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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 2 conditions that have been proven to be beneficial to screened for?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism
NEVER
Starts at 20 for both M and W

2. Who should get shingles vaccine?
NEVER
Adults > 60
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
HISTORY

3. What is the USPSTF guideline for fall prevention in the elderly?
Meningitis and Epiglottitis
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
Exercise or physical therapy and vit D for patients > 65
Persons with no known risk factors

4. What is the schedule for Hep B vaccine?
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 dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

5. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
Femoral neck

6. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs
Children up to 7 yo and < 5' should be placed in a booster seat.

7. 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
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...
Persons with no known risk factors
Women 55 - 79 yo

8. What type of illnesses does Hib vaccine prevent?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Starts at 20 for both M and W
1300 mg/day
Meningitis and Epiglottitis

9. What is the schedule for Gardasil?
More than 15
Total cholesterol - FOBT
Adults > 60
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

10. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

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

12. When should the meningococcal vaccine be given and to which group?
Exercise or physical therapy and vit D for patients > 65
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 20 for both M and W
0.4 mg/day

13. How much calcium should adults (19 - 50) take?
1000 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

14. Some contraindications for aspirin
1000 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
During 2nd - 3rd trimester

15. What tests are appropriate to order in an asymptomatic 57 yo male?
Women 55 - 79 yo
0.4 - 0.8 mg/day for 1 month prior to conception
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Total cholesterol - FOBT

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

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17. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after

18. What is the schedule for polio vaccine?
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs
HISTORY
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)

19. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis
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
Stroke and DVT

20. What kind of polio vaccine is preferred?
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

21. How often do asplenic patients receive pneumococcal vaccine?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Every 5 years

22. How much calcium should women > 50 take?
1200 mg/day
To get IgA protection
1300 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

23. At what age should women have DEXA scan?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
65 (earlier if have increased risk factors)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Women 55 - 79 yo

24. If traveling to endemic areas - Why should one get a dose of live vaccine?
During 2nd - 3rd trimester
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
To get IgA protection
Preschool children : 3-4 yo - Elderly patients: > 65 yo

25. What 3 things should always be done in an office visit?
Breast CA - thromboembolic event - stroke and CAD
BP - Height - Weight
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

26. What can decrease fall in the elderly?
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
2mo - 4mo - 6-18 mo and 4-6 yrs
When they are > 40 lbs and still less then 5'

27. Who are at increased risk for adverse effect catching a flu?
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
One time abdominal X-ray for all MALES who ever SMOKES
1200 mg/day

28. What kind of car seat should children < 2 yo be placed in?
NEVER
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15

29. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo

30. What kind of sunscreen SPF is recommended for sun protection?
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

31. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Breast CA - thromboembolic event - stroke and CAD
> 2 yo and less than 40 lbs
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

32. What are some safety issues you should counsel parents with young children?
1000 mg/day
Total cholesterol - FOBT
NEVER
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...

33. 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
More than 15
Persons with no known risk factors
Smoking - Alcoholism

34. When is area of induration > 10 mm considered TB positive?
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
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
NEVER

35. What is the NCEP III guideline for cholesterol screening?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart
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

36. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm
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
During 2nd - 3rd trimester

37. What are the risks of combination HRT?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

38. When should tetanus immunoglobulin be given?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Persons with no known risk factors
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

39. When should pregnant women get a flu shot?
1000 IU/day
During 2nd - 3rd trimester
Adults > 60
2mo - 4mo - 6-18 mo and 4-6 yrs

40. How much calcium should adolescents (9 -18) take?
Femoral neck
1300 mg/day
More than 15
4 mg/day

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

42. What is the ADA guideline for DMT2 screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)
Smoking - Alcoholism
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

43. When should chest X-ray be used for screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Total cholesterol - FOBT
NEVER
Starts at 50 (recommends against starting at 40) and every 2 years

44. How much flouride should non military children in the state of HI be given?
One dose at 12-15 mod - Booster at least 4-weeks after
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 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

45. How much vit D should adults > 50 take?
Exercise or physical therapy and vit D for patients > 65
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 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

46. How much vit D should adults < 50 take?
To get IgA protection
800 IU/ day
Women 55 - 79 yo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

47. Measurement of which anatomic structure is best predictor for hip fracture?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
Stroke and DVT
Femoral neck

48. What are some RFs for DMT2?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Preschool children : 3-4 yo - Elderly patients: > 65 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)
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

49. When is area of induration > 15 mm considered TB positive?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
0.4 - 0.8 mg/day for 1 month prior to conception
Persons with no known risk factors
Every 5 years

50. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception
HISTORY