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Family Medicine/ambulatory 1

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. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Ofloxacin OR levofloxacin +/- metronidazole
MCC melanoma. Radial growth.
Ear pain - itching - inflammation/swollen canal - exudates/discharge

2. Tx otitis media
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium hydroxyapatite crystals
Normal mental status; no other injuries; seen within 10 days of injury
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

3. Recommended folic acid daily dose
NAC or IV NaHCO3
Bupropion - varenicline - nicotine replacement
Prostatitis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

4. Sx otitis media
Cataracts
Angioedema
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
After delivery until delivery of placenta and membranes <30 mins

5. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Prostatitis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Urticaria

6. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Ampicillin/sulbactam AND doxycycline
(ofloxacin OR levofloxacin) +/- metronidazole
Age-related sensorineural hearing loss (high frequency and speech discrimination)

7. Superficial spreading melanoma
Onset of labor until cervix dilation
Prostatitis
16-18 weeks GA
MCC melanoma. Radial growth.

8. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Normal mental status; no other injuries; seen within 10 days of injury

9. Sx otitis externa
5 yo - draws person - ties shoes - skips
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Aortic aneurysm
(ofloxacin OR levofloxacin) +/- metronidazole

10. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Prostatitis
(ofloxacin OR levofloxacin) +/- metronidazole
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

11. Only therapy to decrease mortality in stage IV COPD
Pneumovax - influenza
Oxygen intervention 15h/d
0.2-0.5mg aqueous EPI IM/SubQ
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

12. Corrected serum calcium =

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13. Recommendations for rear-facing car seat
Fe deficient anemia
Diabetes - HTN - GN
Angioedema
<20lb - <1YO - Reacts to pain - Responds to noise

14. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Oxytocin (IV)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Measures strength of contractions

15. painless - deep - subQ swelling (periorbital - circumoral - facial)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Onset of labor until cervix dilation
Angioedema
Tuberculosis; sarcoidosis; hodgkin disease

16. Regards human face - eye contact
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1 mo - eyes follow object to midline - vocalizes
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

17. Sx epiglottitis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Biopsy
Stridor - drooling - toxic appearance
9 mo - walks - throws - 1-3 words - 1-step commands

18. Nonfunctioning nodules > 1cm require _____
5+ rads
Biopsy
0.2-0.5mg aqueous EPI IM/SubQ
Flexion - internal rotation - extension - external rotation

19. parallel play
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Monosodium urate crystals (gout)
Thiazides

20. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
<20lb - <1YO - Reacts to pain - Responds to noise
MTX
Fluoroquinolones

21. Tx acute sinusitis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Thiazdes; lithium
Biopsy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

22. dyspnea - visceral edema - hypotension
Anaphylaxis
Hypomagnesemia
Loratadine - fexofenadine - cetirizine
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

23. Causes of CKD
4 yo - copies triangle - catches ball - dresses self
Patch - bupropion - varenicline
Urticaria
Diabetes - HTN - GN

24. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Angioedema
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

25. bipyramidal - strongly positive birefringent
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium oxalate crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Calcium hydroxyapatite crystals

26. Estimated delivery date (Naegele's rule)
5 yo - draws person - ties shoes - skips
Urinary calcium. Hyper PTH (high) >> FHH (normal)
= LMP + 7 days - 3 months
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

27. IV tx for PID
0.2-0.5mg aqueous EPI IM/SubQ
Bathing - dressing - eating - transferring - continence - toileting
(cefotetan OR cefoxitin) AND doxycycline
MCC melanoma in Africans/Asians. Under nails - soles - palms.

28. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Short-acting + 40mg prednisone x 10-14days
4mo - sits unsupported - hand transfer - babbles

29. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Thiazides
Metronidazole or clindamycin

30. social smile - parent recognition
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Measures strength of contractions

31. Tx bacterial vaginosis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium hydroxyapatite crystals
Calcium oxalate crystals
Metronidazole or clindamycin

32. Emphysema - <45YO - nonsmoker
Monosodium urate crystals (gout)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Alpha-1 antitrypsin deficiency

33. Tender - boggy prostate. Dx?
Prostatitis
After delivery until delivery of placenta and membranes <30 mins
Bupropion - varenicline - nicotine replacement
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

34. Dx bacterial vaginosis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

35. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Esophagitis - gastritis - dysphagia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

36. bacteria causing pharyngitis
Hypomagnesemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

37. cystoplasmic inclusions - not birefringent
Prostatitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Calcium hydroxyapatite crystals
= LMP + 7 days - 3 months

38. Smoking cessation agents
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Loratadine - fexofenadine - cetirizine
Bupropion - varenicline - nicotine replacement
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

39. Tx acute exacerbation COPD
Starts at contraction. caused by increased vagal tone from fetal head compression.
DTaP - hepB - Hib - rotavirus - inactivated polio
Short-acting + 40mg prednisone x 10-14days
0.2-0.5mg aqueous EPI IM/SubQ

40. group play - gender - knows name
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
After delivery until delivery of placenta and membranes <30 mins

41. Pflx for traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ampicillin/sulbactam AND doxycycline
Fluoroquinolones
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

42. IUPC (intrauterine pressure catheter)
7-10d sx: purulent nasal discharge - maxillary tooth or facial pain - unilateral maxillary sinus tenderness - worsening of Sx after initial improvement (post viral URI possibly)
Measures strength of contractions
110-160bpm
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

43. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Urticaria
Onset of labor until cervix dilation

44. social interaction
Biopsy
4 yo - copies triangle - catches ball - dresses self
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

45. Granulomatous causes of hypercalcemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Tuberculosis; sarcoidosis; hodgkin disease
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

46. Acral lentinous melanoma
Cataracts
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ampicillin/sulbactam AND doxycycline
MCC melanoma in Africans/Asians. Under nails - soles - palms.

47. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
IV penicillin (or ampicillin)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

48. Immunizations for adult 65YO+
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Tdap - influenza - pneumovax
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Most aggressive melanoma.

49. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
6-9MO
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
110-160bpm

50. Augments contractions
Oxytocin (IV)
5 yo - draws person - ties shoes - skips
Anaphylaxis
Bathing - dressing - eating - transferring - continence - toileting