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. When is intensive individualized home-based intervention recommended?
More than 15
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)
Persons with no known 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

2. In which group of patients should aspirin be given as primary prevention for stroke?
1000 IU/day
Women 55 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60

3. What is the schedule for MMR vaccine?
Total cholesterol - FOBT
During 2nd - 3rd trimester
Starts at 50 (recommends against starting at 40) and every 2 years
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

4. How much calcium should adolescents (9 -18) take?
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
1200 mg/day
1300 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after

5. How much vit D should adults < 50 take?
2mo - 4 mo - 6mo and 12-15 mo
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...
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
800 IU/ day

6. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
Total cholesterol - FOBT
Children up to 7 yo and < 5' should be placed in a booster seat.
Breast CA - thromboembolic event - stroke and CAD

7. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Children up to 7 yo and < 5' should be placed in a booster seat.
More than 15
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

8. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
Breast CA - thromboembolic event - stroke and CAD
Exercise - Environmental hazard reduction - Close monitoring of medication
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

9. Who should get shingles vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
Adults > 60
1200 mg/day

10. How much vit D should adults > 50 take?
2mo - 4 mo - 6mo and 12-15 mo
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 IU/day

11. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
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
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

12. What are some risk factors for CAD?
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
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
Exercise or physical therapy and vit D for patients > 65

13. What is the schedule for Hep B vaccine?
800 IU/ day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

14. How much calcium should women > 50 take?
1200 mg/day
Exercise or physical therapy and vit D for patients > 65
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD

15. When should chest X-ray be used for screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Total cholesterol - FOBT
NEVER
Adults > 60

16. What are the guidelines for pap smear?
12 - 23 mo - 2 doses are to be given 6 mo apart
HISTORY
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)

17. What is the USPSTF guideline for fall prevention in the elderly?
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'
Exercise or physical therapy and vit D for patients > 65

18. What is the USPSTF guideline for chlamydial screening?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
Stroke and DVT

19. Who should get Tdap vaccine and how often?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
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...

20. What are some safety issues you should counsel parents with young children?
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...
Total cholesterol - FOBT
Stroke and DVT
Every 5 years

21. When should tetanus immunoglobulin be given?
Meningitis and Epiglottitis
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo - 6mo and 12-15 mo
800 IU/ day

22. What is the schedule for polio vaccine?
Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
2mo - 4mo - 6-18 mo and 4-6 yrs
1000 IU/day

23. What kind of car seat should children < 2 yo be placed in?
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
One dose at 12-15 mod - Booster at least 4-weeks after
Smoking - Alcoholism

24. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W
> 2 yo and less than 40 lbs

25. When can children sit in a booster seat?

26. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Adults > 60
0.4 - 0.8 mg/day for 1 month prior to conception
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

27. What type of illnesses does Hib vaccine prevent?
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
To get IgA protection
Meningitis and Epiglottitis

28. What is the ADA guideline for DMT2 screening?
Children up to 7 yo and < 5' should be placed in a booster seat.
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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

29. Who are at increased risk for adverse effect catching a flu?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 - 0.8 mg/day for 1 month prior to conception
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

30. How much flouride should non military children in the state of HI be given?
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
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
1300 mg/day

31. What can decrease fall in the elderly?
65 (earlier if have increased risk factors)
1300 mg/day
> 2 yo and less than 40 lbs
Exercise - Environmental hazard reduction - Close monitoring of medication

32. Measurement of which anatomic structure is best predictor for hip fracture?
Women 55 - 79 yo
1300 mg/day
Femoral neck
Breast CA - thromboembolic event - stroke and CAD

33. What is the schedule for Hib vaccine?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

34. Unopposed estrogen increases risks for what conditions?
Men 45 - 79 yo
65 (earlier if have increased risk factors)
Persons with no known risk factors
Stroke and DVT

35. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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

36. Which children should use a semi-upright/forward facing carseat?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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
> 2 yo and less than 40 lbs

37. Some contraindications for aspirin
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg
1000 mg/day
During 2nd - 3rd trimester

38. What is the schedule for varicella vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
One dose at 12-15 mod - Booster at least 4-weeks after
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Women 55 - 79 yo

39. When is area of induration > 5mm considered TB positive?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

40. How much folate should all women of child bearing age take?
Total cholesterol - FOBT
0.4 mg/day
Starts at 20 for both M and W
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

41. How often do asplenic patients receive pneumococcal vaccine?
Forearm
One time abdominal X-ray for all MALES who ever SMOKES
During 2nd - 3rd trimester
Every 5 years

42. What are the guidelines for visual screening?
4 mg/day
Adults > 60
65 (earlier if have increased risk factors)
Preschool children : 3-4 yo - Elderly patients: > 65 yo

43. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
> 2 yo and less than 40 lbs
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

44. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Exercise - Environmental hazard reduction - Close monitoring of medication
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

45. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
HISTORY
Exercise or physical therapy and vit D for patients > 65

46. How much folate and for How long should a woman take for planned pregnancy?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day

47. What are the risks of combination HRT?
1200 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
Breast CA - thromboembolic event - stroke and CAD
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

48. What is the schedule for Hep A vaccine?
Start at 20 for all M and W regardless of RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
12 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism

49. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
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
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
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

50. What are some RFs for DMT2?
Children up to 7 yo and < 5' should be placed in a booster seat.
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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