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 are the guidelines for colon cancer screening?
Smoking - Alcoholism
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
Breast CA - thromboembolic event - stroke and CAD
HISTORY

2. How much vit D should adults < 50 take?
800 IU/ 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
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo

3. How much calcium should women > 50 take?
BP - Height - Weight
4 mg/day
1200 mg/day
Total cholesterol - FOBT

4. How much calcium should adolescents (9 -18) take?
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
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...
Exercise or physical therapy and vit D for patients > 65

5. What is HI law for booster seat?

6. What is the schedule for Hep B vaccine?
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
Women 55 - 79 yo
Exercise or physical therapy and vit D for patients > 65
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

7. In which group of patients should aspirin be given as primary prevention for stroke?
2mo - 4 mo - 6mo and 12-15 mo
In adults with sustained BP > 135/80 mmHg
65 (earlier if have increased risk factors)
Women 55 - 79 yo

8. What is the schedule for Hep A vaccine?
Persons with no known risk factors
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
More than 15
12 - 23 mo - 2 doses are to be given 6 mo apart

9. What is the USPSTF guideline for fall prevention in the elderly?
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
Exercise or physical therapy and vit D for patients > 65
Starts at 50 (recommends against starting at 40) and every 2 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

10. What is the schedule for Hib vaccine?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Smoking - Alcoholism
2mo - 4 mo - 6mo and 12-15 mo
One time abdominal X-ray for all MALES who ever SMOKES

11. What 3 things should always be done in an office visit?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight

12. How often do asplenic patients receive pneumococcal vaccine?
Persons with no known risk factors
Every 5 years
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis

13. What are the guidelines for visual screening?
1200 mg/day
Persons with no known risk factors
2mo - 4mo - 6-18 mo and 4-6 yrs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

14. What are some RFs for DMT2?
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
NEVER
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

15. Some contraindications for aspirin
1200 mg/day
1000 mg/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

16. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection
Total cholesterol - FOBT

17. 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
One dose at 12-15 mod - Booster at least 4-weeks after
Stroke and DVT
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)

18. What is the schedule for Gardasil?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Women 55 - 79 yo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

19. How much flouride should non military children in the state of HI be given?
1200 mg/day
During 2nd - 3rd trimester
When they are > 40 lbs and still less then 5'
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

20. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
Starts at 20 for both M and W
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

21. When is area of induration > 5mm considered TB positive?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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)
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
Starts at 20 for both M and W

22. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 mg/day
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
To get IgA protection

23. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
More than 15
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

24. When should the meningococcal vaccine be given and to which group?
Stroke and DVT
Meningitis and Epiglottitis
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

25. Who are at increased risk for adverse effect catching a flu?
NEVER
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
During 2nd - 3rd trimester

26. What type of illnesses does Hib vaccine prevent?
Starts at 50 (recommends against starting at 40) and every 2 years
0.4 mg/day
In adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis

27. What are 2 conditions that have been proven to be beneficial to screened for?
Starts at 20 for both M and W
Stroke and DVT
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years

28. When should pregnant women get a flu shot?
Start at 20 for all M and W regardless of RFs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
During 2nd - 3rd trimester

29. When is area of induration > 15 mm considered TB positive?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Persons with no known risk factors
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after

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
0.4 - 0.8 mg/day for 1 month prior to conception
4 mg/day

31. In which group of patients should aspirin be given as primary prevention for MI?
Stroke and DVT
Adults > 60
Men 45 - 79 yo
In adults with sustained BP > 135/80 mmHg

32. What is the USPSTF guideline for DMT2 screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
In adults with sustained BP > 135/80 mmHg

33. How much folate should all women of child bearing age take?
NEVER
Adults > 60
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 mg/day

34. How much calcium should adults (19 - 50) take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
To get IgA protection
1000 mg/day
Breast CA - thromboembolic event - stroke and CAD

35. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day
1000 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

36. Who should get shingles 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
Stroke and DVT
1000 IU/day
Adults > 60

37. When should chest X-ray be used for screening?
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
In all W < 24 who are sexually active - In W > 24 with increased risk
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

38. When can children sit in a booster seat?

39. Who should get Tdap vaccine and how often?
1200 mg/day
NEVER
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
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

40. Which children should use a semi-upright/forward facing carseat?
Exercise or physical therapy and vit D for patients > 65
> 2 yo and less than 40 lbs
0.4 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

41. 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
During 2nd - 3rd trimester
1300 mg/day
When they are > 40 lbs and still less then 5'

42. What is the USPSTF guideline for chlamydial screening?
Starts at 50 (recommends against starting at 40) and every 2 years
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
In all W < 24 who are sexually active - In W > 24 with increased risk

43. What are some safety issues you should counsel parents with young children?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In all W < 24 who are sexually active - In W > 24 with increased risk
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...
NEVER

44. How much folate and for How long should a woman take for planned pregnancy?
Adults > 60
Total cholesterol - FOBT
0.4 - 0.8 mg/day for 1 month prior to conception
More than 15

45. At what age should women have DEXA scan?
Exercise or physical therapy and vit D for patients > 65
65 (earlier if have increased risk factors)
Persons with no known risk factors
Femoral neck

46. What are the guidelines for pap smear?
Starts at 50 (recommends against starting at 40) and every 2 years
65 (earlier if have increased risk factors)
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. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
4 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Stroke and DVT

48. 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
Starts at 20 for both M and W
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

49. When should tetanus immunoglobulin be given?
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...
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

50. What kind of polio vaccine is preferred?
Forearm
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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In all W < 24 who are sexually active - In W > 24 with increased risk