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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. How much vit D should adults < 50 take?
800 IU/ day
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
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...

2. At what age should women have DEXA scan?
65 (earlier if have increased risk factors)
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
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'

3. What is the schedule for Hep A vaccine?
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs
12 - 23 mo - 2 doses are to be given 6 mo apart
Women 55 - 79 yo
Exercise - Environmental hazard reduction - Close monitoring of medication

4. How much calcium should adults (19 - 50) take?
In adults with sustained BP > 135/80 mmHg
1000 mg/day
When they are > 40 lbs and still less then 5'
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

5. Unopposed estrogen increases risks for what conditions?
Rear facing
Persons with no known risk factors
Men 45 - 79 yo
Stroke and DVT

6. What is the schedule for Gardasil?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
One time abdominal X-ray for all MALES who ever SMOKES
When they are > 40 lbs and still less then 5'

7. 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)
Smoking - Alcoholism
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
Rear facing

8. If traveling to endemic areas - Why should one get a dose of live vaccine?
To get IgA protection
Femoral neck
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

9. What is the schedule for Hib 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...
2mo - 4 mo - 6mo and 12-15 mo
0.4 mg/day
During 2nd - 3rd trimester

10. When is area of induration > 10 mm considered TB positive?
Breast CA - thromboembolic event - stroke and CAD
1000 IU/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
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

11. What are the risks of combination HRT?
Breast CA - thromboembolic event - stroke and CAD
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
HISTORY
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

12. What is the NCEP III guideline for cholesterol screening?
Start at 20 for all M and W regardless of RFs
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 - 4 mo - 6mo and 12-15 mo
Men starting at 35 yo to 65 - Women starting at 45 yo to 65 - Every 5 years

13. 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
65 (earlier if have increased risk factors)
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
When they are > 40 lbs and still less then 5'

14. How much calcium should adolescents (9 -18) take?
4 mg/day
1300 mg/day
During 2nd - 3rd trimester
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

15. What are some safety issues you should counsel parents with young children?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
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...
Exercise or physical therapy and vit D for patients > 65
One dose at 12-15 mod - Booster at least 4-weeks after

16. When should Gardasil be given and for what purposes?
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
More than 15
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
1300 mg/day

17. What is the schedule for MMR vaccine?
Exercise - Environmental hazard reduction - Close monitoring of medication
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Persons with no known risk factors
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients

18. How much folate should all women of child bearing age take?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
One time abdominal X-ray for all MALES who ever SMOKES
0.4 mg/day
Breast CA - thromboembolic event - stroke and CAD

19. When should chest X-ray be used for screening?
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 : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
Start at 20 for all M and W regardless of RFs
NEVER

20. When should the meningococcal vaccine be given and to which group?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
Preschool children : 3-4 yo - Elderly patients: > 65 yo
800 IU/ day
Starts at 20 for both M and W

21. What is the ADA guideline for DMT2 screening?
1000 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
Children 6 mos - 18 yrs - Adults > 50 yo - Chronic cardiopulmonary diseases - Metabolic disease - Immunocompromised - Household contacts of people with increased risks
In overweight M and W > 45 - In overweight M and W < 45 with 1 or more RFs

22. When should pregnant women get a flu shot?
During 2nd - 3rd trimester
1000 IU/day
Meningitis and Epiglottitis
NEVER

23. How much vit D should adults > 50 take?
NEVER
Adults > 60
1000 IU/day
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy

24. When is area of induration > 15 mm considered TB positive?
Persons with no known risk factors
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
1000 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

25. How often do asplenic patients receive pneumococcal vaccine?
Women 55 - 79 yo
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 adults with sustained BP > 135/80 mmHg
Every 5 years

26. What are the USPSTF guidelines for mammogram?
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

27. Measurement of which anatomic structure is best predictor for fractures elsewhere beside hip fracture?
Total cholesterol - FOBT
Forearm
One dose at 12-15 mod - Booster at least 4-weeks after
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

28. How much folate and for How long should a woman with hx of NTD take for planned pregnancy?
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
4 mg/day
1000 IU/day
Femoral neck

29. When is area of induration > 5mm considered TB positive?
Femoral neck
Starts at 50 (recommends against starting at 40) and every 2 years
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

30. Who should get shingles vaccine?
Breast CA - thromboembolic event - stroke and CAD
Adults > 60
During 2nd - 3rd trimester
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 is HI law for booster seat?

32. What tests are appropriate to order in an asymptomatic 57 yo male?
To get IgA protection
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
Total cholesterol - FOBT
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound

33. What can decrease fall in the elderly?
12 - 23 mo - 2 doses are to be given 6 mo apart
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
Exercise - Environmental hazard reduction - Close monitoring of medication

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

35. 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
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
Femoral neck

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

37. What are the guidelines for visual screening?
Preschool children : 3-4 yo - Elderly patients: > 65 yo
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
HISTORY
BP - Height - Weight

38. How much fluoride should military children in HI be given?
Smoking - Alcoholism
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
4 mg/day
Rear facing

39. 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
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

40. What is the USPSTF guideline for chlamydial screening?
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
11 - 12 yo - Unvaccinated adolescents at high school entry - Unvaccinated college freshman
In all W < 24 who are sexually active - In W > 24 with increased risk
Meningitis and Epiglottitis

41. What are the guidelines for colon cancer screening?
BP - Height - Weight
Femoral neck
Women 55 - 79 yo
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

42. What is the schedule for polio vaccine?
2mo - 4mo - 6-18 mo and 4-6 yrs
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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
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

43. What is the schedule for Hep B vaccine?
1300 mg/day
First dose at birth - Second dose at 1-2 mo - Third dose at 6 mo
2nd dose 2 mo after 1st dose - 3rd dose 6 mo after 2nd dose
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

44. What are 2 conditions that have been proven to be beneficial to screened for?
Smoking - Alcoholism
12-15 mos and 4-6 yrs - MMR is live and contraindicated in pregnant women and immunocompromised patients
More than 15
Preschool children : 3-4 yo - Elderly patients: > 65 yo

45. What are the USPSTF guidelines for cholesterol screening in people with increased risks?
PUD - bleeding disorders - liver disease - kidney disease - ASA allergy - uncontrolled HTN - diabetic retinopathy
Children up to 7 yo and < 5' should be placed in a booster seat.
Starts at 20 for both M and W
Children < 7 yo - 2 mo - 4 mo - 6 mo - 15-18 mo and 4-5 yrs

46. What kind of polio vaccine is preferred?
First degree relative with DMT2 - GDM or baby > 9 lbs - Physical inactivity - Ethnicity (AA - Hawaiian - Native) - HTN - PCOS - Prediabetics ( HbA1C 5.7 - 6.4)
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
Subq (inactivated - Salk) - The oral kind (Sabin - is a live vaccine and can induced polio)
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

47. 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
800 IU/ day
NEVER
One dose at 12-15 mod - Booster at least 4-weeks after

48. What type of illnesses does Hib vaccine prevent?
Meningitis and Epiglottitis
6 mos - 3 yrs : none - 3 yrs - 6 yrs: 0.25 mg/day - 6 yrs - 16 yrs : 0.5 mg/day
To get IgA protection
1300 mg/day

49. What are the guidelines for pap smear?
2mo - 4 mo and 6mo - Do not give 1st dose after 15 weeks of age - Do not give past 8mo of age
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 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)
2mo - 4 mo - 6mo and 12-15 mo

50. How much calcium should women > 50 take?
Adults > 60
1200 mg/day
For incompletely vaccinated patients (did not receive first three shots in series) with deep or contaminated wound
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