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 is HI law for booster seat?

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

3. What kind of car seat should children < 2 yo be placed in?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Rear facing
1000 mg/day
800 IU/ day

4. Who should get Tdap vaccine and how often?
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
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
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
Femoral neck

5. In which group of patients should aspirin be given as primary prevention for MI?
One dose at 12-15 mod - Booster at least 4-weeks after
Men 45 - 79 yo
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

6. What is USPSTF guideline for abdominal aortic aneurysm screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
One time abdominal X-ray for all MALES who ever SMOKES

7. When should pregnant women get a flu shot?
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
One time abdominal X-ray for all MALES who ever SMOKES
Rear facing

8. Who should get shingles vaccine?
Adults > 60
Stroke and DVT
1300 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

9. How much vit D should adults < 50 take?
Children up to 7 yo and < 5' should be placed in a booster seat.
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
Breast CA - thromboembolic event - stroke and CAD

10. What can decrease fall in the elderly?
BP - Height - Weight
1000 IU/day
800 IU/ day
Exercise - Environmental hazard reduction - Close monitoring of medication

11. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
Femoral neck

12. What are the guidelines for colon cancer screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

13. 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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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'

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Forearm
2mo - 4mo - 6-18 mo and 4-6 yrs
800 IU/ day

15. What kind of sunscreen SPF is recommended for sun protection?
More than 15
NEVER
1000 IU/day
> 2 yo and less than 40 lbs

16. Some contraindications for aspirin
1000 IU/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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
NEVER

17. At what age should women have DEXA scan?
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)
1000 IU/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...

18. In which group of patients should aspirin be given as primary prevention for stroke?
Women 55 - 79 yo
Femoral neck
> 2 yo and less than 40 lbs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

19. How much calcium should women > 50 take?
1200 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
One dose at 12-15 mod - Booster at least 4-weeks after
Exercise - Environmental hazard reduction - Close monitoring of medication

20. 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
More than 15
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...
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

21. 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
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
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...

22. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
NEVER
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

23. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
BP - Height - Weight
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
4 mg/day

24. How much fluoride should military children in HI be given?
1000 IU/day
2mo - 4 mo - 6mo and 12-15 mo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs

25. What are the guidelines for pap smear?
Meningitis and Epiglottitis
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)
One time abdominal X-ray for all MALES who ever SMOKES

26. Unopposed estrogen increases risks for what conditions?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Breast CA - thromboembolic event - stroke and CAD
Rear facing
Stroke and DVT

27. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
12 - 23 mo - 2 doses are to be given 6 mo apart
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

28. What is the most important way to screen for CAD in an asymptomatic patients?
4 mg/day
HISTORY
> 2 yo and less than 40 lbs
Breast CA - thromboembolic event - stroke and CAD

29. What is the schedule for Gardasil?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

30. If traveling to endemic areas - Why should one get a dose of live vaccine?
0.4 mg/day
NEVER
To get IgA protection
Exercise or physical therapy and vit D for patients > 65

31. When should chest X-ray be used for screening?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
4 mg/day
NEVER
Persons with no known risk factors

32. What is the USPSTF guideline for fall prevention in the elderly?
To get IgA protection
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
When they are > 40 lbs and still less then 5'
Exercise or physical therapy and vit D for patients > 65

33. What is the schedule for Hep B vaccine?
Adults > 60
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

34. When should the meningococcal vaccine be given and to which group?
Children up to 7 yo and < 5' should be placed in a booster seat.
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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

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

36. What are the USPSTF guidelines for mammogram?
One dose at 12-15 mod - Booster at least 4-weeks after
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
Starts at 50 (recommends against starting at 40) and every 2 years

37. When should tetanus immunoglobulin be given?
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
Starts at 20 for both M and W
Start at 20 for all M and W regardless of RFs

38. What is the schedule for DTap vaccine?
> 2 yo and less than 40 lbs
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One time abdominal X-ray for all MALES who ever SMOKES

39. 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
Exercise or physical therapy and vit D for patients > 65
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
To get IgA protection

40. What is the schedule for Hep A vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
1300 mg/day
One dose at 12-15 mod - Booster at least 4-weeks after
12 - 23 mo - 2 doses are to be given 6 mo apart

41. What are some risk factors for CAD?
0.4 mg/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
> 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

42. What type of illnesses does Hib vaccine prevent?
Breast CA - thromboembolic event - stroke and CAD
Every 5 years
Meningitis and Epiglottitis
When they are > 40 lbs and still less then 5'

43. When is intensive individualized home-based intervention recommended?
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
Smoking - Alcoholism
1000 mg/day
Stroke and DVT

44. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
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
HISTORY
Starts at 50 (recommends against starting at 40) and every 2 years

45. Measurement of which anatomic structure is best predictor for hip fracture?
4 mg/day
2mo - 4 mo - 6mo and 12-15 mo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Femoral neck

46. When can children sit in a booster seat?

47. What is the USPSTF guideline for DMT2 screening?
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
When they are > 40 lbs and still less then 5'
In adults with sustained BP > 135/80 mmHg

48. What is the schedule for rotavirus vaccine?
Total cholesterol - FOBT
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Women 55 - 79 yo
To get IgA protection

49. What are some safety issues you should counsel parents with young children?
Meningitis and Epiglottitis
Women 55 - 79 yo
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...
> 2 yo and less than 40 lbs

50. How much calcium should adults (19 - 50) take?
1000 mg/day
More than 15
In adults with sustained BP > 135/80 mmHg
Every 5 years