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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. Mediators released in response to allergen
Ask - Advise - Assess - Assist - Arrange
= LMP + 7 days - 3 months
Urticaria
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

2. Optimal time for trisomy screen
Esophagitis - gastritis - dysphagia
16-18 weeks GA
<20lb - <1YO - Reacts to pain - Responds to noise
6 mo - pincer - crawls - cruises - mamma - dada - byebye

3. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Measures strength of contractions
Aortic aneurysm
(cefotetan OR cefoxitin) AND doxycycline

4. Tx GAS ifxn
0.2-0.5mg aqueous EPI IM/SubQ
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

5. IV tx for PID
IV penicillin (or ampicillin)
Cataracts
Clindamycin AND gentamicin
2 mo - eyes follow object past midline - rolls over - laughs - squeals

6. Bacteria causing chronic sinusitis
Ask - Advise - Assess - Assist - Arrange
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Calcium hydroxyapatite crystals

7. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Diabetes - HTN - GN
Ofloxacin OR levofloxacin +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

8. Tx gonorrhea
Ceftriaxone 125mg IM
Pneumovax - influenza
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Metronidazole or clindamycin

9. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Tuberculosis; sarcoidosis; hodgkin disease
Age-related sensorineural hearing loss (high frequency and speech discrimination)

10. Tocodynamometer
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anemia
Conrtaction monitoring along with fetal heart rate assessment
Fluoroquinolones

11. Fe deficient anemia tx
Ferrous sulfate 325mg tid
4mo - sits unsupported - hand transfer - babbles
= LMP + 7 days - 3 months
Cataracts

12. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Calcium oxalate crystals
Anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Lung; SCC head & neck; RCC; breast; MM; prostate

13. First stage of labor
6-9MO
Steroids + bronchodilators
Metronidazole or clindamycin
Onset of labor until cervix dilation

14. Tx of traveler's diarrhea
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
5 yo - draws person - ties shoes - skips

15. Low serum iron - low MCV - low ferritin - +stool guaiac
Clindamycin AND gentamicin
Fe deficient anemia
MCC melanoma. Radial growth.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

16. social interaction
2 mo - eyes follow object past midline - rolls over - laughs - squeals
4 yo - copies triangle - catches ball - dresses self
Prostatitis
Conrtaction monitoring along with fetal heart rate assessment

17. IADL
Fe deficient anemia
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(cefotetan OR cefoxitin) AND doxycycline

18. Only therapy to decrease mortality in stage IV COPD
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Oxygen intervention 15h/d
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Bupropion - varenicline - nicotine replacement

19. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anemia
Urinary calcium. Hyper PTH (high) >> FHH (normal)

20. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

21. Complications of GAS infxn
Ofloxacin OR levofloxacin +/- metronidazole
Oxytocin (IV)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

22. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
4mo - sits unsupported - hand transfer - babbles

23. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
5+ rads
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)
Urticaria

24. Second stage of labor
Alpha-1 antitrypsin deficiency
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

25. social smile - parent recognition
Tdap - influenza - pneumovax
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Calcium pyrophosphate dehydrate crystals (pseudogout)

26. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Nicotine inhaler - nasal spray - gum
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
16-18 weeks GA

27. presbycusis
1 mo - eyes follow object to midline - vocalizes
DTaP - hepB - Hib - rotavirus - inactivated polio
Onset of labor until cervix dilation
Age-related sensorineural hearing loss (high frequency and speech discrimination)

28. GBS tx
Angioedema
IV penicillin (or ampicillin)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Oxytocin (IV)

29. DDX for geriatric hearing impairment
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
110-160bpm
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Anterior shoulder cannot readily pass below the pubic symphysis.

30. Unstable angina vs MI Dx tests
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Hypomagnesemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

31. How much radiation is associated with fetal harm?
Lung; SCC head & neck; RCC; breast; MM; prostate
Measures strength of contractions
9 mo - walks - throws - 1-3 words - 1-step commands
5+ rads

32. Complications of PID
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Esophagitis - gastritis - dysphagia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Most aggressive melanoma.

33. bacteria causing pharyngitis
Conrtaction monitoring along with fetal heart rate assessment
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
IV penicillin (or ampicillin)

34. variable deceleration
6-9MO
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
= LMP + 7 days - 3 months
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

35. Cockcroft-Gault equation
Diphenhydramine - chlorpheniramine - hydroxyzine
Fe deficient anemia
Ferrous sulfate 325mg tid
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

36. Pflx for traveler's diarrhea
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Biopsy
Fluoroquinolones

37. Augments contractions
Oxytocin (IV)
Pneumovax - influenza
Ceftriaxone 125mg IM
Metronidazole or clindamycin

38. Lentigo Maligna
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Cataracts
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

39. Causes of CKD
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Diabetes - HTN - GN
Measures strength of contractions

40. Other causes of hypercalcemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
6 yo
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ampicillin/sulbactam AND doxycycline

41. medications causing hypercalcemia
Calcium hydroxyapatite crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thiazdes; lithium
0.2-0.5mg aqueous EPI IM/SubQ

42. explorations
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
After delivery until delivery of placenta and membranes <30 mins
9 mo - walks - throws - 1-3 words - 1-step commands
Clindamycin AND gentamicin

43. Screened at 11-13 weeks GA for trisomy
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Nuchal translucency - serum hCG - PAPP-A
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

44. dyspnea - visceral edema - hypotension
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaphylaxis

45. Age by which child says 'mama' and 'dada'
6-9MO
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Oxygen intervention 15h/d
Fe deficient anemia

46. Tx hyperkalemia in CKD
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators
Oxygen intervention 15h/d
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

47. MCC blindness worldwide
Ask - Advise - Assess - Assist - Arrange
Cataracts
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaphylaxis

48. DOC for HTN in elderly
Thiazides
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Calcium oxalate crystals
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)

49. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
5 yo - draws person - ties shoes - skips
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

50. Sx of hypercalcemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Steroids + bronchodilators
Metronidazole or clindamycin