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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 is the ADA guideline for DMT2 screening?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
Start at 20 for all M and W regardless of RFs

2. When is area of induration > 10 mm considered TB positive?
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
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 up to 7 yo and < 5' should be placed in a booster seat.
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...

3. How much calcium should adults (19 - 50) take?
NEVER
1000 mg/day
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

4. What can decrease fall in the elderly?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs
Men 45 - 79 yo

5. How much folate and for How long should a woman take for planned pregnancy?
800 IU/ day
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
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

6. How often do asplenic patients receive pneumococcal vaccine?
In adults with sustained BP > 135/80 mmHg
Every 5 years
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

7. How much vit D should adults > 50 take?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1000 IU/day
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

8. What 3 things should always be done in an office visit?
BP - Height - Weight
Stroke and DVT
One dose at 12-15 mod - Booster at least 4-weeks after
Start at 20 for all M and W regardless of RFs

9. 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 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)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

10. When should the meningococcal vaccine be given and to which group?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/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
During 2nd - 3rd trimester
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

11. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Rear facing
To get IgA protection
One dose at 12-15 mod - Booster at least 4-weeks after

12. 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
65 (earlier if have increased risk factors)
Rear facing
Femoral neck

13. When should pregnant women get a flu shot?
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
1000 IU/day

14. What is the schedule for Hep A vaccine?
1000 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
12 - 23 mo - 2 doses are to be given 6 mo apart

15. 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
Every 5 years
NEVER
Men 45 - 79 yo

16. When should chest X-ray be used for screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Breast CA - thromboembolic event - stroke and CAD
12 - 23 mo - 2 doses are to be given 6 mo apart
NEVER

17. What is the NCEP III guideline for cholesterol screening?
Every 5 years
Starts at 20 for both M and W
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Start at 20 for all M and W regardless of RFs

18. When is intensive individualized home-based intervention recommended?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Femoral neck
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

19. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

20. At what age should women have DEXA scan?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism
65 (earlier if have increased risk factors)
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

21. What tests are appropriate to order in an asymptomatic 57 yo male?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT
Rear facing
More than 15

22. Who should get shingles vaccine?
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
To get IgA protection
2mo - 4mo - 6-18 mo and 4-6 yrs
Adults > 60

23. 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
0.4 - 0.8 mg/day for 1 month prior to conception
Women 55 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

24. How much folate should all women of child bearing age take?
Smoking - Alcoholism
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

25. 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
Meningitis and Epiglottitis
BP - Height - Weight
During 2nd - 3rd trimester

26. What is the schedule for DTap vaccine?
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 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

27. Unopposed estrogen increases risks for what conditions?
BP - Height - Weight
During 2nd - 3rd trimester
Stroke and DVT
When they are > 40 lbs and still less then 5'

28. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
> 2 yo and less than 40 lbs
Persons with no known risk factors
Exercise or physical therapy and vit D for patients > 65
4 mg/day

29. How much calcium should women > 50 take?
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
1200 mg/day
Starts at 20 for both M and W

30. How much calcium should adolescents (9 -18) take?
Total cholesterol - FOBT
Starts at 20 for both M and W
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day

31. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Children up to 7 yo and < 5' should be placed in a booster seat.
To get IgA protection
Starts at 20 for both M and W
> 2 yo and less than 40 lbs

32. What is USPSTF guideline for abdominal aortic aneurysm screening?
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
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

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

34. In which group of patients should aspirin be given as primary prevention for stroke?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4mo - 6-18 mo and 4-6 yrs
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

35. When should tetanus immunoglobulin be given?
Persons with no known risk factors
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
65 (earlier if have increased risk factors)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

36. How much vit D should adults < 50 take?
When they are > 40 lbs and still less then 5'
Every 5 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
800 IU/ day

37. What is the USPSTF guideline for chlamydial screening?
> 2 yo and less than 40 lbs
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Meningitis and Epiglottitis
In all W < 24 who are sexually active - In W > 24 with increased risk

38. What kind of polio vaccine is preferred?
Starts at 50 (recommends against starting at 40) and every 2 years
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. Which children should use a semi-upright/forward facing carseat?
BP - Height - Weight
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
> 2 yo and less than 40 lbs

40. What kind of sunscreen SPF is recommended for sun protection?
Total cholesterol - FOBT
BP - Height - Weight
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
More than 15

41. Some contraindications for aspirin
One dose at 12-15 mod - Booster at least 4-weeks after
During 2nd - 3rd trimester
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Women 55 - 79 yo

42. What are the guidelines for visual screening?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
HISTORY
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. When can children sit in a booster seat?

44. If traveling to endemic areas - Why should one get a dose of live vaccine?
1300 mg/day
More than 15
To get IgA protection
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

45. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
0.4 mg/day

46. What are the USPSTF guidelines for mammogram?
During 2nd - 3rd trimester
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
Forearm

47. Who should get Tdap vaccine and how often?
Meningitis and Epiglottitis
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
In all W < 24 who are sexually active - In W > 24 with increased risk
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

48. What is HI law for booster seat?

49. Measurement of which anatomic structure is best predictor for hip fracture?
In adults with sustained BP > 135/80 mmHg
Femoral neck
One time abdominal X-ray for all MALES who ever SMOKES
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

50. What is the USPSTF guideline for fall prevention in the elderly?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Exercise or physical therapy and vit D for patients > 65
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