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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. If traveling to endemic areas - Why should one get a dose of live vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
To get IgA protection

2. When should the meningococcal vaccine be given and to which group?
Femoral neck
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
In adults with sustained BP > 135/80 mmHg

3. Unopposed estrogen increases risks for what conditions?
To get IgA protection
Stroke and DVT
Children up to 7 yo and < 5' should be placed in a booster seat.
Exercise or physical therapy and vit D for patients > 65

4. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
800 IU/ day
Men 45 - 79 yo
Children up to 7 yo and < 5' should be placed in a booster seat.

5. What type of illnesses does Hib vaccine prevent?
Starts at 50 (recommends against starting at 40) and every 2 years
Children up to 7 yo and < 5' should be placed in a booster seat.
Meningitis and Epiglottitis
Smoking - Alcoholism

6. When is area of induration > 10 mm considered TB positive?
Femoral neck
65 (earlier if have increased risk factors)
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

7. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
To get IgA protection
Stroke and DVT

8. At what age should women have DEXA scan?
2mo - 4 mo - 6mo and 12-15 mo
65 (earlier if have increased risk factors)
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
Start at 20 for all M and W regardless of RFs

9. Some contraindications for aspirin
Exercise - Environmental hazard reduction - Close monitoring of medication
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs

10. How much calcium should women > 50 take?
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
1200 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

11. In which group of patients should aspirin be given as primary prevention for stroke?
Starts at 20 for both M and W
Women 55 - 79 yo
800 IU/ day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

12. What is the schedule for Hep A vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1000 mg/day
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

13. What 3 things should always be done in an office visit?
4 mg/day
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
BP - Height - Weight
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

14. 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
NEVER
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

15. What is the schedule for Hib vaccine?
800 IU/ day
> 2 yo and less than 40 lbs
2mo - 4 mo - 6mo and 12-15 mo
Exercise - Environmental hazard reduction - Close monitoring of medication

16. In which group of patients should aspirin be given as primary prevention for MI?
1000 IU/day
1300 mg/day
Men 45 - 79 yo
During 2nd - 3rd trimester

17. How much calcium should adults (19 - 50) take?
Start at 20 for all M and W regardless of 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)
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
1000 mg/day

18. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
65 (earlier if have increased risk factors)

19. What kind of sunscreen SPF is recommended for sun protection?
0.4 mg/day
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...
In adults with sustained BP > 135/80 mmHg

20. 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
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
12 - 23 mo - 2 doses are to be given 6 mo apart

21. When is area of induration > 15 mm considered TB positive?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Persons with no known risk factors
Every 5 years
Starts at 50 (recommends against starting at 40) and every 2 years

22. What are 2 conditions that have been proven to be beneficial to screened for?
65 (earlier if have increased risk factors)
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Smoking - Alcoholism
More than 15

23. What kind of polio vaccine is preferred?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

24. What is the schedule for varicella vaccine?
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 years
Preschool children : 3-4 yo - Elderly patients: > 65 yo
2mo - 4 mo - 6mo and 12-15 mo

25. 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
Children up to 7 yo and < 5' should be placed in a booster seat.
1200 mg/day
65 (earlier if have increased risk factors)

26. When is intensive individualized home-based intervention recommended?
0.4 - 0.8 mg/day for 1 month prior to conception
1000 mg/day
Rear facing
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

27. What is the USPSTF guideline for fall prevention in the elderly?
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
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Exercise or physical therapy and vit D for patients > 65
Rear facing

28. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
Preschool children : 3-4 yo - Elderly patients: > 65 yo
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

29. What are the guidelines for visual screening?
Adults > 60
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In adults with sustained BP > 135/80 mmHg
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

30. What is the schedule for polio vaccine?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
To get IgA protection
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
2mo - 4mo - 6-18 mo and 4-6 yrs

31. What is the schedule for MMR vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
2mo - 4 mo - 6mo and 12-15 mo
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

32. 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1200 mg/day
Women 55 - 79 yo

33. What can decrease fall in the elderly?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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...
0.4 mg/day
Exercise - Environmental hazard reduction - Close monitoring of medication

34. What is the schedule for Gardasil?
Breast CA - thromboembolic event - stroke and CAD
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

35. How much vit D should adults < 50 take?
Persons with no known risk factors
NEVER
800 IU/ day
0.4 mg/day

36. What is the schedule for DTap vaccine?
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
Men 45 - 79 yo
1300 mg/day

37. When should Gardasil be given and for what purposes?
Start at 20 for all M and W regardless of RFs
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 - 0.8 mg/day for 1 month prior to conception
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

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

39. How much vit D should adults > 50 take?
1000 IU/day
Women 55 - 79 yo
Meningitis and Epiglottitis
Start at 20 for all M and W regardless of RFs

40. When can children sit in a booster seat?

41. What is the USPSTF guideline for chlamydial screening?
1200 mg/day
In all W < 24 who are sexually active - In W > 24 with increased risk
When they are > 40 lbs and still less then 5'
Every 5 years

42. What are some safety issues you should counsel parents with young children?
HISTORY
65 (earlier if have increased risk factors)
1000 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...

43. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
4 mg/day
More than 15
Forearm
Adults > 60

44. What are the USPSTF guidelines for mammogram?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Stroke and DVT
0.4 - 0.8 mg/day for 1 month prior to conception
Starts at 50 (recommends against starting at 40) and every 2 years

45. What is the most important way to screen for CAD in an asymptomatic patients?
Men 45 - 79 yo
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
Adults > 60
HISTORY

46. What are the risks of combination HRT?
1000 mg/day
Breast CA - thromboembolic event - stroke and CAD
In adults with sustained BP > 135/80 mmHg
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

47. How much calcium should adolescents (9 -18) take?
In all W < 24 who are sexually active - In W > 24 with increased risk
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
1300 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

48. What is the NCEP III guideline for cholesterol 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
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
Adults > 60

49. When should pregnant women get a flu shot?
Meningitis and Epiglottitis
Men 45 - 79 yo
During 2nd - 3rd trimester
Stroke and DVT

50. Who are at increased risk for adverse effect catching a flu?
Breast CA - thromboembolic event - stroke and CAD
Meningitis and Epiglottitis
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
4 mg/day