Test your basic knowledge |

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 type of illnesses does Hib vaccine prevent?
One time abdominal X-ray for all MALES who ever SMOKES
65 (earlier if have increased risk factors)
Meningitis and Epiglottitis
1000 mg/day

2. What is USPSTF guideline for abdominal aortic aneurysm screening?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
One time abdominal X-ray for all MALES who ever SMOKES
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Total cholesterol - FOBT

3. When is area of induration > 15 mm considered TB positive?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Persons with no known risk factors

4. When is intensive individualized home-based intervention recommended?
Femoral neck
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 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
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

5. What is the schedule for Gardasil?
Children up to 7 yo and < 5' should be placed in a booster seat.
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)
BP - Height - Weight
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

6. Some contraindications for aspirin
Forearm
More than 15
Starts at 50 (recommends against starting at 40) and every 2 years
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

7. When should Gardasil be given and for what purposes?
65 (earlier if have increased risk factors)
Starts at 20 for both M and W
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
4 mg/day

8. At what age should women have DEXA scan?
Stroke and DVT
When they are > 40 lbs and still less then 5'
Forearm
65 (earlier if have increased risk factors)

9. What is the USPSTF guideline for chlamydial screening?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
2mo - 4 mo - 6mo and 12-15 mo
To get IgA protection
In all W < 24 who are sexually active - In W > 24 with increased risk

10. How much folate and for How long should a woman take for planned pregnancy?
> 2 yo and less than 40 lbs
0.4 - 0.8 mg/day for 1 month prior to conception
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

11. When should the meningococcal vaccine be given and to which group?
Stroke and DVT
Women 55 - 79 yo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman

12. What tests are appropriate to order in an asymptomatic 57 yo male?
Total cholesterol - FOBT
2mo - 4 mo - 6mo and 12-15 mo
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

13. What are some RFs for DMT2?
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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
4 mg/day

14. What is the ADA guideline for DMT2 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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
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
Smoking - Alcoholism

15. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
2mo - 4 mo - 6mo and 12-15 mo
HISTORY
4 mg/day
Breast CA - thromboembolic event - stroke and CAD

16. When should pregnant women get a flu shot?
1000 IU/day
Meningitis and Epiglottitis
During 2nd - 3rd trimester
More than 15

17. When can children sit in a booster seat?

18. In which group of patients should aspirin be given as primary prevention for stroke?
4 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Women 55 - 79 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)

19. What is the NCEP III guideline for cholesterol screening?
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
Start at 20 for all M and W regardless of RFs
Rear facing

20. Who are at increased risk for adverse effect catching a flu?
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
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
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity

21. How much calcium should adolescents (9 -18) take?
1000 mg/day
1300 mg/day
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 - 4mo - 6-18 mo and 4-6 yrs

22. When should chest X-ray be used for screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
NEVER
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
In adults with sustained BP > 135/80 mmHg

23. How much calcium should adults (19 - 50) take?
1000 mg/day
HISTORY
Women 55 - 79 yo
Every 5 years

24. What are the guidelines for visual screening?
Breast CA - thromboembolic event - stroke and CAD
Men 45 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo
In all W < 24 who are sexually active - In W > 24 with increased risk

25. What 3 things should always be done in an office visit?
Starts at 20 for both M and W
BP - Height - Weight
One time abdominal X-ray for all MALES who ever SMOKES
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

26. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
> 2 yo and less than 40 lbs
Forearm
Rear facing
Women 55 - 79 yo

27. What is HI law for booster seat?

28. How much calcium should women > 50 take?
One dose at 12-15 mod - Booster at least 4-weeks after
1200 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2mo - 4mo - 6-18 mo and 4-6 yrs

29. Measurement of which anatomic structure is best predictor for hip fracture?
1000 IU/day
Children up to 7 yo and < 5' should be placed in a booster seat.
In all W < 24 who are sexually active - In W > 24 with increased risk
Femoral neck

30. What are the USPSTF guidelines for mammogram?
Starts at 50 (recommends against starting at 40) and every 2 years
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 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
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

31. What are the guidelines for pap smear?
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
Adults > 60
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)
Forearm

32. How much vit D should adults < 50 take?
800 IU/ day
Men 45 - 79 yo
NEVER
Preschool children : 3-4 yo - Elderly patients: > 65 yo

33. What is the schedule for DTap vaccine?
In all W < 24 who are sexually active - In W > 24 with increased risk
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
800 IU/ 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

34. How much flouride should non military children in the state of HI be given?
Meningitis and Epiglottitis
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

35. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Stroke and DVT
Adults > 60

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

37. What is the USPSTF guideline for DMT2 screening?
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
In adults with sustained BP > 135/80 mmHg
0.4 mg/day

38. What is the schedule for rotavirus vaccine?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 - 0.8 mg/day for 1 month prior to conception
Persons with no known risk factors
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

39. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
NEVER
Children up to 7 yo and < 5' should be placed in a booster seat.
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo

40. What are some risk factors for CAD?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
During 2nd - 3rd trimester
One time abdominal X-ray for all MALES who ever SMOKES

41. What is the schedule for Hep A vaccine?
12 - 23 mo - 2 doses are to be given 6 mo apart
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)
Stroke and DVT
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

42. Who should get Tdap vaccine and how often?
1000 IU/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
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 50 (recommends against starting at 40) and every 2 years

43. Unopposed estrogen increases risks for what conditions?
2mo - 4 mo - 6mo and 12-15 mo
Stroke and DVT
More than 15
To get IgA protection

44. What is the schedule for varicella vaccine?
HISTORY
One dose at 12-15 mod - Booster at least 4-weeks after
4 mg/day
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

45. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
Persons with no known risk factors

46. How much folate should all women of child bearing age take?
Exercise or physical therapy and vit D for patients > 65
Adults > 60
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
0.4 mg/day

47. What is the USPSTF guideline for fall prevention in the elderly?
Exercise or physical therapy and vit D for patients > 65
Start at 20 for all M and W regardless of RFs
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing

48. Which children should use a semi-upright/forward facing carseat?
65 (earlier if have increased risk factors)
> 2 yo and less than 40 lbs
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

49. If traveling to endemic areas - Why should one get a dose of live vaccine?
Starts at 50 (recommends against starting at 40) and every 2 years
To get IgA protection
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
0.4 mg/day

50. What is the schedule for Hep B vaccine?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Starts at 50 (recommends against starting at 40) and every 2 years
4 mg/day
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day