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 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
When they are > 40 lbs and still less then 5'
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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

2. What 3 things should always be done in an office visit?
Forearm
> 2 yo and less than 40 lbs
In all W < 24 who are sexually active - In W > 24 with increased risk
BP - Height - Weight

3. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
65 (earlier if have increased risk factors)

4. What are some RFs for DMT2?
Start at 20 for all M and W regardless of RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
BP - Height - Weight
800 IU/ day

5. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
NEVER
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Every 5 years

6. When is area of induration > 15 mm considered TB positive?
In adults with sustained BP > 135/80 mmHg
0.4 - 0.8 mg/day for 1 month prior to conception
1300 mg/day
Persons with no known risk factors

7. 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
HISTORY
When they are > 40 lbs and still less then 5'
Start at 20 for all M and W regardless of RFs

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

9. What are the guidelines for pap smear?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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)
During 2nd - 3rd trimester
1200 mg/day

10. Who should get shingles vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Adults > 60
Smoking - Alcoholism
Persons with no known risk factors

11. What is the schedule for Hep A vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
12 - 23 mo - 2 doses are to be given 6 mo apart
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
0.4 - 0.8 mg/day for 1 month prior to conception

12. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1000 mg/day
1200 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

13. When can children sit in a booster seat?

14. What is HI law for booster seat?

15. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
4 mg/day
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

16. What is the schedule for DTap vaccine?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Smoking - Alcoholism
2mo - 4 mo - 6mo and 12-15 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

17. What is USPSTF guideline for abdominal aortic aneurysm screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Forearm
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
One time abdominal X-ray for all MALES who ever SMOKES

18. What are the guidelines for colon cancer screening?
Stroke and DVT
Rear facing
More than 15
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

19. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
In all W < 24 who are sexually active - In W > 24 with increased risk

20. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
1200 mg/day
To get IgA protection
In all W < 24 who are sexually active - In W > 24 with increased risk

21. When should chest X-ray be used for screening?
1200 mg/day
NEVER
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W

22. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 IU/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

23. What type of illnesses does Hib vaccine prevent?
Exercise or physical therapy and vit D for patients > 65
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
Meningitis and Epiglottitis
> 2 yo and less than 40 lbs

24. In which group of patients should aspirin be given as primary prevention for MI?
Start at 20 for all M and W regardless of RFs
Men 45 - 79 yo
2mo - 4 mo - 6mo and 12-15 mo
Exercise or physical therapy and vit D for patients > 65

25. How much calcium should adults (19 - 50) take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 IU/day
1000 mg/day
Every 5 years

26. In which group of patients should aspirin be given as primary prevention for stroke?
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Women 55 - 79 yo
Start at 20 for all M and W regardless of RFs

27. What is the most important way to screen for CAD in an asymptomatic patients?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
HISTORY

28. What is the schedule for MMR vaccine?
Men 45 - 79 yo
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

29. How much vit D should adults > 50 take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day
To get IgA protection
0.4 mg/day

30. How much folate and for How long should a woman take for planned pregnancy?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
0.4 - 0.8 mg/day for 1 month prior to conception
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

31. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

32. What kind of sunscreen SPF is recommended for sun protection?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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)
More than 15

33. At what age should women have DEXA scan?
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

34. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Forearm
1000 IU/day

35. How much flouride should non military children in the state of 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
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
Every 5 years
1000 mg/day

36. 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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4mo - 6-18 mo and 4-6 yrs

37. What are some risk factors for CAD?
One time abdominal X-ray for all MALES who ever SMOKES
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
Men 45 - 79 yo

38. Who should get Tdap vaccine and how often?
Exercise or physical therapy and vit D for patients > 65
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
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

39. If traveling to endemic areas - Why should one get a dose of live 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
To get IgA protection
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
Exercise - Environmental hazard reduction - Close monitoring of medication

40. 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
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

41. What are 2 conditions that have been proven to be beneficial to screened for?
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism
Exercise or physical therapy and vit D for patients > 65

42. What tests are appropriate to order in an asymptomatic 57 yo male?
Start at 20 for all M and W regardless of RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT
Every 5 years

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

44. What are the risks of combination HRT?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD

45. How often do asplenic patients receive pneumococcal vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
Every 5 years
Forearm
4 mg/day

46. What kind of car seat should children < 2 yo be placed in?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Rear facing
More than 15
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

47. How much calcium should adolescents (9 -18) take?
1300 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

48. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1000 IU/day

49. 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
Start at 20 for all M and W regardless of RFs
Meningitis and Epiglottitis
2mo - 4 mo - 6mo and 12-15 mo

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