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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. Measurement of which anatomic structure is best predictor for hip fracture?
One time abdominal X-ray for all MALES who ever SMOKES
Femoral neck
Breast CA - thromboembolic event - stroke and CAD
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

2. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Every 5 years
HISTORY
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
Starts at 20 for both M and W

3. What is the schedule for MMR 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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...
Forearm

4. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Forearm
65 (earlier if have increased risk factors)

5. What is HI law for booster seat?

6. When can children sit in a booster seat?

7. What is the NCEP III guideline for cholesterol screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
> 2 yo and less than 40 lbs
Start at 20 for all M and W regardless of RFs
Meningitis and Epiglottitis

8. What kind of car seat should children < 2 yo be placed in?
Rear facing
More than 15
Exercise or physical therapy and vit D for patients > 65
In all W < 24 who are sexually active - In W > 24 with increased risk

9. How much vit D should adults < 50 take?
Exercise - Environmental hazard reduction - Close monitoring of medication
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
800 IU/ day

10. Who are at increased risk for adverse effect catching a flu?
In all W < 24 who are sexually active - In W > 24 with increased risk
One dose at 12-15 mod - Booster at least 4-weeks after
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

11. 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
4 mg/day
Smoking - Alcoholism
800 IU/ day

12. When should the meningococcal vaccine be given and to which group?
More than 15
Men 45 - 79 yo
800 IU/ day
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

13. How much calcium should adolescents (9 -18) take?
1300 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
Women 55 - 79 yo
0.4 mg/day

14. What is the schedule for Gardasil?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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
4 mg/day

15. What are the guidelines for pap smear?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Meningitis and Epiglottitis
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)
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

16. What tests are appropriate to order in an asymptomatic 57 yo male?
Exercise - Environmental hazard reduction - Close monitoring of medication
> 2 yo and less than 40 lbs
Total cholesterol - FOBT
Men 45 - 79 yo

17. 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
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
1300 mg/day

18. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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)
In adults with sustained BP > 135/80 mmHg
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

19. What is the USPSTF guideline for DMT2 screening?
1200 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...
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

20. What are the guidelines for colon cancer screening?
65 (earlier if have increased risk factors)
Exercise or physical therapy and vit D for patients > 65
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
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

21. What is the USPSTF guideline for chlamydial screening?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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
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
In all W < 24 who are sexually active - In W > 24 with increased risk

22. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
Start at 20 for all M and W regardless of RFs
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

23. Some contraindications for aspirin
Starts at 50 (recommends against starting at 40) and every 2 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)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

24. How much calcium should women > 50 take?
Forearm
1200 mg/day
Men 45 - 79 yo
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

25. How much vit D should adults > 50 take?
To get IgA protection
1000 IU/day
65 (earlier if have increased risk factors)
During 2nd - 3rd trimester

26. When should tetanus immunoglobulin be given?
Rear facing
Femoral neck
NEVER
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

27. When is area of induration > 15 mm considered TB positive?
Stroke and DVT
Femoral neck
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

28. When is area of induration > 10 mm considered TB positive?
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...
Persons with no known risk factors
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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

29. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
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
800 IU/ day
Persons with no known risk factors

30. What is the schedule for varicella vaccine?
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
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
One dose at 12-15 mod - Booster at least 4-weeks after

31. In which group of patients should aspirin be given as primary prevention for stroke?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
Women 55 - 79 yo

32. What are the USPSTF guidelines for cholesterol screening in people with normal risks?
0.4 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
Breast CA - thromboembolic event - stroke and CAD
0.4 - 0.8 mg/day for 1 month prior to conception

33. Unopposed estrogen increases risks for what conditions?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Stroke and DVT
Exercise - Environmental hazard reduction - Close monitoring of medication
Preschool children : 3-4 yo - Elderly patients: > 65 yo

34. When should pregnant women get a flu shot?
Start at 20 for all M and W regardless of RFs
1300 mg/day
12 - 23 mo - 2 doses are to be given 6 mo apart
During 2nd - 3rd trimester

35. What type of illnesses does Hib vaccine prevent?
0.4 mg/day
Meningitis and Epiglottitis
BP - Height - Weight
Children up to 7 yo and < 5' should be placed in a booster seat.

36. What is the most important way to screen for CAD in an asymptomatic patients?
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
One time abdominal X-ray for all MALES who ever SMOKES
HISTORY

37. What is the schedule for Hep A vaccine?
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
12 - 23 mo - 2 doses are to be given 6 mo apart
Femoral neck

38. Who should get shingles vaccine?
Adults > 60
Total cholesterol - FOBT
One time abdominal X-ray for all MALES who ever SMOKES
Preschool children : 3-4 yo - Elderly patients: > 65 yo

39. What is the schedule for polio vaccine?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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
Femoral neck

40. What is the USPSTF guideline for fall prevention in the elderly?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Exercise or physical therapy and vit D for patients > 65
Every 5 years
BP - Height - Weight

41. What kind of polio vaccine is preferred?
Children up to 7 yo and < 5' should be placed in a booster seat.
1300 mg/day
Forearm
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

42. How much calcium should adults (19 - 50) take?
NEVER
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
In all W < 24 who are sexually active - In W > 24 with increased risk
1000 mg/day

43. What is the schedule for rotavirus vaccine?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
1000 IU/day
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

44. Who should get Tdap vaccine and how often?
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
> 2 yo and less than 40 lbs
2mo - 4 mo - 6mo and 12-15 mo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

45. What 3 things should always be done in an office visit?
Women 55 - 79 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
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
BP - Height - Weight

46. When should chest X-ray be used for screening?
NEVER
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
Smoking - Alcoholism
During 2nd - 3rd trimester

47. What are some RFs for DMT2?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
NEVER
Rear facing
In adults with sustained BP > 135/80 mmHg

48. What can decrease fall in the elderly?
HISTORY
Exercise - Environmental hazard reduction - Close monitoring of medication
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

49. What is the schedule for DTap vaccine?
1000 IU/day
1300 mg/day
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

50. When is intensive individualized home-based intervention recommended?
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...
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