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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. Who are at increased risk for adverse effect catching a flu?
Starts at 20 for both M and W
Breast CA - thromboembolic event - stroke and CAD
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 mg/day

2. What is the schedule for rotavirus 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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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 - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

3. At what age should women have DEXA scan?
NEVER
65 (earlier if have increased risk factors)
1000 mg/day
Persons with no known risk factors

4. Who should get shingles vaccine?
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
Adults > 60
NEVER

5. What are the risks of combination HRT?
When they are > 40 lbs and still less then 5'
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
Breast CA - thromboembolic event - stroke and CAD
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)

6. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk

7. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Men 45 - 79 yo
One time abdominal X-ray for all MALES who ever SMOKES
When they are > 40 lbs and still less then 5'

8. What 3 things should always be done in an office visit?
Persons with no known risk factors
Total cholesterol - FOBT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
BP - Height - Weight

9. When is intensive individualized home-based intervention recommended?
> 2 yo and less than 40 lbs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)

10. If traveling to endemic areas - Why should one get a dose of live vaccine?
BP - Height - Weight
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Start at 20 for all M and W regardless of RFs
To get IgA protection

11. What is the schedule for Hep A vaccine?
1000 IU/day
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
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart

12. When should tetanus immunoglobulin be given?
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
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)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day

13. How much calcium should adolescents (9 -18) take?
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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

14. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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...
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In adults with sustained BP > 135/80 mmHg

15. When is area of induration > 15 mm considered TB positive?
BP - Height - Weight
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
Persons with no known risk factors
Exercise or physical therapy and vit D for patients > 65

16. Who should get Tdap vaccine and how often?
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
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

17. What is the USPSTF guideline for fall prevention in the elderly?
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise or physical therapy and vit D for patients > 65
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

18. 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
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
Meningitis and Epiglottitis

19. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight
When they are > 40 lbs and still less then 5'
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

20. How much vit D should adults > 50 take?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/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
In adults with sustained BP > 135/80 mmHg

21. How much fluoride should military children in HI be given?
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
1200 mg/day
Smoking - Alcoholism

22. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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 up to 7 yo and < 5' should be placed in a booster seat.
One time abdominal X-ray for all MALES who ever SMOKES

23. What is HI law for booster seat?

24. How much folate should all women of child bearing age take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
0.4 mg/day
Every 5 years
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)

25. What is the most important way to screen for CAD in an asymptomatic patients?
800 IU/ day
HISTORY
More than 15
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

26. What is the schedule for varicella vaccine?
> 2 yo and less than 40 lbs
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)
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4 mo - 6mo and 12-15 mo

27. What can decrease fall in the elderly?
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)
2mo - 4 mo - 6mo and 12-15 mo
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication

28. How much calcium should adults (19 - 50) take?
Exercise or physical therapy and vit D for patients > 65
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 mg/day

29. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

30. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
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
1000 IU/day
> 2 yo and less than 40 lbs

31. When should pregnant women get a flu shot?
12 - 23 mo - 2 doses are to be given 6 mo apart
1200 mg/day
During 2nd - 3rd trimester
To get IgA protection

32. What is the NCEP III guideline for cholesterol screening?
Rear facing
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs

33. 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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Femoral neck
Every 5 years

34. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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...
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
4 mg/day

35. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs
Forearm
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

36. What is the ADA guideline for DMT2 screening?
> 2 yo and less than 40 lbs
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

37. What kind of polio vaccine is preferred?
In all W < 24 who are sexually active - In W > 24 with increased risk
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Women 55 - 79 yo

38. What are the guidelines for visual screening?
Adults > 60
1200 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Breast CA - thromboembolic event - stroke and CAD

39. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Exercise - Environmental hazard reduction - Close monitoring of medication
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
In all W < 24 who are sexually active - In W > 24 with increased risk

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

41. What kind of sunscreen SPF is recommended for sun protection?
More than 15
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
During 2nd - 3rd trimester

42. What is the schedule for Gardasil?
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 up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

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

44. What kind of car seat should children < 2 yo be placed in?
1000 mg/day
BP - Height - Weight
Persons with no known risk factors
Rear facing

45. What type of illnesses does Hib vaccine prevent?
Rear facing
Meningitis and Epiglottitis
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1200 mg/day

46. What is the schedule for polio vaccine?
4 mg/day
Rear facing
2mo - 4mo - 6-18 mo and 4-6 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

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

48. How much calcium should women > 50 take?
1300 mg/day
Adults > 60
1200 mg/day
More than 15

49. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
NEVER
Forearm
800 IU/ day

50. What is the schedule for Hib vaccine?
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
Persons with no known risk factors
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
2mo - 4 mo - 6mo and 12-15 mo