Test your basic knowledge |

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. Third stage of labor
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
After delivery until delivery of placenta and membranes <30 mins
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Lung; SCC head & neck; RCC; breast; MM; prostate

2. Tender - boggy prostate. Dx?
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Prostatitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Bupropion - varenicline - nicotine replacement

3. Bacteria causing chronic sinusitis
Nuchal translucency - serum hCG - PAPP-A
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
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)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

4. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
NAC or IV NaHCO3

5. medications causing hypercalcemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Thiazdes; lithium
9 mo - walks - throws - 1-3 words - 1-step commands
Hypomagnesemia

6. Tx for thyroid storm
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tdap - influenza - pneumovax
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

7. How much radiation is associated with fetal harm?
5+ rads
Ampicillin/sulbactam AND doxycycline
6-9MO
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

8. Tx GAS ifxn
Metronidazole or clindamycin
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Starts at contraction. caused by increased vagal tone from fetal head compression.
MCC melanoma. Radial growth.

9. Fetal heart rate range
4 yo - copies triangle - catches ball - dresses self
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
110-160bpm

10. Tx hyperkalemia in CKD
Anaphylaxis
Anemia
Most aggressive melanoma.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

11. Tx acute gout
Colchicine
Starts at contraction. caused by increased vagal tone from fetal head compression.
Normal mental status; no other injuries; seen within 10 days of injury
Aortic aneurysm

12. Nonfunctioning nodules > 1cm require _____
Pneumovax - influenza
Biopsy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5 yo - draws person - ties shoes - skips

13. Granulomatous causes of hypercalcemia
Fe deficient anemia
Patch - bupropion - varenicline
Tuberculosis; sarcoidosis; hodgkin disease
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

14. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Angioedema

15. parallel play
DTaP - hepB - Hib - rotavirus - inactivated polio
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

16. Early deceleration
Prostatitis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Starts at contraction. caused by increased vagal tone from fetal head compression.

17. Only therapy to decrease mortality in stage IV COPD
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Oxygen intervention 15h/d
Flexion - internal rotation - extension - external rotation

18. Bisphospohonates sfx
5+ rads
Esophagitis - gastritis - dysphagia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
= LMP + 7 days - 3 months

19. Dx criteria for RA
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ask - Advise - Assess - Assist - Arrange
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Loratadine - fexofenadine - cetirizine

20. DOC for HTN in elderly
Loratadine - fexofenadine - cetirizine
Thiazides
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MTX

21. MCC blindness worldwide
DTaP - hepB - Hib - rotavirus - inactivated polio
Cataracts
<20lb - <1YO - Reacts to pain - Responds to noise
Ofloxacin OR levofloxacin +/- metronidazole

22. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Nuchal translucency - serum hCG - PAPP-A
1 mo - eyes follow object to midline - vocalizes
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

23. First stage of labor
Onset of labor until cervix dilation
Measures strength of contractions
Fe deficient anemia
Bupropion - varenicline - nicotine replacement

24. Dx bacterial rhinosinusitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Nicotine inhaler - nasal spray - gum
4mo - sits unsupported - hand transfer - babbles
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)

25. Augments contractions
IV penicillin (or ampicillin)
Oxytocin (IV)
Prostatitis
Loratadine - fexofenadine - cetirizine

26. Sx otitis media
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
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)
Nuchal translucency - serum hCG - PAPP-A

27. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Bathing - dressing - eating - transferring - continence - toileting
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Tdap - influenza - pneumovax

28. IUPC (intrauterine pressure catheter)
Patch - bupropion - varenicline
Nicotine inhaler - nasal spray - gum
6-9MO
Measures strength of contractions

29. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Bathing - dressing - eating - transferring - continence - toileting
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
<20lb - <1YO - Reacts to pain - Responds to noise

30. X-ray of ankle?
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Normal mental status; no other injuries; seen within 10 days of injury

31. Late deceleration
Calcium pyrophosphate dehydrate crystals (pseudogout)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Flexion - internal rotation - extension - external rotation
Stridor - drooling - toxic appearance

32. Rod shaped - rhomboid - weakly positive birefringent
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
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)
Ferrous sulfate 325mg tid
Calcium pyrophosphate dehydrate crystals (pseudogout)

33. Acral lentinous melanoma
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
110-160bpm
Hypomagnesemia
MCC melanoma in Africans/Asians. Under nails - soles - palms.

34. Screened at 16-20 weeks GA for trisomy
16-18 weeks GA
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Conrtaction monitoring along with fetal heart rate assessment
3 yo - identify body part - copies square - hops - throws - past tense - story telling

35. cystoplasmic inclusions - not birefringent
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
110-160bpm
Calcium hydroxyapatite crystals
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

36. shoulder dystocia
<20lb - <1YO - Reacts to pain - Responds to noise
Fe deficient anemia
Anterior shoulder cannot readily pass below the pubic symphysis.
Anaphylaxis

37. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

38. Screening for 65-76YO male smoker
Aortic aneurysm
Thiazdes; lithium
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ceftriaxone 125mg IM

39. Unstable angina vs MI Dx tests
Metronidazole or clindamycin
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Loratadine - fexofenadine - cetirizine
Esophagitis - gastritis - dysphagia

40. Tx bacterial vaginosis
MCC melanoma. Radial growth.
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)
Metronidazole or clindamycin
110-160bpm

41. painless - deep - subQ swelling (periorbital - circumoral - facial)
Pneumovax - influenza
Calcium oxalate crystals
Angioedema
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

42. Tx acute exacerbation COPD
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)
Short-acting + 40mg prednisone x 10-14days
4mo - sits unsupported - hand transfer - babbles
Bathing - dressing - eating - transferring - continence - toileting

43. causes of acute bronchitis
4 yo - copies triangle - catches ball - dresses self
Metronidazole or clindamycin
Bathing - dressing - eating - transferring - continence - toileting
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

44. Tx gonorrhea
Anaphylaxis
Measures strength of contractions
Ceftriaxone 125mg IM
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

45. Signs of rupture of membranes

46. Nodular melanoma
Conrtaction monitoring along with fetal heart rate assessment
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Most aggressive melanoma.
Colchicine

47. Tx of traveler's diarrhea
4 yo - copies triangle - catches ball - dresses self
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

48. bacteria causing pharyngitis
Alpha-1 antitrypsin deficiency
6 yo
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

49. tx shoulder dystocia

50. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Nuchal translucency - serum hCG - PAPP-A
Ear pain - itching - inflammation/swollen canal - exudates/discharge