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 should chest X-ray be used for screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
1200 mg/day
NEVER
Exercise or physical therapy and vit D for patients > 65

2. When is intensive individualized home-based intervention recommended?
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

3. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
4 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...
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

4. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
1200 mg/day

5. When is area of induration > 15 mm considered TB positive?
Every 5 years
4 mg/day
Persons with no known risk factors
1300 mg/day

6. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'

7. How much calcium should adults (19 - 50) take?
1000 mg/day
2mo - 4 mo - 6mo and 12-15 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
800 IU/ day

8. What is the schedule for polio vaccine?
Smoking - Alcoholism
Starts at 50 (recommends against starting at 40) and every 2 years
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

9. What is the USPSTF guideline for fall prevention in the elderly?
Meningitis and Epiglottitis
Exercise or physical therapy and vit D for patients > 65
Total cholesterol - FOBT
Adults > 60

10. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs

11. What is the schedule for Hib vaccine?
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 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
2mo - 4 mo - 6mo and 12-15 mo

12. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

13. How much folate should all women of child bearing age take?
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication
To get IgA protection
When they are > 40 lbs and still less then 5'

14. What kind of sunscreen SPF is recommended for sun protection?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors
More than 15
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

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

16. What is the schedule for varicella vaccine?
0.4 - 0.8 mg/day for 1 month prior to conception
One dose at 12-15 mod - Booster at least 4-weeks after
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

17. What is HI law for booster seat?

18. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
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

19. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
Rear facing
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
During 2nd - 3rd trimester

20. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
During 2nd - 3rd trimester
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

21. Who should get Tdap vaccine and how often?
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
65 (earlier if have increased risk factors)
One dose at 12-15 mod - Booster at least 4-weeks after
Meningitis and Epiglottitis

22. Which children should use a semi-upright/forward facing carseat?
One time abdominal X-ray for all MALES who ever SMOKES
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg

23. Unopposed estrogen increases risks for what conditions?
65 (earlier if have increased risk factors)
Breast CA - thromboembolic event - stroke and CAD
1000 mg/day
Stroke and DVT

24. What is the NCEP III guideline for cholesterol screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection
Start at 20 for all M and W regardless of RFs
When they are > 40 lbs and still less then 5'

25. How much fluoride should military children in HI be given?
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)
One dose at 12-15 mod - Booster at least 4-weeks after
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

26. 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
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
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)

27. What is the schedule for rotavirus vaccine?
800 IU/ day
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 : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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

28. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Start at 20 for all M and W regardless of RFs
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
Breast CA - thromboembolic event - stroke and CAD

29. How much calcium should adolescents (9 -18) take?
> 2 yo and less than 40 lbs
When they are > 40 lbs and still less then 5'
1300 mg/day
Rear facing

30. Who should get shingles vaccine?
BP - Height - Weight
Adults > 60
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

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

32. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
Starts at 20 for both M and W
800 IU/ 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

33. What kind of polio vaccine is preferred?
In adults with sustained BP > 135/80 mmHg
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
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)

34. Measurement of which anatomic structure is best predictor for hip fracture?
HISTORY
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
Total cholesterol - FOBT

35. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
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
Starts at 20 for both M and W
12 - 23 mo - 2 doses are to be given 6 mo apart

36. What are some risk factors for CAD?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
> 2 yo and less than 40 lbs
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

37. When can children sit in a booster seat?

38. How much vit D should adults < 50 take?
1000 IU/day
800 IU/ day
In adults with sustained BP > 135/80 mmHg
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

39. What are some RFs for DMT2?
Breast CA - thromboembolic event - stroke and CAD
Smoking - Alcoholism
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 degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

40. At what age should women have DEXA scan?
In all W < 24 who are sexually active - In W > 24 with increased risk
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
65 (earlier if have increased risk factors)

41. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
Forearm
To get IgA protection
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
4 mg/day

42. 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
Forearm
More than 15
Stroke and DVT

43. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
800 IU/ day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Persons with no known risk factors

44. How much folate and for How long should a woman take for planned pregnancy?
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
Adults > 60
Breast CA - thromboembolic event - stroke and CAD

45. 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 20 for both M and W
NEVER
12 - 23 mo - 2 doses are to be given 6 mo apart

46. How much calcium should women > 50 take?
1200 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
One dose at 12-15 mod - Booster at least 4-weeks after
Preschool children : 3-4 yo - Elderly patients: > 65 yo

47. In which group of patients should aspirin be given as primary prevention for MI?
Meningitis and Epiglottitis
Exercise - Environmental hazard reduction - Close monitoring of medication
Men 45 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

48. 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
Starts at 50 (recommends against starting at 40) and every 2 years
When they are > 40 lbs and still less then 5'
Adults > 60

49. When should pregnant women get a flu shot?
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm
Start at 20 for all M and W regardless of RFs
During 2nd - 3rd trimester

50. Who are at increased risk for adverse effect catching a flu?
When they are > 40 lbs and still less then 5'
HISTORY
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men 45 - 79 yo