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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. MONA therapy
Steroids + bronchodilators
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Calcium pyrophosphate dehydrate crystals (pseudogout)

2. IV tx for PID
Clindamycin AND gentamicin
Oxytocin (IV)
MCC melanoma. Radial growth.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

3. IADL
Thiazides
1 mo - eyes follow object to midline - vocalizes
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

4. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Biopsy

5. Screening for 65-76YO male smoker
4mo - sits unsupported - hand transfer - babbles
Aortic aneurysm
Biopsy
= LMP + 7 days - 3 months

6. X-ray on knee?
Fluoroquinolones
Ear pain - itching - inflammation/swollen canal - exudates/discharge
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Diphenhydramine - chlorpheniramine - hydroxyzine

7. Nonfunctioning nodules > 1cm require _____
Short-acting + 40mg prednisone x 10-14days
Biopsy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Normal mental status; no other injuries; seen within 10 days of injury

8. Pregnancy class C smoking cessation drugs
Stridor - drooling - toxic appearance
Ceftriaxone 125mg IM
Patch - bupropion - varenicline
Urinary calcium. Hyper PTH (high) >> FHH (normal)

9. Tocodynamometer
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)
1 mo - eyes follow object to midline - vocalizes
Calcium oxalate crystals
Conrtaction monitoring along with fetal heart rate assessment

10. Complications of GAS infxn
Long axis of fetus to long axis of mother (longitudinal or transverse)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ferrous sulfate 325mg tid
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

11. Malignancies with hypercalcemia
Hypomagnesemia
Lung; SCC head & neck; RCC; breast; MM; prostate
9 mo - walks - throws - 1-3 words - 1-step commands
Age-related sensorineural hearing loss (high frequency and speech discrimination)

12. writes name - counts 10 objects
Calcium pyrophosphate dehydrate crystals (pseudogout)
Diabetes - HTN - GN
5 yo - draws person - ties shoes - skips
110-160bpm

13. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
(ofloxacin OR levofloxacin) +/- metronidazole

14. shoulder dystocia
Onset of labor until cervix dilation
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

15. Dx criteria for RA
(cefotetan OR cefoxitin) AND doxycycline
Oxygen intervention 15h/d
Measures strength of contractions
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

16. Third stage of labor
Tdap - influenza - pneumovax
Calcium hydroxyapatite crystals
Nicotine inhaler - nasal spray - gum
After delivery until delivery of placenta and membranes <30 mins

17. explorations
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Aortic aneurysm
Pneumovax - influenza
9 mo - walks - throws - 1-3 words - 1-step commands

18. Screened at 11-13 weeks GA for trisomy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Nuchal translucency - serum hCG - PAPP-A
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
0.2-0.5mg aqueous EPI IM/SubQ

19. group play - gender - knows name
6 yo
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium oxalate crystals

20. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
4 yo - copies triangle - catches ball - dresses self
Lung; SCC head & neck; RCC; breast; MM; prostate
5 yo - draws person - ties shoes - skips

21. Improve short-term outcomes in acute exacerbations of COPD - asthma
Calcium hydroxyapatite crystals
Steroids + bronchodilators
Onset of labor until cervix dilation
Lung; SCC head & neck; RCC; breast; MM; prostate

22. DDX for geriatric hearing impairment
NAC or IV NaHCO3
4 yo - copies triangle - catches ball - dresses self
Ampicillin/sulbactam AND doxycycline
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

23. Four cardinal fetal movements
4 yo - copies triangle - catches ball - dresses self
Long axis of fetus to long axis of mother (longitudinal or transverse)
Flexion - internal rotation - extension - external rotation
Onset of labor until cervix dilation

24. Other causes of hypercalcemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
MCC melanoma. Radial growth.
Clindamycin AND gentamicin

25. Oral tx for PID
= LMP + 7 days - 3 months
Fe deficient anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
(ofloxacin OR levofloxacin) +/- metronidazole

26. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
= LMP + 7 days - 3 months
Ampicillin/sulbactam AND doxycycline
6-9MO

27. Sx epiglottitis
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Stridor - drooling - toxic appearance
110-160bpm

28. Electrolyte abnormality that increases the incidence of torsades de pointes
<20lb - <1YO - Reacts to pain - Responds to noise
Monosodium urate crystals (gout)
Hypomagnesemia
Thiazdes; lithium

29. painless - deep - subQ swelling (periorbital - circumoral - facial)
Calcium oxalate crystals
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Angioedema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

30. causes of acute bronchitis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Angioedema
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

31. IV tx for PID
Ampicillin/sulbactam AND doxycycline
5 yo - draws person - ties shoes - skips
0.2-0.5mg aqueous EPI IM/SubQ
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

32. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
= LMP + 7 days - 3 months
Urinary calcium. Hyper PTH (high) >> FHH (normal)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

33. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Stridor - drooling - toxic appearance
Alpha-1 antitrypsin deficiency
Age-related sensorineural hearing loss (high frequency and speech discrimination)

34. social interaction
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
4 yo - copies triangle - catches ball - dresses self
Ask - Advise - Assess - Assist - Arrange
Hypomagnesemia

35. Tx hyperkalemia in CKD
MCC melanoma. Radial growth.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

36. Tx bacterial vaginosis
Metronidazole or clindamycin
Bupropion - varenicline - nicotine replacement
Most aggressive melanoma.
Tdap - influenza - pneumovax

37. Immunizations for adult 65YO+
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Tdap - influenza - pneumovax
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Flexion - internal rotation - extension - external rotation

38. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Measures strength of contractions
Aortic aneurysm

39. Large - irregularly shaped - prutitic - erythematous wheals
Most aggressive melanoma.
Urticaria
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

40. Recommended folic acid daily dose
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Diabetes - HTN - GN
Monosodium urate crystals (gout)

41. Tx acute exacerbation COPD
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Short-acting + 40mg prednisone x 10-14days
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

42. Fetal lie
Oxygen intervention 15h/d
Long axis of fetus to long axis of mother (longitudinal or transverse)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
= LMP + 7 days - 3 months

43. Augments contractions
MCC melanoma in Africans/Asians. Under nails - soles - palms.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Oxytocin (IV)

44. Estimated delivery date (Naegele's rule)
Monosodium urate crystals (gout)
Biopsy
MCC melanoma in Africans/Asians. Under nails - soles - palms.
= LMP + 7 days - 3 months

45. dyspnea - visceral edema - hypotension
Metronidazole or clindamycin
Anaphylaxis
Ampicillin/sulbactam AND doxycycline
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

46. Superficial spreading melanoma
6-9MO
MCC melanoma. Radial growth.
Measures strength of contractions
After delivery until delivery of placenta and membranes <30 mins

47. GBS tx
IV penicillin (or ampicillin)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Biopsy
Cataracts

48. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Hypomagnesemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

49. Tx RA (best long-term outcome)
Alpha-1 antitrypsin deficiency
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
MTX

50. Oral tx for PID
Urinary calcium. Hyper PTH (high) >> FHH (normal)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Urticaria