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. Unopposed estrogen increases risks for what conditions?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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)
Stroke and DVT
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

2. What 3 things should always be done in an office visit?
During 2nd - 3rd trimester
1300 mg/day
BP - Height - Weight
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

3. What is the schedule for Hep A vaccine?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

4. Who should get Tdap vaccine and how often?
Women 55 - 79 yo
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

5. How much calcium should women > 50 take?
1200 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
Starts at 20 for both M and W
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

6. What is the schedule for varicella vaccine?
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after
Adults > 60
Femoral neck

7. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
1000 IU/day
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis

8. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
Rear facing
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

9. When should Gardasil be given and for what purposes?
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
Children up to 7 yo and < 5' should be placed in a booster seat.
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

10. At what age should women have DEXA scan?
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 mg/day
65 (earlier if have increased risk factors)
Women 55 - 79 yo

11. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm
More than 15

12. What are the risks of combination HRT?
Men 45 - 79 yo
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD
In all W < 24 who are sexually active - In W > 24 with increased risk

13. When can children sit in a booster seat?

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

15. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
800 IU/ day
During 2nd - 3rd trimester
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

16. How much vit D should adults > 50 take?
1000 IU/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
During 2nd - 3rd trimester
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

17. What is the schedule for Gardasil?
1000 IU/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

18. What is the USPSTF guideline for chlamydial screening?
1200 mg/day
Meningitis and Epiglottitis
Forearm
In all W < 24 who are sexually active - In W > 24 with increased risk

19. How much flouride should non military children in the state of HI be given?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
1300 mg/day

20. What are some safety issues you should counsel parents with young children?
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg
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...
12 - 23 mo - 2 doses are to be given 6 mo apart

21. When should tetanus immunoglobulin be given?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

22. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
1000 IU/day

23. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Persons with no known risk factors
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

24. What tests are appropriate to order in an asymptomatic 57 yo male?
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)
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Total cholesterol - FOBT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

25. When is intensive individualized home-based intervention recommended?
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
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
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

26. 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
Exercise - Environmental hazard reduction - Close monitoring of medication
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

27. What kind of sunscreen SPF is recommended for sun protection?
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
One dose at 12-15 mod - Booster at least 4-weeks after
More than 15
To get IgA protection

28. What is the schedule for rotavirus vaccine?
Start at 20 for all M and W regardless of RFs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One time abdominal X-ray for all MALES who ever SMOKES
Starts at 50 (recommends against starting at 40) and every 2 years

29. How much calcium should adults (19 - 50) take?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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 - 4 mo - 6mo and 12-15 mo
1000 mg/day

30. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

31. What are the guidelines for pap smear?
During 2nd - 3rd trimester
12 - 23 mo - 2 doses are to be given 6 mo apart
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)

32. How much folate and for How long should a woman take for planned pregnancy?
1300 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
Smoking - Alcoholism
To get IgA protection

33. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)
Forearm

34. What is the USPSTF guideline for fall prevention in the elderly?
One time abdominal X-ray for all MALES who ever SMOKES
Exercise or physical therapy and vit D for patients > 65
To get IgA protection
Starts at 20 for both M and W

35. Which children should use a semi-upright/forward facing carseat?
More than 15
Start at 20 for all M and W regardless of RFs
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
> 2 yo and less than 40 lbs

36. How much fluoride should military children in HI be given?
65 (earlier if have increased risk factors)
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
Start at 20 for all M and W regardless of RFs

37. In which group of patients should aspirin be given as primary prevention for stroke?
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...
One time abdominal X-ray for all MALES who ever SMOKES
Women 55 - 79 yo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

38. What is the NCEP III guideline for cholesterol screening?
Every 5 years
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Start at 20 for all M and W regardless of RFs
Starts at 20 for both M and W

39. What kind of car seat should children < 2 yo be placed in?
Rear facing
When they are > 40 lbs and still less then 5'
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
2mo - 4mo - 6-18 mo and 4-6 yrs

40. What kind of polio vaccine is preferred?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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)
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

41. What is the ADA guideline for DMT2 screening?
More than 15
Children up to 7 yo and < 5' should be placed in a booster seat.
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

42. When is area of induration > 10 mm considered TB positive?
Men 45 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
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
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

43. In which group of patients should aspirin be given as primary prevention for MI?
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
Men 45 - 79 yo
During 2nd - 3rd trimester
More than 15

44. What is the schedule for MMR vaccine?
Total cholesterol - FOBT
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after
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
1200 mg/day

46. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Children up to 7 yo and < 5' should be placed in a booster seat.
Total cholesterol - FOBT
Exercise or physical therapy and vit D for patients > 65

47. 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
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
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)

48. What is the USPSTF guideline for DMT2 screening?
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years
1200 mg/day

49. What is HI law for booster seat?

50. 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
Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day