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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. How much calcium should adolescents (9 -18) take?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
NEVER
Exercise or physical therapy and vit D for patients > 65
1300 mg/day

2. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Start at 20 for all M and W regardless of RFs
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W
NEVER

3. What are 2 conditions that have been proven to be beneficial to screened for?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Smoking - Alcoholism
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

4. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
1000 mg/day
HISTORY
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

5. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Adults > 60
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo - 6mo and 12-15 mo

6. Which children should use a semi-upright/forward facing carseat?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
> 2 yo and less than 40 lbs
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

7. When is area of induration > 5mm considered TB positive?
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
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
Forearm
Smoking - Alcoholism

8. When is intensive individualized home-based intervention recommended?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 50 (recommends against starting at 40) and every 2 years
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. Some contraindications for aspirin
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children up to 7 yo and < 5' should be placed in a booster seat.
Rear facing

10. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
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)
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Smoking - Alcoholism

11. 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
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
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
In all W < 24 who are sexually active - In W > 24 with increased risk

12. What are some risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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 adults with sustained BP > 135/80 mmHg
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

13. How much flouride should non military children in the state of HI be given?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
To get IgA protection
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo

14. 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
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
Persons with no known risk factors

15. How much calcium should adults (19 - 50) take?
1000 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

16. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication
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)
4 mg/day

17. When is area of induration > 10 mm considered TB positive?
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 50 (recommends against starting at 40) and every 2 years
Smoking - Alcoholism
Stroke and DVT

18. What are the guidelines for visual screening?
More than 15
Total cholesterol - FOBT
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Preschool children : 3-4 yo - Elderly patients: > 65 yo

19. What kind of car seat should children < 2 yo be placed in?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Rear facing

20. How often do asplenic patients receive pneumococcal vaccine?
4 mg/day
Every 5 years
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)
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...

21. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 mg/day
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
In all W < 24 who are sexually active - In W > 24 with increased risk
One time abdominal X-ray for all MALES who ever SMOKES

22. If traveling to endemic areas - Why should one get a dose of live vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
In all W < 24 who are sexually active - In W > 24 with increased risk
> 2 yo and less than 40 lbs
To get IgA protection

23. What is HI law for booster seat?

24. At what age should women have DEXA scan?
During 2nd - 3rd trimester
65 (earlier if have increased risk factors)
2mo - 4 mo - 6mo and 12-15 mo
NEVER

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

26. Who should get shingles vaccine?
Adults > 60
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
HISTORY
1200 mg/day

27. How much calcium should women > 50 take?
Men 45 - 79 yo
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

28. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
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
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years

29. What kind of sunscreen SPF is recommended for sun protection?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day
More than 15

30. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
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

31. When should pregnant women get a flu shot?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
During 2nd - 3rd trimester
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk

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
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
Forearm
Breast CA - thromboembolic event - stroke and CAD

33. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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
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

34. What is the schedule for polio vaccine?
To get IgA protection
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
> 2 yo and less than 40 lbs
2mo - 4mo - 6-18 mo and 4-6 yrs

35. How much folate and for How long should a woman take for planned pregnancy?
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
1000 IU/day
When they are > 40 lbs and still less then 5'
0.4 - 0.8 mg/day for 1 month prior to conception

36. What are the risks of combination HRT?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
Breast CA - thromboembolic event - stroke and CAD
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)

37. What 3 things should always be done in an office visit?
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
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
BP - Height - Weight

38. What is the schedule for DTap vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
When they are > 40 lbs and still less then 5'
Stroke and DVT
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

39. What is the NCEP III guideline for cholesterol screening?
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
Start at 20 for all M and W regardless of RFs
HISTORY

40. How much folate should all women of child bearing age take?
When they are > 40 lbs and still less then 5'
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Smoking - Alcoholism

41. How much vit D should adults < 50 take?
Meningitis and Epiglottitis
800 IU/ 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)
Exercise or physical therapy and vit D for patients > 65

42. What is the USPSTF guideline for chlamydial screening?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
0.4 - 0.8 mg/day for 1 month prior to conception
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk

43. What are the guidelines for pap smear?
1000 IU/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)
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

44. What are some RFs for DMT2?
One time abdominal X-ray for all MALES who ever SMOKES
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
When they are > 40 lbs and still less then 5'

45. How much vit D should adults > 50 take?
Start at 20 for all M and W regardless of RFs
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
1000 IU/day

46. 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
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
Rear facing

47. What is the USPSTF guideline for fall prevention in the elderly?
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
Exercise or physical therapy and vit D for patients > 65
BP - Height - Weight

48. What kind of polio vaccine is preferred?
0.4 - 0.8 mg/day for 1 month prior to conception
800 IU/ day
In adults with sustained BP > 135/80 mmHg
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

49. What is the schedule for Hep A vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 - 0.8 mg/day for 1 month prior to conception
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
12 - 23 mo - 2 doses are to be given 6 mo apart

50. What is the schedule for Hep B vaccine?
Every 5 years
Stroke and DVT
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo