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. If traveling to endemic areas - Why should one get a dose of live vaccine?
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...
To get IgA protection
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)
4 mg/day

2. How much folate and for How long should a woman take for planned pregnancy?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 - 0.8 mg/day for 1 month prior to conception
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose

3. Some contraindications for aspirin
In adults with sustained BP > 135/80 mmHg
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
HISTORY
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...

4. What is the schedule for Hep A vaccine?
When they are > 40 lbs and still less then 5'
12 - 23 mo - 2 doses are to be given 6 mo apart
More than 15
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks

5. What is the most important way to screen for CAD in an asymptomatic patients?
HISTORY
12 - 23 mo - 2 doses are to be given 6 mo apart
1000 mg/day
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

6. What is the USPSTF guideline for chlamydial screening?
In all W < 24 who are sexually active - In W > 24 with increased risk
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)
Breast CA - thromboembolic event - stroke and CAD

7. When should tetanus immunoglobulin be given?
0.4 mg/day
Children up to 7 yo and < 5' should be placed in a booster seat.
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age

8. How much fluoride should military children in HI be given?
Exercise or physical therapy and vit D for patients > 65
2mo - 4 mo - 6mo and 12-15 mo
12 - 23 mo - 2 doses are to be given 6 mo apart
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day

9. How much folate should all women of child bearing age take?
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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
0.4 mg/day

10. What is the schedule for DTap vaccine?
> 2 yo and less than 40 lbs
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
2mo - 4 mo - 6mo and 12-15 mo

11. What are the guidelines for visual 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
Preschool children : 3-4 yo - Elderly patients: > 65 yo
Stroke and DVT
NEVER

12. What are some risk factors for CAD?
Men 45 - 79 yo
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
NEVER
2mo - 4 mo - 6mo and 12-15 mo

13. How often do asplenic patients receive pneumococcal vaccine?
Every 5 years
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
When they are > 40 lbs and still less then 5'

14. 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
Breast CA - thromboembolic event - stroke and CAD
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Adults > 60

15. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Forearm
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...
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
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 mg/day

16. In which group of patients should aspirin be given as primary prevention for MI?
Men 45 - 79 yo
To get IgA protection
Exercise - Environmental hazard reduction - Close monitoring of medication
0.4 - 0.8 mg/day for 1 month prior to conception

17. When is area of induration > 15 mm considered TB positive?
1200 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
Men 45 - 79 yo
Persons with no known risk factors

18. What is the schedule for polio 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
2mo - 4mo - 6-18 mo and 4-6 yrs
NEVER
One time abdominal X-ray for all MALES who ever SMOKES

19. What are some RFs for DMT2?
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Femoral neck
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)

20. When should chest X-ray be used for screening?
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
NEVER
HISTORY
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

21. What type of illnesses does Hib vaccine prevent?
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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
800 IU/ day
Meningitis and Epiglottitis

22. When should Gardasil be given and for what purposes?
6 mos - 3 yrs : 0.25 mg/day - 3 yrs - 6 yrs: 0.5 mg/day - 6 yrs - 16 yrs : 1 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
2mo - 4mo - 6-18 mo and 4-6 yrs
4 mg/day

23. What 3 things should always be done in an office visit?
Persons with no known risk factors
In adults with sustained BP > 135/80 mmHg
BP - Height - Weight
12 - 23 mo - 2 doses are to be given 6 mo apart

24. What is USPSTF guideline for abdominal aortic aneurysm screening?
0.4 mg/day
One time abdominal X-ray for all MALES who ever SMOKES
To get IgA protection
Starts at 20 for both M and W

25. What kind of car seat should children < 2 yo be placed in?
BP - Height - Weight
Rear facing
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
HISTORY

26. Measurement of which anatomic structure is best predictor for hip fracture?
Femoral neck
1300 mg/day
4 mg/day
Total cholesterol - FOBT

27. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
Starts at 20 for both M and W
1300 mg/day
To get IgA protection
Children up to 7 yo and < 5' should be placed in a booster seat.

28. What kind of sunscreen SPF is recommended for sun protection?
More than 15
Meningitis and Epiglottitis
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
2mo - 4 mo - 6mo and 12-15 mo

29. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
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)
Breast CA - thromboembolic event - stroke and CAD
Forearm
4 mg/day

30. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
HISTORY
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
0.4 - 0.8 mg/day for 1 month prior to conception

31. How much vit D should adults < 50 take?
800 IU/ 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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
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)

32. How much vit D should adults > 50 take?
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
1000 IU/day
1300 mg/day

33. 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
One time abdominal X-ray for all MALES who ever SMOKES
Women 55 - 79 yo
Meningitis and Epiglottitis

34. What are the risks of combination HRT?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
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
During 2nd - 3rd trimester

35. What is the schedule for Hib vaccine?
2mo - 4 mo - 6mo and 12-15 mo
Meningitis and Epiglottitis
Children up to 7 yo and < 5' should be placed in a booster seat.
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)

36. In which group of patients should aspirin be given as primary prevention for stroke?
In all W < 24 who are sexually active - In W > 24 with increased risk
0.4 mg/day
Femoral neck
Women 55 - 79 yo

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

38. What is the schedule for varicella vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
More than 15
One dose at 12-15 mod - Booster at least 4-weeks after
In adults with sustained BP > 135/80 mmHg

39. What are 2 conditions that have been proven to be beneficial to screened for?
Diabetes - non-coronary atherosclerosis - Family History of premature cardiac death ( M < 50 and W < 60) - Smokers - HTN - Obesity
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Smoking - Alcoholism
Meningitis and Epiglottitis

40. What is the USPSTF guideline for DMT2 screening?
Exercise or physical therapy and vit D for patients > 65
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 adults with sustained BP > 135/80 mmHg
Meningitis and Epiglottitis

41. What is the schedule for MMR vaccine?
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
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
Start at 20 for all M and W regardless of RFs
Forearm

42. 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
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
1200 mg/day
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)

43. What are the USPSTF guidelines for mammogram?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
In adults with sustained BP > 135/80 mmHg
Starts at 50 (recommends against starting at 40) and every 2 years
Men 45 - 79 yo

44. Who should get shingles vaccine?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Adults > 60
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
0.4 mg/day

45. Which children should use a semi-upright/forward facing carseat?
> 2 yo and less than 40 lbs
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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

46. When is intensive individualized home-based intervention recommended?
Exercise - Environmental hazard reduction - Close monitoring of medication
Starts at 20 for both M and W
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
2mo - 4mo - 6-18 mo and 4-6 yrs

47. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
Smoking - Alcoholism
Men 45 - 79 yo
Preschool children : 3-4 yo - Elderly patients: > 65 yo

48. How much calcium should adolescents (9 -18) take?
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years
1000 mg/day
Start at 20 for all M and W regardless of RFs
1300 mg/day

49. When should the meningococcal vaccine be given and to which group?
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

50. 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 - 0.8 mg/day for 1 month prior to conception
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs
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