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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 is the schedule for Hep A vaccine?
1300 mg/day
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
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

2. When should Gardasil be given and for what purposes?
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
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
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

3. What is the schedule for DTap vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
When they are > 40 lbs and still less then 5'
Breast CA - thromboembolic event - stroke and CAD

4. Some contraindications for aspirin
Exercise or physical therapy and vit D for patients > 65
Adults > 60
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

5. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Adults > 60
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1200 mg/day

6. What is USPSTF guideline for abdominal aortic aneurysm screening?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

7. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day
When they are > 40 lbs and still less then 5'

8. What can decrease fall in the elderly?
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise - Environmental hazard reduction - Close monitoring of medication
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER

9. What is HI law for booster seat?

10. How much calcium should adults (19 - 50) take?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1000 mg/day
Meningitis and Epiglottitis
Rear facing

11. What kind of polio vaccine is preferred?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
Meningitis and Epiglottitis

12. 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
When they are > 40 lbs and still less then 5'
65 (earlier if have increased risk factors)
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)

13. What is the schedule for polio vaccine?
Stroke and DVT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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 - 4mo - 6-18 mo and 4-6 yrs

14. What is the USPSTF guideline for chlamydial screening?
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
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
4 mg/day

15. When is intensive individualized home-based intervention recommended?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
To get IgA protection
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

16. How much vit D should adults > 50 take?
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
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

17. What is the most important way to screen for CAD in an asymptomatic patients?
Starts at 20 for both M and W
HISTORY
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

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

19. When is area of induration > 10 mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Rear facing
1300 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

20. How much vit D should adults < 50 take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
800 IU/ day
HISTORY
One time abdominal X-ray for all MALES who ever SMOKES

21. When should chest X-ray be used for screening?
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
NEVER
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)

22. What is the USPSTF guideline for fall prevention in the elderly?
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise or physical therapy and vit D for patients > 65
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs

23. What are some safety issues you should counsel parents with young children?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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...
2mo - 4mo - 6-18 mo and 4-6 yrs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

24. Measurement of which anatomic structure is best predictor for hip fracture?
> 2 yo and less than 40 lbs
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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. At what age should women have DEXA scan?
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
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
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES

26. What are the guidelines for pap smear?
Persons with no known risk factors
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)
1000 IU/day
Exercise or physical therapy and vit D for patients > 65

27. What are the guidelines for visual screening?
Forearm
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg

28. What kind of car seat should children < 2 yo be placed in?
Stroke and DVT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Rear facing
1300 mg/day

29. What is the schedule for rotavirus vaccine?
1300 mg/day
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

30. What type of illnesses does Hib vaccine prevent?
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
Meningitis and Epiglottitis
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

31. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
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)
When they are > 40 lbs and still less then 5'
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

32. What is the USPSTF guideline for DMT2 screening?
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
In adults with sustained BP > 135/80 mmHg
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

33. When is area of induration > 5mm considered TB positive?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
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

34. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Forearm

35. 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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors

36. What is the schedule for Hib vaccine?
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo
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
Adults > 60

37. What are some RFs for DMT2?
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Starts at 20 for both M and W
Children up to 7 yo and < 5' should be placed in a booster seat.

38. When should pregnant women get a flu shot?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
During 2nd - 3rd trimester

39. In which group of patients should aspirin be given as primary prevention for MI?
Forearm
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
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
Men 45 - 79 yo

40. Who are at increased risk for adverse effect catching a flu?
800 IU/ 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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Start at 20 for all M and W regardless of RFs

41. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

42. What is the NCEP III guideline for cholesterol screening?
Exercise - Environmental hazard reduction - Close monitoring of medication
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after

43. What kind of sunscreen SPF is recommended for sun protection?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
More than 15
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

44. What are the guidelines for colon cancer screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Rear facing

45. How much fluoride should military children in HI be given?
More than 15
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT
In all W < 24 who are sexually active - In W > 24 with increased risk

46. If traveling to endemic areas - Why should one get a dose of live vaccine?
0.4 mg/day
Every 5 years
To get IgA protection
4 mg/day

47. Who should get shingles vaccine?
Every 5 years
Adults > 60
Rear facing
65 (earlier if have increased risk factors)

48. How much calcium should women > 50 take?
Total cholesterol - FOBT
Men 45 - 79 yo
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

49. When can children sit in a booster seat?

50. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy