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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?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
Rear facing
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

2. Measurement of which anatomic structure is best predictor for hip fracture?
1300 mg/day
Femoral neck
12 - 23 mo - 2 doses are to be given 6 mo apart
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

3. What are the risks of combination HRT?
When they are > 40 lbs and still less then 5'
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Breast CA - thromboembolic event - stroke and CAD
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

4. When is intensive individualized home-based intervention recommended?
Men 45 - 79 yo
Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

5. What is the schedule for Gardasil?
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
HISTORY

6. How much calcium should women > 50 take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Total cholesterol - FOBT
1200 mg/day
4 mg/day

7. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Starts at 20 for both M and W
Persons with no known risk factors

8. When should chest X-ray be used for screening?
NEVER
4 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
To get IgA protection

9. How much folate should all women of child bearing age take?
NEVER
0.4 mg/day
Forearm
To get IgA protection

10. What is the USPSTF guideline for fall prevention in the elderly?
4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
Exercise or physical therapy and vit D for patients > 65

11. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
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

12. If traveling to endemic areas - Why should one get a dose of live vaccine?
Persons with no known risk factors
1300 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection

13. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
In all W < 24 who are sexually active - In W > 24 with increased risk
HISTORY
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

14. In which group of patients should aspirin be given as primary prevention for stroke?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Women 55 - 79 yo
1000 mg/day
Adults > 60

15. What is the ADA guideline for DMT2 screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

16. How often do asplenic patients receive pneumococcal vaccine?
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
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
Persons with no known risk factors
Every 5 years

17. When can children sit in a booster seat?

18. What tests are appropriate to order in an asymptomatic 57 yo male?
Children up to 7 yo and < 5' should be placed in a booster seat.
1000 IU/day
HISTORY
Total cholesterol - FOBT

19. How much vit D should adults < 50 take?
800 IU/ day
1000 mg/day
Starts at 20 for both M and W
> 2 yo and less than 40 lbs

20. How much flouride should non military children in the state of HI be given?
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo - 6mo and 12-15 mo

21. Who should get Tdap vaccine and how often?
Men 45 - 79 yo
Femoral neck
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

22. What are the USPSTF guidelines for mammogram?
1200 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...
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. What are the 4 main groups of people who are candidates for pneumococcal vaccine?

24. What is the USPSTF guideline for chlamydial screening?
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

25. Which children should use a semi-upright/forward facing carseat?
Rear facing
> 2 yo and less than 40 lbs
In adults with sustained BP > 135/80 mmHg
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

26. What are the guidelines for colon cancer screening?
65 (earlier if have increased risk factors)
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 50 for normal risk - age 40 for increased risk - FOBT every year - OR - Sigmodoiscopy every 3-5 years - OR - Colonoscopy every 10 years
2mo - 4mo - 6-18 mo and 4-6 yrs

27. What is the NCEP III guideline for cholesterol screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

28. How much calcium should adults (19 - 50) take?
In adults with sustained BP > 135/80 mmHg
During 2nd - 3rd trimester
1000 mg/day
> 2 yo and less than 40 lbs

29. When is area of induration > 10 mm considered TB positive?
Exercise - Environmental hazard reduction - Close monitoring of medication
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
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

30. When should the meningococcal vaccine be given and to which group?
Start at 20 for all M and W regardless of RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4mo - 6-18 mo and 4-6 yrs
Men 45 - 79 yo

31. 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
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis
Men 45 - 79 yo

32. What is USPSTF guideline for abdominal aortic aneurysm screening?
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
Adults > 60
12 - 23 mo - 2 doses are to be given 6 mo apart

33. In which group of patients should aspirin be given as primary prevention for MI?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
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

34. What are the guidelines for visual screening?
During 2nd - 3rd trimester
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
Starts at 50 (recommends against starting at 40) and every 2 years

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Every 5 years
Forearm

36. What is the schedule for Hep A 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)
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Start at 20 for all M and W regardless of RFs

37. What kind of polio vaccine is preferred?
Exercise or physical therapy and vit D for patients > 65
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 IU/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

38. What are the guidelines for pap smear?
2mo - 4mo - 6-18 mo and 4-6 yrs
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)
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception

39. What is the schedule for Hib vaccine?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
4 mg/day
Women 55 - 79 yo

40. When should Gardasil be given and for what purposes?
To get IgA protection
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 adults with sustained BP > 135/80 mmHg
Femoral neck

41. At what age should women have DEXA scan?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
65 (earlier if have increased 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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

42. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 - 0.8 mg/day for 1 month prior to conception
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W

43. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
BP - Height - Weight
One dose at 12-15 mod - Booster at least 4-weeks after

44. What is the schedule for MMR vaccine?
BP - Height - Weight
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
HISTORY

45. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Children up to 7 yo and < 5' should be placed in a booster seat.
1300 mg/day
Breast CA - thromboembolic event - stroke and CAD

46. 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
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
When they are > 40 lbs and still less then 5'

47. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
800 IU/ day
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

48. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
Forearm

49. How much fluoride should military children in HI be given?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Start at 20 for all M and W regardless of RFs

50. What are some safety issues you should counsel parents with young children?
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
Stroke and DVT
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...
When they are > 40 lbs and still less then 5'