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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. 1st generation antihistamines
Prostatitis
Normal mental status; no other injuries; seen within 10 days of injury
Fluoroquinolones
Diphenhydramine - chlorpheniramine - hydroxyzine

2. Nonfunctioning nodules > 1cm require _____
Biopsy
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Alpha-1 antitrypsin deficiency
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

3. Tx bacterial vaginosis
Metronidazole or clindamycin
Steroids + bronchodilators
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Fluoroquinolones

4. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Oxygen intervention 15h/d
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

5. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
6 mo - pincer - crawls - cruises - mamma - dada - byebye
NAC or IV NaHCO3
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

6. Superficial spreading melanoma
Diabetes - HTN - GN
MCC melanoma. Radial growth.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
5 yo - draws person - ties shoes - skips

7. dyspnea - visceral edema - hypotension
<20lb - <1YO - Reacts to pain - Responds to noise
Pneumovax - influenza
Anaphylaxis
Bupropion - varenicline - nicotine replacement

8. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Long axis of fetus to long axis of mother (longitudinal or transverse)

9. Tx RA (best long-term outcome)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Diphenhydramine - chlorpheniramine - hydroxyzine
Ask - Advise - Assess - Assist - Arrange
MTX

10. Tx for anaphylaxis
Ofloxacin OR levofloxacin +/- metronidazole
Urticaria
6 yo
0.2-0.5mg aqueous EPI IM/SubQ

11. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Nuchal translucency - serum hCG - PAPP-A
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
DTaP - hepB - Hib - rotavirus - inactivated polio

12. Pregnancy class C smoking cessation drugs
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Patch - bupropion - varenicline
6 yo

13. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Calcium oxalate crystals
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Measures strength of contractions
Anemia

14. Four cardinal fetal movements
Diabetes - HTN - GN
Oxytocin (IV)
After delivery until delivery of placenta and membranes <30 mins
Flexion - internal rotation - extension - external rotation

15. explorations
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
9 mo - walks - throws - 1-3 words - 1-step commands
Loratadine - fexofenadine - cetirizine
5 yo - draws person - ties shoes - skips

16. Sx peritonsillar abscess
Patch - bupropion - varenicline
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Bupropion - varenicline - nicotine replacement
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

17. Screened at 16-20 weeks GA for trisomy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Calcium hydroxyapatite crystals

18. needles - strong negative birefringent (yellow crystals parallel light)
Bupropion - varenicline - nicotine replacement
Monosodium urate crystals (gout)
MCC melanoma. Radial growth.
Short-acting + 40mg prednisone x 10-14days

19. Tx GAS ifxn
Hypomagnesemia
Diphenhydramine - chlorpheniramine - hydroxyzine
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Urticaria

20. Recommended folic acid daily dose
Ofloxacin OR levofloxacin +/- metronidazole
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
5+ rads

21. parallel play
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Onset of labor until cervix dilation

22. Age by which child says 'mama' and 'dada'
Most aggressive melanoma.
6-9MO
Ampicillin/sulbactam AND doxycycline
Diabetes - HTN - GN

23. Tx otitis media
Prostatitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
<20lb - <1YO - Reacts to pain - Responds to noise
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

24. Sx otitis media
Calcium hydroxyapatite crystals
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Angioedema
6-9MO

25. CKD Stages
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
5+ rads
Loratadine - fexofenadine - cetirizine

26. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Fe deficient anemia
Metronidazole or clindamycin
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

27. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Thiazides
Hypomagnesemia
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

28. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Diabetes - HTN - GN
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

29. Pflx for traveler's diarrhea
Fluoroquinolones
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ask - Advise - Assess - Assist - Arrange
MCC melanoma. Radial growth.

30. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Measures strength of contractions
5 yo - draws person - ties shoes - skips
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

31. Estimated delivery date (Naegele's rule)
Bathing - dressing - eating - transferring - continence - toileting
(ofloxacin OR levofloxacin) +/- metronidazole
= LMP + 7 days - 3 months
Steroids + bronchodilators

32. IV tx for PID
Ferrous sulfate 325mg tid
3 yo - identify body part - copies square - hops - throws - past tense - story telling
(cefotetan OR cefoxitin) AND doxycycline
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

33. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
<20lb - <1YO - Reacts to pain - Responds to noise
4mo - sits unsupported - hand transfer - babbles

34. Granulomatous causes of hypercalcemia
Fluoroquinolones
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease
Angioedema

35. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Oxytocin (IV)
(ofloxacin OR levofloxacin) +/- metronidazole

36. ADL
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
4mo - sits unsupported - hand transfer - babbles
Bathing - dressing - eating - transferring - continence - toileting
NAC or IV NaHCO3

37. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Short-acting + 40mg prednisone x 10-14days
4mo - sits unsupported - hand transfer - babbles

38. 2nd generation antihistamines
Steroids + bronchodilators
Esophagitis - gastritis - dysphagia
Loratadine - fexofenadine - cetirizine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

39. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
5+ rads
Starts at contraction. caused by increased vagal tone from fetal head compression.

40. Dx bacterial rhinosinusitis
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)
4mo - sits unsupported - hand transfer - babbles
Calcium oxalate crystals
Ampicillin/sulbactam AND doxycycline

41. Tocodynamometer
Cataracts
Conrtaction monitoring along with fetal heart rate assessment
Tdap - influenza - pneumovax
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

42. MONA therapy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
6-9MO
Angioedema
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

43. Screening for 65-76YO male smoker
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Alpha-1 antitrypsin deficiency
Aortic aneurysm
Ferrous sulfate 325mg tid

44. Smoking cessation agents
Stridor - drooling - toxic appearance
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Steroids + bronchodilators
Bupropion - varenicline - nicotine replacement

45. Acral lentinous melanoma
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ofloxacin OR levofloxacin +/- metronidazole

46. cystoplasmic inclusions - not birefringent
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Calcium hydroxyapatite crystals
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

47. stranger/separation anxiety
4mo - sits unsupported - hand transfer - babbles
(ofloxacin OR levofloxacin) +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
4 yo - copies triangle - catches ball - dresses self

48. Complications of GAS infxn
Stridor - drooling - toxic appearance
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Hypomagnesemia

49. The five A's of smoking cessation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
IV penicillin (or ampicillin)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ask - Advise - Assess - Assist - Arrange

50. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
MTX
Angioedema
Age-related sensorineural hearing loss (high frequency and speech discrimination)