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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. Measurement of which anatomic structure is best predictor for hip fracture?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Femoral neck
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
Start at 20 for all M and W regardless of RFs

2. What is the schedule for Hib 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
2mo - 4 mo - 6mo and 12-15 mo
Forearm
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

3. 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
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'
Children up to 7 yo and < 5' should be placed in a booster seat.

4. What is the schedule for DTap vaccine?
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
Exercise - Environmental hazard reduction - Close monitoring of medication
Breast CA - thromboembolic event - stroke and CAD

5. When should tetanus immunoglobulin be given?
One dose at 12-15 mod - Booster at least 4-weeks after
1000 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

6. What is the NCEP III guideline for cholesterol screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Every 5 years
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs

7. Who should get Tdap vaccine and how often?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 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
Meningitis and Epiglottitis

8. When should pregnant women get a flu shot?
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Women 55 - 79 yo
During 2nd - 3rd trimester

9. What kind of sunscreen SPF is recommended for sun protection?
More than 15
One time abdominal X-ray for all MALES who ever SMOKES
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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

10. What can decrease fall in the elderly?
4 mg/day
In adults with sustained BP > 135/80 mmHg
Femoral neck
Exercise - Environmental hazard reduction - Close monitoring of medication

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

12. What is HI law for booster seat?

13. How much vit D should adults < 50 take?
Starts at 50 (recommends against starting at 40) and every 2 years
One time abdominal X-ray for all MALES who ever SMOKES
One dose at 12-15 mod - Booster at least 4-weeks after
800 IU/ day

14. How much folate should all women of child bearing age take?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
1000 IU/day
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

15. 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
1000 IU/day
To get IgA protection

16. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

17. Which children should use a semi-upright/forward facing carseat?
Women 55 - 79 yo
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
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

18. How much calcium should adolescents (9 -18) take?
Starts at 20 for both M and W
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1300 mg/day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

19. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
1000 mg/day
65 (earlier if have increased risk factors)
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

20. How much flouride should non military children in the state of HI be given?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

21. When should the meningococcal vaccine be given and to which group?
HISTORY
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

22. Some contraindications for aspirin
Exercise or physical therapy and vit D for patients > 65
1000 mg/day
Meningitis and Epiglottitis
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

23. Who are at increased risk for adverse effect catching a flu?
Total cholesterol - FOBT
Adults > 60
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
HISTORY

24. What is the schedule for MMR vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT
800 IU/ day
Children up to 7 yo and < 5' should be placed in a booster seat.

25. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 IU/day
Men 45 - 79 yo

26. What kind of polio vaccine is preferred?
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

27. How much folate and for How long should a woman with hx of NTD 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
4 mg/day
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

28. What are the USPSTF guidelines for mammogram?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
Starts at 50 (recommends against starting at 40) and every 2 years
HISTORY

29. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
BP - Height - Weight
1200 mg/day
800 IU/ day

30. In which group of patients should aspirin be given as primary prevention for MI?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Women 55 - 79 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Men 45 - 79 yo

31. What is the schedule for Gardasil?
HISTORY
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

32. 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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
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

33. What are some safety issues you should counsel parents with young children?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
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 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)
2mo - 4mo - 6-18 mo and 4-6 yrs
Children up to 7 yo and < 5' should be placed in a booster seat.

35. How much calcium should women > 50 take?
1200 mg/day
Rear facing
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 mg/day

36. What are 2 conditions that have been proven to be beneficial to screened for?
800 IU/ 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
Smoking - Alcoholism
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

37. What is the USPSTF guideline for DMT2 screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In adults with sustained BP > 135/80 mmHg
Men 45 - 79 yo
Rear facing

38. What are the risks of combination HRT?
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
Breast CA - thromboembolic event - stroke and CAD
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

39. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
NEVER
1000 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

40. Unopposed estrogen increases risks for what conditions?
Stroke and DVT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Meningitis and Epiglottitis

41. When is area of induration > 5mm considered TB positive?
When they are > 40 lbs and still less then 5'
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

42. What are the guidelines for colon cancer screening?
1300 mg/day
In adults with sustained BP > 135/80 mmHg
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
Rear facing

43. What are the guidelines for visual screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Every 5 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12 - 23 mo - 2 doses are to be given 6 mo apart

44. How much fluoride should military children in HI be given?
2mo - 4 mo - 6mo and 12-15 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

45. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Femoral neck
800 IU/ day

46. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
When they are > 40 lbs and still less then 5'
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

47. Who should get shingles vaccine?
When they are > 40 lbs and still less then 5'
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day

48. What is the schedule for Hep B vaccine?
Men 45 - 79 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

49. What are some RFs for DMT2?
0.4 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)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
2mo - 4mo - 6-18 mo and 4-6 yrs

50. What kind of car seat should children < 2 yo be placed in?
Exercise or physical therapy and vit D for patients > 65
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing
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