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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 risk factors for CAD?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
65 (earlier if have increased 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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

2. What is the schedule for Gardasil?
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Men 45 - 79 yo
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

3. How much vit D should adults > 50 take?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
1200 mg/day
1000 IU/day
Exercise - Environmental hazard reduction - Close monitoring of medication

4. In which group of patients should aspirin be given as primary prevention for stroke?
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
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
In adults with sustained BP > 135/80 mmHg

5. What are the risks of combination HRT?
In adults with sustained BP > 135/80 mmHg
In all W < 24 who are sexually active - In W > 24 with increased risk
Breast CA - thromboembolic event - stroke and CAD
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

6. What is USPSTF guideline for abdominal aortic aneurysm screening?
During 2nd - 3rd trimester
One time abdominal X-ray for all MALES who ever SMOKES
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
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

7. What type of illnesses does Hib vaccine prevent?
Persons with no known risk factors
Meningitis and Epiglottitis
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65

8. When should the meningococcal vaccine be given and to which group?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Starts at 50 (recommends against starting at 40) and every 2 years
Meningitis and Epiglottitis

9. What can decrease fall in the elderly?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
0.4 mg/day
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication

10. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
> 2 yo and less than 40 lbs
4 mg/day
2mo - 4mo - 6-18 mo and 4-6 yrs

11. 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)
4 mg/day
0.4 mg/day

12. Unopposed estrogen increases risks for what conditions?
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
HISTORY
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

13. In which group of patients should aspirin be given as primary prevention for MI?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
Every 5 years
Men 45 - 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...

14. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Forearm
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4mo - 6-18 mo and 4-6 yrs

15. How much calcium should adults (19 - 50) take?
1000 mg/day
4 mg/day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
NEVER

16. What kind of sunscreen SPF is recommended for sun protection?
1200 mg/day
> 2 yo and less than 40 lbs
More than 15
Starts at 20 for both M and W

17. What 3 things should always be done in an office visit?
Men 45 - 79 yo
NEVER
BP - Height - Weight
1300 mg/day

18. How much calcium should adolescents (9 -18) take?
65 (earlier if have increased risk factors)
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Breast CA - thromboembolic event - stroke and CAD

19. 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
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
65 (earlier if have increased risk factors)

20. 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
1200 mg/day
When they are > 40 lbs and still less then 5'
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...

21. Which children should use a semi-upright/forward facing carseat?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
> 2 yo and less than 40 lbs
One time abdominal X-ray for all MALES who ever SMOKES
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

22. What is the ADA guideline for DMT2 screening?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
Total cholesterol - FOBT

23. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
HISTORY
Starts at 20 for both M and W
4 mg/day
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

24. Who should get Tdap vaccine and how often?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Femoral neck
When they are > 40 lbs and still less then 5'
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

25. Who should get shingles vaccine?
Forearm
Adults > 60
Breast CA - thromboembolic event - stroke and CAD
2mo - 4 mo - 6mo and 12-15 mo

26. How often do asplenic patients receive pneumococcal vaccine?
To get IgA protection
0.4 - 0.8 mg/day for 1 month prior to conception
65 (earlier if have increased risk factors)
Every 5 years

27. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
In adults with sustained BP > 135/80 mmHg
Breast CA - thromboembolic event - stroke and CAD
Starts at 50 (recommends against starting at 40) and every 2 years

28. Who are at increased risk for adverse effect catching a flu?
Start at 20 for all M and W regardless of RFs
Adults > 60
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

29. What is the USPSTF guideline for chlamydial screening?
BP - Height - Weight
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
65 (earlier if have increased risk factors)
In all W < 24 who are sexually active - In W > 24 with increased risk

30. How much folate should all women of child bearing age take?
1000 mg/day
BP - Height - Weight
0.4 mg/day
To get IgA protection

31. 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
Persons with no known risk factors
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Breast CA - thromboembolic event - stroke and CAD

32. What is the NCEP III guideline for cholesterol screening?
12 - 23 mo - 2 doses are to be given 6 mo apart
Start at 20 for all M and W regardless of RFs
> 2 yo and less than 40 lbs
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

33. What kind of car seat should children < 2 yo be placed in?
Rear facing
4 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)
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

34. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
2mo - 4 mo - 6mo and 12-15 mo
When they are > 40 lbs and still less then 5'
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

35. When can children sit in a booster seat?

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36. 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
Forearm
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

37. 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
During 2nd - 3rd trimester
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
One time abdominal X-ray for all MALES who ever SMOKES

38. What is the schedule for Hep A vaccine?
0.4 mg/day
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
One dose at 12-15 mod - Booster at least 4-weeks after
12 - 23 mo - 2 doses are to be given 6 mo apart

39. At what age should women have DEXA scan?
Persons with no known risk factors
During 2nd - 3rd trimester
NEVER
65 (earlier if have increased risk factors)

40. What is the most important way to screen for CAD in an asymptomatic patients?
Meningitis and Epiglottitis
During 2nd - 3rd trimester
HISTORY
65 (earlier if have increased risk factors)

41. What is the schedule for MMR vaccine?
1000 IU/day
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

42. When should pregnant women get a flu shot?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
HISTORY
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester

43. What is the USPSTF guideline for fall prevention in the elderly?
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
Starts at 50 (recommends against starting at 40) and every 2 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

44. How much vit D should adults < 50 take?
800 IU/ day
HISTORY
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Adults > 60

45. If traveling to endemic areas - Why should one get a dose of live vaccine?
Breast CA - thromboembolic event - stroke and CAD
Exercise or physical therapy and vit D for patients > 65
To get IgA protection
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

46. What is the schedule for polio vaccine?
Starts at 20 for both M and W
2mo - 4mo - 6-18 mo and 4-6 yrs
Forearm
1200 mg/day

47. What are some safety issues you should counsel parents with young children?
Men 45 - 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...
During 2nd - 3rd trimester
Exercise or physical therapy and vit D for patients > 65

48. What is the schedule for Hib vaccine?
Breast CA - thromboembolic event - stroke and CAD
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
BP - Height - Weight
2mo - 4 mo - 6mo and 12-15 mo

49. How much folate and for How long should a woman take for planned pregnancy?
Starts at 50 (recommends against starting at 40) and every 2 years
12 - 23 mo - 2 doses are to be given 6 mo apart
0.4 - 0.8 mg/day for 1 month prior to conception
2mo - 4 mo - 6mo and 12-15 mo

50. Some contraindications for aspirin
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
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
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose