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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. Unopposed estrogen increases risks for what conditions?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Stroke and DVT
During 2nd - 3rd trimester

2. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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 time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs

3. Who should get Tdap vaccine and how often?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One time abdominal X-ray for all MALES who ever SMOKES
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
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

4. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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)
Women 55 - 79 yo
Meningitis and Epiglottitis

5. What are some RFs for DMT2?
Smoking - Alcoholism
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In adults with sustained BP > 135/80 mmHg
Adults > 60

6. What is the schedule for Hep A vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1000 IU/day
Breast CA - thromboembolic event - stroke and CAD
12 - 23 mo - 2 doses are to be given 6 mo apart

7. Which children should use a semi-upright/forward facing carseat?
12 - 23 mo - 2 doses are to be given 6 mo apart
Rear facing
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs

8. 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
BP - Height - Weight
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER

9. Some contraindications for aspirin
Forearm
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)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

10. What is the schedule for Gardasil?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Every 5 years

11. What is the schedule for polio vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
Smoking - Alcoholism
2mo - 4mo - 6-18 mo and 4-6 yrs
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

12. What is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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)
BP - Height - Weight
0.4 mg/day

13. What are the guidelines for pap smear?
800 IU/ 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)
1000 IU/day
In adults with sustained BP > 135/80 mmHg

14. When should tetanus immunoglobulin be given?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'

15. How much fluoride should military children in HI be given?
65 (earlier if have increased risk factors)
Total cholesterol - FOBT
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis

16. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Persons with no known risk factors
Exercise - Environmental hazard reduction - Close monitoring of medication
Stroke and DVT

17. When should the meningococcal vaccine be given and to which group?
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
65 (earlier if have increased risk factors)
Forearm

18. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

19. When should Gardasil be given and for what purposes?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years

20. If traveling to endemic areas - Why should one get a dose of live 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
Women 55 - 79 yo
To get IgA protection
Exercise or physical therapy and vit D for patients > 65

21. At what age should women have DEXA scan?
Adults > 60
65 (earlier if have increased risk factors)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo

22. What is the NCEP III guideline for cholesterol screening?
NEVER
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
Start at 20 for all M and W regardless of RFs
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)

23. Measurement of which anatomic structure is best predictor for hip fracture?
Breast CA - thromboembolic event - stroke and CAD
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
Femoral neck
Stroke and DVT

24. What is the schedule for MMR vaccine?
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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...

25. What is the USPSTF guideline for fall prevention in the elderly?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Exercise or physical therapy and vit D for patients > 65
1000 IU/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

26. When can children sit in a booster seat?

27. Who should get shingles vaccine?
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.
Adults > 60
During 2nd - 3rd trimester

28. How much vit D should adults < 50 take?
Stroke and DVT
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day

29. How much calcium should adolescents (9 -18) take?
1300 mg/day
1000 IU/day
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

30. When should pregnant women get a flu shot?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
During 2nd - 3rd trimester
Starts at 20 for both M and W
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

31. What 3 things should always be done in an office visit?
BP - Height - Weight
Persons with no known risk factors
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
Starts at 20 for both M and W

32. Who are at increased risk for adverse effect catching a flu?
> 2 yo and less than 40 lbs
Stroke and DVT
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Total cholesterol - FOBT

33. What is the schedule for varicella vaccine?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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...

34. What are the guidelines for colon cancer screening?
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 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4mo - 6-18 mo and 4-6 yrs
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

35. How much calcium should adults (19 - 50) take?
0.4 - 0.8 mg/day for 1 month prior to conception
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 mg/day
> 2 yo and less than 40 lbs

36. How much folate should all women of child bearing age take?
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)
1200 mg/day
0.4 mg/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

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

38. What is the schedule for Hib vaccine?
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
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

39. What kind of car seat should children < 2 yo be placed in?
Forearm
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing

40. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
Preschool children : 3-4 yo - Elderly patients: > 65 yo

41. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
Persons with no known risk factors
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

42. 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
Every 5 years
NEVER
One time abdominal X-ray for all MALES who ever SMOKES

43. What are the guidelines for visual screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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

44. When is intensive individualized home-based intervention recommended?
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Adults > 60
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

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

46. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

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

48. What type of illnesses does Hib vaccine prevent?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4mo - 6-18 mo and 4-6 yrs
0.4 mg/day
Meningitis and Epiglottitis

49. How much vit D should adults > 50 take?
Men 45 - 79 yo
1000 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'

50. How much flouride should non military children in the state of HI be given?
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Men 45 - 79 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...