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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 2 conditions that have been proven to be beneficial to screened for?
Forearm
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism
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. What are the guidelines for pap smear?
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)
Women 55 - 79 yo
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
Exercise or physical therapy and vit D for patients > 65

3. How much calcium should adults (19 - 50) take?
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 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2mo - 4 mo - 6mo and 12-15 mo
1000 mg/day

4. How much vit D should adults < 50 take?
1000 IU/day
800 IU/ day
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Adults > 60

5. What is the schedule for varicella vaccine?
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
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 50 (recommends against starting at 40) and every 2 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)

6. What are the risks of combination HRT?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 yo
Breast CA - thromboembolic event - stroke and CAD

7. How often do asplenic patients receive pneumococcal vaccine?
One time abdominal X-ray for all MALES who ever SMOKES
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
Every 5 years
During 2nd - 3rd trimester

8. What tests are appropriate to order in an asymptomatic 57 yo male?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 mg/day
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Total cholesterol - FOBT

9. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
> 2 yo and less than 40 lbs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In all W < 24 who are sexually active - In W > 24 with increased risk

10. What are some risk factors for CAD?
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis

11. What is the ADA guideline for DMT2 screening?
Femoral neck
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
HISTORY

12. What is USPSTF guideline for abdominal aortic aneurysm screening?
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
Start at 20 for all M and W regardless of RFs

13. What is HI law for booster seat?

14. 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
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
During 2nd - 3rd trimester
Every 5 years

15. 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)
0.4 mg/day
65 (earlier if have increased risk factors)

16. What are some RFs for DMT2?
Forearm
1000 IU/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)
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

17. When is area of induration > 5mm considered TB positive?
800 IU/ 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
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
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

18. In which group of patients should aspirin be given as primary prevention for MI?
Meningitis and Epiglottitis
Men 45 - 79 yo
HISTORY
2mo - 4 mo - 6mo and 12-15 mo

19. When should tetanus immunoglobulin be given?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart

20. What kind of sunscreen SPF is recommended for sun protection?
More than 15
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Forearm

21. Who should get shingles vaccine?
Every 5 years
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Adults > 60

22. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
When they are > 40 lbs and still less then 5'
Preschool children : 3-4 yo - Elderly patients: > 65 yo
To get IgA protection

23. What kind of polio vaccine is preferred?
> 2 yo and less than 40 lbs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
1000 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

24. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Exercise - Environmental hazard reduction - Close monitoring of medication
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

25. What are the guidelines for colon cancer screening?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
4 mg/day

26. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
2mo - 4mo - 6-18 mo and 4-6 yrs
Smoking - Alcoholism
800 IU/ day

27. What is the schedule for Hep A vaccine?
Men 45 - 79 yo
0.4 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
In all W < 24 who are sexually active - In W > 24 with increased risk

28. How much folate and for How long should a woman take for planned pregnancy?
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
Smoking - Alcoholism
1000 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

29. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Stroke and DVT
0.4 - 0.8 mg/day for 1 month prior to conception
BP - Height - Weight

30. When is area of induration > 15 mm considered TB positive?
Children up to 7 yo and < 5' should be placed in a booster seat.
Breast CA - thromboembolic event - stroke and CAD
Persons with no known risk factors
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

31. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
Start at 20 for all M and W regardless of RFs
Exercise or physical therapy and vit D for patients > 65
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

32. In which group of patients should aspirin be given as primary prevention for stroke?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
In adults with sustained BP > 135/80 mmHg
Women 55 - 79 yo
1000 mg/day

33. How much calcium should women > 50 take?
Men 45 - 79 yo
1200 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

34. What is the schedule for rotavirus vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
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'
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

35. What is the schedule for polio vaccine?
Men 45 - 79 yo
800 IU/ day
2mo - 4 mo - 6mo and 12-15 mo
2mo - 4mo - 6-18 mo and 4-6 yrs

36. 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
0.4 mg/day
Every 5 years
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

37. When can children sit in a booster seat?

38. What 3 things should always be done in an office visit?
BP - Height - Weight
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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

39. When should chest X-ray be used for screening?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
NEVER
2mo - 4mo - 6-18 mo and 4-6 yrs
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

40. If traveling to endemic areas - Why should one get a dose of live vaccine?
Persons with no known risk factors
Femoral neck
To get IgA protection
1200 mg/day

41. At what age should women have DEXA scan?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
65 (earlier if have increased risk factors)

42. 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
One dose at 12-15 mod - Booster at least 4-weeks after
Breast CA - thromboembolic event - stroke and CAD
Preschool children : 3-4 yo - Elderly patients: > 65 yo

43. What is the schedule for DTap vaccine?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
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

44. What can decrease fall 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
Exercise - Environmental hazard reduction - Close monitoring of medication
800 IU/ day
In adults with sustained BP > 135/80 mmHg

45. How much folate should all women of child bearing age take?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
Start at 20 for all M and W regardless of RFs

46. Who are at increased risk for adverse effect catching a flu?
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
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

47. When should the meningococcal vaccine be given and to which group?
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
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Start at 20 for all M and W regardless of RFs

48. What is the schedule for Hep B vaccine?
1000 mg/day
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Exercise or physical therapy and vit D for patients > 65
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

49. Measurement of which anatomic structure is best predictor for hip fracture?
When they are > 40 lbs and still less then 5'
Femoral neck
0.4 mg/day
In adults with sustained BP > 135/80 mmHg

50. When should pregnant women get a flu shot?
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
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
During 2nd - 3rd trimester