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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. IV tx for PID
<20lb - <1YO - Reacts to pain - Responds to noise
(cefotetan OR cefoxitin) AND doxycycline
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Thiazides

2. explorations
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
9 mo - walks - throws - 1-3 words - 1-step commands
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Thiazdes; lithium

3. Screened at 16-20 weeks GA for trisomy
6 yo
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Pneumovax - influenza

4. First stage of labor
Short-acting + 40mg prednisone x 10-14days
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Onset of labor until cervix dilation
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

5. Pregnancy class C smoking cessation drugs
Ofloxacin OR levofloxacin +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Patch - bupropion - varenicline

6. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
3 yo - identify body part - copies square - hops - throws - past tense - story telling
(ofloxacin OR levofloxacin) +/- metronidazole
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

7. stranger/separation anxiety
Anterior shoulder cannot readily pass below the pubic symphysis.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Biopsy
Monosodium urate crystals (gout)

8. Tx chlamydia
Nicotine inhaler - nasal spray - gum
Nuchal translucency - serum hCG - PAPP-A
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

9. Age by which child says 'mama' and 'dada'
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Measures strength of contractions
= LMP + 7 days - 3 months
6-9MO

10. Corrected serum calcium =

11. The five A's of smoking cessation
Ceftriaxone 125mg IM
Ask - Advise - Assess - Assist - Arrange
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
= LMP + 7 days - 3 months

12. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Calcium hydroxyapatite crystals
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Alpha-1 antitrypsin deficiency
Anemia

13. Tx acute exacerbation COPD
5+ rads
Short-acting + 40mg prednisone x 10-14days
Thiazdes; lithium
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

14. Immunizations for adult 65YO+
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Tdap - influenza - pneumovax
Diphenhydramine - chlorpheniramine - hydroxyzine
Anemia

15. Malignancies with hypercalcemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate

16. Cockcroft-Gault equation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
NAC or IV NaHCO3
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

17. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
6 mo - pincer - crawls - cruises - mamma - dada - byebye

18. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Loratadine - fexofenadine - cetirizine
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
DTaP - hepB - Hib - rotavirus - inactivated polio

19. MONA therapy
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Steroids + bronchodilators
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Oxytocin (IV)

20. IV tx for PID
Calcium oxalate crystals
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ampicillin/sulbactam AND doxycycline
Nuchal translucency - serum hCG - PAPP-A

21. Estimated delivery date (Naegele's rule)
Ceftriaxone 125mg IM
Prostatitis
= LMP + 7 days - 3 months
MTX

22. How much radiation is associated with fetal harm?
Prostatitis
5+ rads
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

23. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Ferrous sulfate 325mg tid
Diabetes - HTN - GN
Ampicillin/sulbactam AND doxycycline

24. IV tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anemia
Ofloxacin OR levofloxacin +/- metronidazole

25. Late deceleration
(ofloxacin OR levofloxacin) +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
= LMP + 7 days - 3 months
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

26. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ampicillin/sulbactam AND doxycycline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Monosodium urate crystals (gout)

27. Second stage of labor
Nicotine inhaler - nasal spray - gum
0.2-0.5mg aqueous EPI IM/SubQ
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

28. Optimal time for trisomy screen
Tdap - influenza - pneumovax
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
16-18 weeks GA
Diabetes - HTN - GN

29. Only therapy to decrease mortality in stage IV COPD
Ofloxacin OR levofloxacin +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Oxygen intervention 15h/d
4 yo - copies triangle - catches ball - dresses self

30. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
4mo - sits unsupported - hand transfer - babbles
(cefotetan OR cefoxitin) AND doxycycline

31. Dx bacterial rhinosinusitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
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)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

32. Tx hyperkalemia in CKD
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)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

33. IV tx for PID
5 yo - draws person - ties shoes - skips
Clindamycin AND gentamicin
Fluoroquinolones
Hypomagnesemia

34. group play - gender - knows name
Lung; SCC head & neck; RCC; breast; MM; prostate
Short-acting + 40mg prednisone x 10-14days
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Oxygen intervention 15h/d

35. X-ray of ankle?
Tdap - influenza - pneumovax
Normal mental status; no other injuries; seen within 10 days of injury
Flexion - internal rotation - extension - external rotation
16-18 weeks GA

36. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Flexion - internal rotation - extension - external rotation
Nicotine inhaler - nasal spray - gum

37. Tx acute gout
Colchicine
16-18 weeks GA
Ofloxacin OR levofloxacin +/- metronidazole
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

38. parallel play
<20lb - <1YO - Reacts to pain - Responds to noise
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Esophagitis - gastritis - dysphagia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

39. Complications of PID
Monosodium urate crystals (gout)
Fe deficient anemia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Bathing - dressing - eating - transferring - continence - toileting

40. Screened at 11-13 weeks GA for trisomy
Normal mental status; no other injuries; seen within 10 days of injury
Nuchal translucency - serum hCG - PAPP-A
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

41. Dx PID
Colchicine
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Long axis of fetus to long axis of mother (longitudinal or transverse)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

42. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Cataracts
Thiazdes; lithium

43. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
110-160bpm
4 yo - copies triangle - catches ball - dresses self
Short-acting + 40mg prednisone x 10-14days

44. Bacteria causing chronic sinusitis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Oxygen intervention 15h/d

45. Fe deficient anemia tx
Esophagitis - gastritis - dysphagia
Ferrous sulfate 325mg tid
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Short-acting + 40mg prednisone x 10-14days

46. Sx of hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Conrtaction monitoring along with fetal heart rate assessment

47. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
3 yo - identify body part - copies square - hops - throws - past tense - story telling
IV penicillin (or ampicillin)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

48. Large - irregularly shaped - prutitic - erythematous wheals
Ofloxacin OR levofloxacin +/- metronidazole
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Urticaria
Calcium oxalate crystals

49. Early deceleration
110-160bpm
Ofloxacin OR levofloxacin +/- metronidazole
MTX
Starts at contraction. caused by increased vagal tone from fetal head compression.

50. presbycusis
Anterior shoulder cannot readily pass below the pubic symphysis.
Short-acting + 40mg prednisone x 10-14days
5+ rads
Age-related sensorineural hearing loss (high frequency and speech discrimination)