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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. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12 - 23 mo - 2 doses are to be given 6 mo apart
BP - Height - Weight
Start at 20 for all M and W regardless of RFs

2. How much flouride should non military children in the state of HI be given?
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
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

3. How much calcium should women > 50 take?
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1200 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.

4. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
To get IgA protection
One time abdominal X-ray for all MALES who ever SMOKES

5. How often do asplenic patients receive pneumococcal vaccine?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 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
Every 5 years

6. If traveling to endemic areas - Why should one get a dose of live vaccine?
More than 15
Start at 20 for all M and W regardless of RFs
Total cholesterol - FOBT
To get IgA protection

7. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

8. 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
Exercise or physical therapy and vit D for patients > 65
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

9. 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
1300 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

10. How much calcium should adults (19 - 50) take?
1000 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Starts at 20 for both M and W

11. What are the guidelines for pap smear?
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)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo
Starts at 50 (recommends against starting at 40) and every 2 years

12. When should chest X-ray be used for screening?
1200 mg/day
More than 15
NEVER
0.4 - 0.8 mg/day for 1 month prior to conception

13. What are the risks of combination HRT?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
Breast CA - thromboembolic event - stroke and CAD
When they are > 40 lbs and still less then 5'

14. What is HI law for booster seat?

15. What is the schedule for Hib vaccine?
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo - 6mo and 12-15 mo
Persons with no known risk factors

16. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Rear facing

17. When is area of induration > 10 mm considered TB positive?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

18. 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
Meningitis and Epiglottitis
Starts at 20 for both M and W
Total cholesterol - FOBT

19. What kind of sunscreen SPF is recommended for sun protection?
1300 mg/day
Femoral neck
More than 15
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

20. When is intensive individualized home-based intervention recommended?
Children up to 7 yo and < 5' should be placed in a booster seat.
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

21. What is the schedule for DTap vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

22. What are 2 conditions that have been proven to be beneficial to screened for?
Breast CA - thromboembolic event - stroke and CAD
Persons with no known risk factors
65 (earlier if have increased risk factors)
Smoking - Alcoholism

23. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
1200 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
BP - Height - Weight

24. What is the USPSTF guideline for fall prevention in the elderly?
Stroke and DVT
1300 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Exercise or physical therapy and vit D for patients > 65

25. Who should get shingles vaccine?
Adults > 60
Starts at 50 (recommends against starting at 40) and every 2 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
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

26. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
800 IU/ day
NEVER
Adults > 60

27. What tests are appropriate to order in an asymptomatic 57 yo male?
More than 15
Men 45 - 79 yo
Women 55 - 79 yo
Total cholesterol - FOBT

28. How much vit D should adults > 50 take?
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
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
1000 IU/day

29. How much vit D should adults < 50 take?
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 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
800 IU/ day

30. What can decrease fall in the elderly?
Women 55 - 79 yo
Rear facing
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 mg/day

31. What is the NCEP III guideline for cholesterol screening?
65 (earlier if have increased risk factors)
Start at 20 for all M and W regardless of RFs
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

32. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
HISTORY
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Women 55 - 79 yo

33. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Femoral neck
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Forearm

34. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Exercise - Environmental hazard reduction - Close monitoring of medication
4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

35. What are some RFs for DMT2?
2mo - 4 mo - 6mo and 12-15 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
1300 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

36. What are some safety issues you should counsel parents with young children?
NEVER
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
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...

37. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Starts at 50 (recommends against starting at 40) and every 2 years
> 2 yo and less than 40 lbs

38. What are some risk factors for CAD?
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
During 2nd - 3rd trimester
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

39. How much calcium should adolescents (9 -18) take?
Smoking - Alcoholism
In all W < 24 who are sexually active - In W > 24 with increased risk
1300 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

40. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

41. What is the schedule for polio vaccine?
NEVER
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4mo - 6-18 mo and 4-6 yrs

42. What is USPSTF guideline for abdominal aortic aneurysm screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
To get IgA protection
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day

43. When should Gardasil be given and for what purposes?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

44. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years

45. When should tetanus immunoglobulin be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
To get IgA protection

46. Who should get Tdap vaccine and how often?
Starts at 50 (recommends against starting at 40) and every 2 years
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Adults > 60

47. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
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
In adults with sustained BP > 135/80 mmHg
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

48. Who are at increased risk for adverse effect catching a flu?
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
65 (earlier if have increased risk factors)
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

49. What is the schedule for rotavirus vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

50. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
Breast CA - thromboembolic event - stroke and CAD