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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. Some contraindications for aspirin
Children up to 7 yo and < 5' should be placed in a booster seat.
0.4 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Total cholesterol - FOBT

2. 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Stroke and DVT

3. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Start at 20 for all M and W regardless of RFs
12 - 23 mo - 2 doses are to be given 6 mo apart

4. How much calcium should women > 50 take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1200 mg/day

5. What is the schedule for polio 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...
2mo - 4mo - 6-18 mo and 4-6 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk

6. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 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)
0.4 - 0.8 mg/day for 1 month prior to conception
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

7. What kind of car seat should children < 2 yo be placed in?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Rear facing
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

8. What are the guidelines for pap smear?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Meningitis and Epiglottitis
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)

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

10. What is HI law for booster seat?

11. When should chest X-ray be used for screening?
During 2nd - 3rd trimester
Femoral neck
NEVER
Adults > 60

12. What can decrease fall in the elderly?
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
Femoral neck
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

13. What is the schedule for Hep B vaccine?
Women 55 - 79 yo
Stroke and DVT
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise - Environmental hazard reduction - Close monitoring of medication

14. What is the schedule for Hep A 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
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
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

15. What is the USPSTF guideline for fall prevention in the elderly?
BP - Height - Weight
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)
To get IgA protection

16. If traveling to endemic areas - Why should one get a dose of live vaccine?
Children up to 7 yo and < 5' should be placed in a booster seat.
Start at 20 for all M and W regardless of RFs
To get IgA protection
When they are > 40 lbs and still less then 5'

17. When is area of induration > 15 mm considered TB positive?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
Persons with no known risk factors

18. What are 2 conditions that have been proven to be beneficial to screened for?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Smoking - Alcoholism
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
One dose at 12-15 mod - Booster at least 4-weeks after

19. What is the schedule for MMR vaccine?
Total cholesterol - FOBT
Starts at 20 for both M and W
One dose at 12-15 mod - Booster at least 4-weeks after
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

20. How often do asplenic patients receive pneumococcal vaccine?
Women 55 - 79 yo
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)
Children up to 7 yo and < 5' should be placed in a booster seat.
Every 5 years

21. What is the most important way to screen for CAD in an asymptomatic patients?
In adults with sustained BP > 135/80 mmHg
800 IU/ day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
HISTORY

22. 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...
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Adults > 60

23. When is area of induration > 5mm considered TB positive?
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
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
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
1300 mg/day

24. What tests are appropriate to order in an asymptomatic 57 yo male?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Every 5 years
Total cholesterol - FOBT
NEVER

25. What is the ADA guideline for DMT2 screening?
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Total cholesterol - FOBT

26. What is the schedule for Gardasil?
2mo - 4 mo - 6mo and 12-15 mo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

27. Who should get Tdap vaccine and how often?
HISTORY
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

28. How much calcium should adults (19 - 50) take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1000 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 IU/day

29. Who are at increased risk for adverse effect catching a flu?
To get IgA protection
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
> 2 yo and less than 40 lbs
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

30. When is area of induration > 10 mm considered TB positive?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
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

31. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1200 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
When they are > 40 lbs and still less then 5'

32. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 50 (recommends against starting at 40) and every 2 years
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
One time abdominal X-ray for all MALES who ever SMOKES

33. When should the meningococcal vaccine be given and to which group?
Starts at 50 (recommends against starting at 40) and every 2 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
1300 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

34. What are the risks of combination HRT?
1300 mg/day
Starts at 20 for both M and W
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo
Forearm

36. Measurement of which anatomic structure is best predictor for hip fracture?
Exercise or physical therapy and vit D for patients > 65
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck

37. When is intensive individualized home-based intervention recommended?
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
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
> 2 yo and less than 40 lbs
Persons with no known risk factors

38. 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
Rear facing
One time abdominal X-ray for all MALES who ever SMOKES

39. How much folate should all women of child bearing age take?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 mg/day
4 mg/day

40. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day
65 (earlier if have increased risk factors)
Exercise - Environmental hazard reduction - Close monitoring of medication

41. What is the USPSTF guideline for chlamydial screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo
Women 55 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

42. What is the schedule for varicella vaccine?
Adults > 60
One dose at 12-15 mod - Booster at least 4-weeks after
Stroke and DVT
> 2 yo and less than 40 lbs

43. At what age should women have DEXA scan?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Smoking - Alcoholism
65 (earlier if have increased risk factors)
Rear facing

44. How much vit D should adults < 50 take?
800 IU/ day
1200 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
In adults with sustained BP > 135/80 mmHg

45. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs
Stroke and DVT

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
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
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)

47. What is the schedule for DTap vaccine?
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
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...

48. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
65 (earlier if have increased risk factors)

49. When can children sit in a booster seat?

50. What are the USPSTF guidelines for mammogram?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years