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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. At what age should women have DEXA scan?
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
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

2. When is intensive individualized home-based intervention recommended?
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)
In all W < 24 who are sexually active - In W > 24 with increased risk
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

3. How much calcium should women > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1200 mg/day

4. How much folate should all women of child bearing age take?
NEVER
0.4 mg/day
Forearm
Rear facing

5. What is HI law for booster seat?

6. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

7. 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
Total cholesterol - FOBT
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In adults with sustained BP > 135/80 mmHg

8. What is the schedule for Gardasil?
Rear facing
65 (earlier if have increased risk factors)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
0.4 mg/day

9. How much fluoride should military children in HI be given?
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1000 mg/day
0.4 mg/day

10. When can children sit in a booster seat?

11. What is the schedule for varicella vaccine?
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

12. What is the schedule for polio vaccine?
1000 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
1200 mg/day
2mo - 4 mo - 6mo and 12-15 mo

13. How much calcium should adolescents (9 -18) take?
Start at 20 for all M and W regardless of RFs
Persons with no known risk factors
1300 mg/day
Starts at 20 for both M and W

14. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
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

15. When should Gardasil be given and for what purposes?
Women 55 - 79 yo
NEVER
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

16. Which children should use a semi-upright/forward facing carseat?
Adults > 60
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)
> 2 yo and less than 40 lbs

17. 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
4 mg/day
> 2 yo and less than 40 lbs
Smoking - Alcoholism

18. What is the schedule for Hep B vaccine?
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
When they are > 40 lbs and still less then 5'
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

19. What 3 things should always be done in an office visit?
Adults > 60
BP - Height - Weight
More than 15
2mo - 4mo - 6-18 mo and 4-6 yrs

20. What is the USPSTF guideline for DMT2 screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In adults with sustained BP > 135/80 mmHg
In all W < 24 who are sexually active - In W > 24 with increased risk
Women 55 - 79 yo

21. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

23. Measurement of which anatomic structure is best predictor for hip fracture?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...
Femoral neck
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

24. What is the most important way to screen for CAD in an asymptomatic patients?
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
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
Exercise or physical therapy and vit D for patients > 65
HISTORY

25. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
When they are > 40 lbs and still less then 5'
Men 45 - 79 yo

26. Who should get shingles vaccine?
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 mg/day
4 mg/day
Adults > 60

27. What tests are appropriate to order in an asymptomatic 57 yo male?
In all W < 24 who are sexually active - In W > 24 with increased risk
800 IU/ day
HISTORY
Total cholesterol - FOBT

28. Who are at increased risk for adverse effect catching a flu?
More than 15
Rear facing
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

29. What type of illnesses does Hib vaccine prevent?
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
Meningitis and Epiglottitis
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 - 6mo and 12-15 mo

30. How much flouride should non military children in the state of HI be given?
> 2 yo and less than 40 lbs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
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...

31. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Exercise - Environmental hazard reduction - Close monitoring of medication

32. In which group of patients should aspirin be given as primary prevention for MI?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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
Men 45 - 79 yo

33. What are some RFs for DMT2?
Exercise - Environmental hazard reduction - Close monitoring of medication
Total cholesterol - FOBT
Adults > 60
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

34. What is the ADA guideline for DMT2 screening?
One time abdominal X-ray for all MALES who ever SMOKES
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day

35. How much calcium should adults (19 - 50) take?
Men 45 - 79 yo
1000 mg/day
1000 IU/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

36. How often do asplenic patients receive pneumococcal vaccine?
Adults > 60
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - 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
Every 5 years

37. When should tetanus immunoglobulin be given?
In adults with sustained BP > 135/80 mmHg
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
800 IU/ day

38. What is the schedule for rotavirus vaccine?
800 IU/ day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
NEVER
Persons with no known risk factors

39. What is USPSTF guideline for abdominal aortic aneurysm screening?
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
Forearm
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism

40. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
1000 IU/day
Adults > 60
Forearm
2mo - 4 mo - 6mo and 12-15 mo

41. What are some risk factors for CAD?
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
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

42. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Starts at 50 (recommends against starting at 40) and every 2 years
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

43. What kind of car seat should children < 2 yo be placed in?
Rear facing
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
Women 55 - 79 yo
Forearm

44. When is area of induration > 15 mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Persons with no known 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
Men 45 - 79 yo

45. What are the guidelines for pap smear?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One time abdominal X-ray for all MALES who ever SMOKES
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)

46. How much vit D should adults > 50 take?
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 - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

47. What are 2 conditions that have been proven to be beneficial to screened for?
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo

48. Unopposed estrogen increases risks for what conditions?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
4 mg/day
Stroke and DVT
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

49. What are the guidelines for colon cancer screening?
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
> 2 yo and less than 40 lbs
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

50. How much vit D should adults < 50 take?
800 IU/ day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)