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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. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Women 55 - 79 yo
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
12 - 23 mo - 2 doses are to be given 6 mo apart

2. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
12 - 23 mo - 2 doses are to be given 6 mo apart
65 (earlier if have increased risk factors)
Stroke and DVT

3. What is the schedule for Hep B vaccine?
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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

4. When should pregnant women get a flu shot?
To get IgA protection
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

5. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
1300 mg/day
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
4 mg/day

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

7. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Men 45 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Starts at 20 for both M and W

8. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 mg/day

9. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Smoking - Alcoholism
Meningitis and Epiglottitis
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

10. What kind of sunscreen SPF is recommended for sun protection?
0.4 mg/day
Men 45 - 79 yo
More than 15
In adults with sustained BP > 135/80 mmHg

11. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
> 2 yo and less than 40 lbs
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

12. How much folate should all women of child bearing age take?
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day
0.4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

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

14. What are some risk factors for CAD?
To get IgA protection
During 2nd - 3rd trimester
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

15. When can children sit in a booster seat?

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

17. 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
One time abdominal X-ray for all MALES who ever SMOKES
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Children up to 7 yo and < 5' should be placed in a booster seat.

18. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
HISTORY
Every 5 years
NEVER

19. What 3 things should always be done in an office visit?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Women 55 - 79 yo
BP - Height - Weight
Starts at 20 for both M and W

20. What is the schedule for rotavirus vaccine?
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

21. How much calcium should women > 50 take?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Rear facing
In all W < 24 who are sexually active - In W > 24 with increased risk
1200 mg/day

22. When should chest X-ray be used for screening?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Total cholesterol - FOBT
4 mg/day
NEVER

23. What is the most important way to screen for CAD in an asymptomatic patients?
Exercise or physical therapy and vit D for patients > 65
Meningitis and Epiglottitis
HISTORY
During 2nd - 3rd trimester

24. What is HI law for booster seat?

25. 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
Smoking - Alcoholism
Exercise or physical therapy and vit D for patients > 65
When they are > 40 lbs and still less then 5'

26. How much fluoride should military children in HI be given?
1000 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Starts at 50 (recommends against starting at 40) and every 2 years
2mo - 4 mo - 6mo and 12-15 mo

27. If traveling to endemic areas - Why should one get a dose of live vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
To get IgA protection
NEVER
> 2 yo and less than 40 lbs

28. What is USPSTF guideline for abdominal aortic aneurysm screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
One time abdominal X-ray for all MALES who ever SMOKES

29. What is the USPSTF guideline for DMT2 screening?
1000 mg/day
1200 mg/day
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo

30. What is the schedule for MMR vaccine?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Forearm
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
One time abdominal X-ray for all MALES who ever SMOKES

31. How much flouride should non military children in the state of HI be given?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

32. What type of illnesses does Hib vaccine prevent?
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
Start at 20 for all M and W regardless of RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Meningitis and Epiglottitis

33. What is the schedule for varicella vaccine?
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
NEVER
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

34. How much vit D should adults > 50 take?
Persons with no known risk factors
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1000 IU/day

35. What tests are appropriate to order in an asymptomatic 57 yo male?
Men 45 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Total cholesterol - FOBT
To get IgA protection

36. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
In adults with sustained BP > 135/80 mmHg
Every 5 years
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

37. What are 2 conditions that have been proven to be beneficial to screened for?
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
Smoking - Alcoholism
To get IgA protection
1300 mg/day

38. When is area of induration > 5mm considered TB positive?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
NEVER
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. How much calcium should adults (19 - 50) take?
1000 mg/day
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)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

40. Who should get shingles vaccine?
During 2nd - 3rd trimester
Adults > 60
Exercise or physical therapy and vit D for patients > 65
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 USPSTF guideline for chlamydial screening?
Persons with no known risk factors
Women 55 - 79 yo
In all W < 24 who are sexually active - In W > 24 with increased risk
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

42. In which group of patients should aspirin be given as primary prevention for MI?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Men 45 - 79 yo
Adults > 60

43. What are the guidelines for pap smear?
Every 5 years
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 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)

44. When should tetanus immunoglobulin be given?
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
When they are > 40 lbs and still less then 5'
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

45. Who should get Tdap vaccine and how often?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
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

46. What is the NCEP III guideline for cholesterol screening?
2mo - 4mo - 6-18 mo and 4-6 yrs
One time abdominal X-ray for all MALES who ever SMOKES
Start at 20 for all M and W regardless of RFs
Preschool children : 3-4 yo - Elderly patients: > 65 yo

47. When should the meningococcal vaccine be given and to which group?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT
Meningitis and Epiglottitis

48. How much calcium should adolescents (9 -18) take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1300 mg/day
When they are > 40 lbs and still less then 5'
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

49. Some contraindications for aspirin
800 IU/ day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
To get IgA protection

50. In which group of patients should aspirin be given as primary prevention for stroke?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
To get IgA protection
Women 55 - 79 yo
Every 5 years