Test your basic knowledge |

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 can decrease fall in the elderly?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Exercise - Environmental hazard reduction - Close monitoring of medication
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

2. Unopposed estrogen increases risks for what conditions?
Adults > 60
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Stroke and DVT

3. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
More than 15
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs

4. What are the USPSTF guidelines for mammogram?
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

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

6. How much flouride should non military children in the state of HI be given?
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
During 2nd - 3rd trimester
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

7. When is area of induration > 15 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Persons with no known risk factors
65 (earlier if have increased risk factors)

8. What kind of polio vaccine is preferred?
Femoral neck
Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 IU/day

9. Measurement of which anatomic structure is best predictor for hip fracture?
During 2nd - 3rd trimester
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Femoral neck

10. Which children should use a semi-upright/forward facing carseat?
0.4 mg/day
Women 55 - 79 yo
> 2 yo and less than 40 lbs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

11. How much fluoride should military children in HI be given?
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
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

12. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
When they are > 40 lbs and still less then 5'
1000 IU/day

13. How much folate should all women of child bearing age take?
0.4 mg/day
When they are > 40 lbs and still less then 5'
Femoral neck
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

14. When can children sit in a booster seat?

15. When should pregnant women get a flu shot?
> 2 yo and less than 40 lbs
Children up to 7 yo and < 5' should be placed in a booster seat.
During 2nd - 3rd trimester
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

16. How much folate and for How long should a woman take for planned pregnancy?
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
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 20 for both M and W
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

17. What is the NCEP III guideline for cholesterol screening?
> 2 yo and less than 40 lbs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Start at 20 for all M and W regardless of RFs
800 IU/ day

18. What is the schedule for MMR vaccine?
1000 IU/day
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.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

19. What is the USPSTF guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day
In adults with sustained BP > 135/80 mmHg
Children up to 7 yo and < 5' should be placed in a booster seat.

20. What kind of car seat should children < 2 yo be placed in?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk
Rear facing

21. What is the schedule for varicella vaccine?
Total cholesterol - FOBT
One dose at 12-15 mod - Booster at least 4-weeks after
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

22. When is area of induration > 10 mm considered TB positive?
0.4 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
Men 45 - 79 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

23. What kind of sunscreen SPF is recommended for sun protection?
0.4 mg/day
Meningitis and Epiglottitis
More than 15
Total cholesterol - FOBT

24. How much calcium should adolescents (9 -18) take?
1300 mg/day
Smoking - Alcoholism
Exercise - Environmental hazard reduction - Close monitoring of medication
In all W < 24 who are sexually active - In W > 24 with increased risk

25. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
Start at 20 for all M and W regardless of RFs
Forearm
More than 15

26. What is USPSTF guideline for abdominal aortic aneurysm screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY
One time abdominal X-ray for all MALES who ever SMOKES
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

27. How much calcium should adults (19 - 50) take?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 mg/day
Adults > 60
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

28. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In adults with sustained BP > 135/80 mmHg
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
Exercise - Environmental hazard reduction - Close monitoring of medication

29. What are some safety issues you should counsel parents with young children?
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...
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
800 IU/ day
Stroke and DVT

30. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Forearm
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise or physical therapy and vit D for patients > 65

31. What 3 things should always be done in an office visit?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
BP - Height - Weight

32. What are the guidelines for colon cancer screening?
Every 5 years
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4 mo - 6mo and 12-15 mo

33. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Forearm
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

34. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

35. Who are at increased risk for adverse effect catching a flu?
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
Femoral neck
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Children up to 7 yo and < 5' should be placed in a booster seat.

36. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
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

37. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men 45 - 79 yo
Starts at 20 for both M and W
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

38. How much vit D should adults < 50 take?
4 mg/day
800 IU/ day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
NEVER

39. When should tetanus immunoglobulin be given?
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
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 - 0.8 mg/day for 1 month prior to conception
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

40. 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)
12 - 23 mo - 2 doses are to be given 6 mo apart
One time abdominal X-ray for all MALES who ever SMOKES
Persons with no known risk factors

41. What is the schedule for Gardasil?
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication
Smoking - Alcoholism
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

42. What is the USPSTF guideline for chlamydial screening?
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
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
In all W < 24 who are sexually active - In W > 24 with increased risk

43. What is the ADA guideline for DMT2 screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

44. How often do asplenic patients receive pneumococcal vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Every 5 years

45. What are the risks of combination HRT?
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
To get IgA protection

46. 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
Femoral neck
1000 IU/day
More than 15

47. What is the schedule for polio vaccine?
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT

48. Who should get shingles vaccine?
0.4 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Adults > 60
65 (earlier if have increased risk factors)

49. What are 2 conditions that have been proven to be beneficial to screened for?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection
Smoking - Alcoholism

50. At what age should women have DEXA scan?
1000 mg/day
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)