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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 the USPSTF guidelines for cholesterol screening in people with increased risks?
BP - Height - Weight
One dose at 12-15 mod - Booster at least 4-weeks after
Starts at 20 for both M and W
In all W < 24 who are sexually active - In W > 24 with increased risk

2. What is the schedule for rotavirus vaccine?
65 (earlier if have increased risk factors)
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
One time abdominal X-ray for all MALES who ever SMOKES

3. What is the schedule for Hib vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
Start at 20 for all M and W regardless of RFs
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...
2mo - 4 mo - 6mo and 12-15 mo

4. What is the schedule for DTap vaccine?
More than 15
0.4 - 0.8 mg/day for 1 month prior to conception
Exercise - Environmental hazard reduction - Close monitoring of medication
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

5. 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
Men 45 - 79 yo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

6. How much vit D should adults < 50 take?
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
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Breast CA - thromboembolic event - stroke and CAD

7. How much flouride should non military children in the state of HI be given?
To get IgA protection
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
BP - Height - Weight
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

8. What is the schedule for varicella vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One dose at 12-15 mod - Booster at least 4-weeks after
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
Femoral neck

9. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
During 2nd - 3rd trimester
Total cholesterol - FOBT
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

10. What is the schedule for MMR vaccine?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Starts at 20 for both M and W
Preschool children : 3-4 yo - Elderly patients: > 65 yo

11. How much vit D should adults > 50 take?
12 - 23 mo - 2 doses are to be given 6 mo apart
Smoking - Alcoholism
1000 IU/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

12. What is the USPSTF guideline for DMT2 screening?
In adults with sustained BP > 135/80 mmHg
1000 IU/day
12 - 23 mo - 2 doses are to be given 6 mo apart
Forearm

13. Some contraindications for aspirin
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
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
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

14. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
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
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

15. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
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
Forearm
0.4 - 0.8 mg/day for 1 month prior to conception
During 2nd - 3rd trimester

16. What is the schedule for Hep B vaccine?
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
NEVER
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

17. What is the ADA guideline for DMT2 screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Meningitis and Epiglottitis
Starts at 50 (recommends against starting at 40) and every 2 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

18. 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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

19. How much calcium should adults (19 - 50) take?
Meningitis and Epiglottitis
Femoral neck
1000 mg/day
When they are > 40 lbs and still less then 5'

20. What tests are appropriate to order in an asymptomatic 57 yo male?
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
Total cholesterol - FOBT
Breast CA - thromboembolic event - stroke and CAD
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

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

22. Unopposed estrogen increases risks for what conditions?
To get IgA protection
12 - 23 mo - 2 doses are to be given 6 mo apart
Stroke and DVT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

23. 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
0.4 - 0.8 mg/day for 1 month prior to conception

24. When should chest X-ray be used for screening?
Femoral neck
NEVER
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
65 (earlier if have increased risk factors)

25. If traveling to endemic areas - Why should one get a dose of live vaccine?
Start at 20 for all M and W regardless of RFs
To get IgA protection
Persons with no known risk factors
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

26. 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
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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day

27. 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
1200 mg/day
800 IU/ day
> 2 yo and less than 40 lbs

28. What kind of sunscreen SPF is recommended for sun protection?
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
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15

29. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
1300 mg/day
More than 15

30. How much calcium should adolescents (9 -18) take?
Smoking - Alcoholism
800 IU/ day
1300 mg/day
Stroke and DVT

31. What is HI law for booster seat?

32. What kind of car seat should children < 2 yo be placed in?
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
Rear facing
NEVER
Every 5 years

33. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
> 2 yo and less than 40 lbs
2mo - 4mo - 6-18 mo and 4-6 yrs

34. What are some risk factors for CAD?
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
Total cholesterol - FOBT
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

35. In which group of patients should aspirin be given as primary prevention for MI?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Men 45 - 79 yo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
> 2 yo and less than 40 lbs

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
> 2 yo and less than 40 lbs
Forearm
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

37. When should tetanus immunoglobulin be given?
Start at 20 for all M and W regardless of RFs
In all W < 24 who are sexually active - In W > 24 with increased risk
65 (earlier if have increased risk factors)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

38. Who should get Tdap vaccine and how often?
Start at 20 for all M and W regardless of RFs
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
0.4 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)

39. What is the USPSTF guideline for chlamydial screening?
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
When they are > 40 lbs and still less then 5'
In all W < 24 who are sexually active - In W > 24 with increased risk
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

40. What is the USPSTF guideline for fall prevention in the elderly?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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
Exercise or physical therapy and vit D for patients > 65

41. What is the NCEP III guideline for cholesterol 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
Breast CA - thromboembolic event - stroke and CAD
Start at 20 for all M and W regardless of RFs
2mo - 4 mo - 6mo and 12-15 mo

42. What is the schedule for Gardasil?
Exercise or physical therapy and vit D for patients > 65
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Breast CA - thromboembolic event - stroke and CAD
When they are > 40 lbs and still less then 5'

43. In which group of patients should aspirin be given as primary prevention for stroke?
Breast CA - thromboembolic event - stroke and CAD
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
Women 55 - 79 yo
More than 15

44. At what age should women have DEXA scan?
During 2nd - 3rd trimester
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
Rear facing
65 (earlier if have increased risk factors)

45. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
2mo - 4 mo - 6mo and 12-15 mo
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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

46. How much folate should all women of child bearing age take?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
Preschool children : 3-4 yo - Elderly patients: > 65 yo

47. What are the guidelines for pap smear?
0.4 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)
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
1300 mg/day

48. What can decrease fall in the elderly?
Exercise - Environmental hazard reduction - Close monitoring of medication
1000 IU/day
800 IU/ day
1300 mg/day

49. What type of illnesses does Hib vaccine prevent?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Meningitis and Epiglottitis
Every 5 years
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

50. When should Gardasil be given and for what purposes?
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
65 (earlier if have increased risk factors)
NEVER
Persons with no known risk factors