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 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
Every 5 years

25. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Femoral neck
2mo - 4mo - 6-18 mo and 4-6 yrs

26. If traveling to endemic areas - Why should one get a dose of live vaccine?
Meningitis and Epiglottitis
One time abdominal X-ray for all MALES who ever SMOKES
Exercise or physical therapy and vit D for patients > 65
To get IgA protection

27. What 3 things should always be done in an office visit?
0.4 mg/day
65 (earlier if have increased risk factors)
BP - Height - Weight
NEVER

28. How much vit D should adults < 50 take?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day
Adults > 60
BP - Height - Weight

29. 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs

30. What is USPSTF guideline for abdominal aortic aneurysm screening?
Femoral neck
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
1000 IU/day

31. What is the USPSTF guideline for DMT2 screening?
Femoral neck
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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 tetanus immunoglobulin be given?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT

33. How much calcium should women > 50 take?
Total cholesterol - FOBT
1300 mg/day
Exercise or physical therapy and vit D for patients > 65
1200 mg/day

34. How much fluoride should military children in HI be given?
Forearm
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

35. What is the USPSTF guideline for fall prevention in the elderly?
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise or physical therapy and vit D for patients > 65
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)

36. When is intensive individualized home-based intervention recommended?
Every 5 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
12 - 23 mo - 2 doses are to be given 6 mo apart
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

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

38. What are the guidelines for pap smear?
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)
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
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...
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

39. What is the schedule for MMR vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
800 IU/ day
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What is the USPSTF guideline for chlamydial screening?
More than 15
Total cholesterol - FOBT
In all W < 24 who are sexually active - In W > 24 with increased risk
Persons with no known risk factors

41. 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
1000 mg/day
Adults > 60
1300 mg/day

42. What can decrease fall in the elderly?
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
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
One dose at 12-15 mod - Booster at least 4-weeks after

43. Who should get shingles vaccine?
Adults > 60
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

44. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication

45. Who should get Tdap vaccine and how often?
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)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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

46. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
1300 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

47. What are the risks of combination HRT?
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
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. Measurement of which anatomic structure is best predictor for hip fracture?
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Every 5 years
Femoral neck

49. 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
1200 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
Rear facing

50. What kind of polio vaccine is preferred?
65 (earlier if have increased risk factors)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Femoral neck
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)