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Family Medicine Health Maintenance
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Subjects
:
health-sciences
,
family-medicine
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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 can decrease fall in the elderly?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2. What are the 4 main groups of people who are candidates for pneumococcal vaccine?
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3. What are the risks of combination HRT?
1000 mg/day
Breast CA - thromboembolic event - stroke and CAD
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
65 (earlier if have increased risk factors)
4. How much flouride should non military children in the state of HI be given?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
> 2 yo and less than 40 lbs
BP - Height - Weight
5. What are the guidelines for visual screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6. What is the ADA guideline for DMT2 screening?
Stroke and DVT
Women 55 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Adults > 60
7. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
800 IU/ day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
To get IgA protection
8. When can children sit in a booster seat?
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9. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Total cholesterol - FOBT
HISTORY
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day
10. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day
Smoking - Alcoholism
Total cholesterol - FOBT
12. Who should get shingles vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Rear facing
13. What kind of car seat should children < 2 yo be placed in?
Rear facing
HISTORY
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
14. What type of illnesses does Hib vaccine prevent?
One time abdominal X-ray for all MALES who ever SMOKES
Meningitis and Epiglottitis
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
15. What are some risk factors for CAD?
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Stroke and DVT
Breast CA - thromboembolic event - stroke and CAD
16. What are 2 conditions that have been proven to be beneficial to screened for?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Smoking - Alcoholism
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart
17. What is the schedule for Hep B vaccine?
In adults with sustained BP > 135/80 mmHg
4 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
800 IU/ day
18. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
19. When should pregnant women get a flu shot?
Persons with no known risk factors
During 2nd - 3rd trimester
In adults with sustained BP > 135/80 mmHg
Smoking - Alcoholism
20. What is the most important way to screen for CAD in an asymptomatic patients?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
HISTORY
21. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
HISTORY
Forearm
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...
22. What is the schedule for DTap vaccine?
1200 mg/day
Forearm
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'
23. How much vit D should adults < 50 take?
800 IU/ day
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT
24. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Meningitis and Epiglottitis
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
25. What is the USPSTF guideline for chlamydial screening?
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
BP - Height - Weight
26. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
0.4 - 0.8 mg/day for 1 month prior to conception
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after
27. Who are at increased risk for adverse effect catching a flu?
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
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
During 2nd - 3rd trimester
28. What are the guidelines for colon cancer screening?
Smoking - Alcoholism
One time abdominal X-ray for all MALES who ever SMOKES
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
29. How much calcium should women > 50 take?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Children up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day
30. How often do asplenic patients receive pneumococcal vaccine?
HISTORY
Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
31. In which group of patients should aspirin be given as primary prevention for MI?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Adults > 60
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
32. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
Adults > 60
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
33. When is area of induration > 5mm considered TB positive?
Starts at 50 (recommends against starting at 40) and every 2 years
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT
34. What are some safety issues you should counsel parents with young children?
Start at 20 for all M and W regardless of RFs
Stroke and DVT
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...
35. How much vit D should adults > 50 take?
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
65 (earlier if have increased risk factors)
1000 IU/day
Rear facing
36. What is USPSTF guideline for abdominal aortic aneurysm screening?
1200 mg/day
2mo - 4 mo - 6mo and 12-15 mo
1300 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
37. At what age should women have DEXA scan?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
HISTORY
65 (earlier if have increased risk factors)
Men 45 - 79 yo
38. How much folate should all women of child bearing age take?
65 (earlier if have increased risk factors)
Rear facing
0.4 mg/day
1000 IU/day
39. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
Forearm
Breast CA - thromboembolic event - stroke and CAD
1000 IU/day
40. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
1000 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
One dose at 12-15 mod - Booster at least 4-weeks after
41. In which group of patients should aspirin be given as primary prevention for stroke?
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
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
Women 55 - 79 yo
42. When is intensive individualized home-based intervention recommended?
0.4 - 0.8 mg/day for 1 month prior to conception
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)
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...
43. When is area of induration > 10 mm considered TB positive?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
1200 mg/day
44. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg
45. When is area of induration > 15 mm considered TB positive?
To get IgA protection
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Persons with no known risk factors
46. How much folate and for How long should a woman take for planned pregnancy?
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
0.4 - 0.8 mg/day for 1 month prior to conception
47. What is the schedule for Hep A vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
12 - 23 mo - 2 doses are to be given 6 mo apart
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
48. How much fluoride should military children in HI be given?
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...
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
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)
49. What is the USPSTF guideline for fall prevention in the elderly?
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day
More than 15
Exercise or physical therapy and vit D for patients > 65
50. When should the meningococcal vaccine be given and to which group?
Persons with no known risk factors
In all W < 24 who are sexually active - In W > 24 with increased risk
Adults > 60
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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