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. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
16-18 weeks GA
Pneumovax - influenza
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

2. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Oxygen intervention 15h/d
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

3. DDX for geriatric hearing impairment
Cataracts
Biopsy
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Most aggressive melanoma.

4. IV tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Metronidazole or clindamycin
Clindamycin AND gentamicin

5. Dx criteria for RA
Prostatitis
Tdap - influenza - pneumovax
Calcium hydroxyapatite crystals
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

6. Sx otitis externa
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

7. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Esophagitis - gastritis - dysphagia
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA

8. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Nuchal translucency - serum hCG - PAPP-A
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

9. IADL
Pneumovax - influenza
Colchicine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ampicillin/sulbactam AND doxycycline

10. Screened at 11-13 weeks GA for trisomy
Fe deficient anemia
Tuberculosis; sarcoidosis; hodgkin disease
Ferrous sulfate 325mg tid
Nuchal translucency - serum hCG - PAPP-A

11. X-ray on knee?
Alpha-1 antitrypsin deficiency
Tuberculosis; sarcoidosis; hodgkin disease
Metronidazole or clindamycin
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

12. Tender - boggy prostate. Dx?
Prostatitis
Anterior shoulder cannot readily pass below the pubic symphysis.
Tuberculosis; sarcoidosis; hodgkin disease
(ofloxacin OR levofloxacin) +/- metronidazole

13. IV tx for PID
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ask - Advise - Assess - Assist - Arrange
(cefotetan OR cefoxitin) AND doxycycline

14. Second stage of labor
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium oxalate crystals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

15. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
16-18 weeks GA
Urinary calcium. Hyper PTH (high) >> FHH (normal)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anemia

16. Granulomatous causes of hypercalcemia
MCC melanoma. Radial growth.
Anterior shoulder cannot readily pass below the pubic symphysis.
Alpha-1 antitrypsin deficiency
Tuberculosis; sarcoidosis; hodgkin disease

17. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6 yo
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Thiazdes; lithium

18. Tx gonorrhea
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Nicotine inhaler - nasal spray - gum
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ceftriaxone 125mg IM

19. GBS tx
Ferrous sulfate 325mg tid
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Tuberculosis; sarcoidosis; hodgkin disease
IV penicillin (or ampicillin)

20. bacteria causing pharyngitis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Tuberculosis; sarcoidosis; hodgkin disease
Clindamycin AND gentamicin
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

21. Third stage of labor
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)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
After delivery until delivery of placenta and membranes <30 mins
Ferrous sulfate 325mg tid

22. Oral tx for PID
Flexion - internal rotation - extension - external rotation
Pneumovax - influenza
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Clindamycin AND gentamicin

23. Pregnancy class D smoking cessation drugs
0.2-0.5mg aqueous EPI IM/SubQ
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Nicotine inhaler - nasal spray - gum

24. IUPC (intrauterine pressure catheter)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Colchicine
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Measures strength of contractions

25. Tx acute sinusitis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Normal mental status; no other injuries; seen within 10 days of injury
Calcium pyrophosphate dehydrate crystals (pseudogout)

26. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
After delivery until delivery of placenta and membranes <30 mins
= LMP + 7 days - 3 months
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

27. Augments contractions
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Oxytocin (IV)

28. Sx epiglottitis
Anaphylaxis
Stridor - drooling - toxic appearance
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Fluoroquinolones

29. Recommended folic acid daily dose
Thiazdes; lithium
Long axis of fetus to long axis of mother (longitudinal or transverse)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

30. ADL
Aortic aneurysm
6-9MO
Bathing - dressing - eating - transferring - continence - toileting
Anaphylaxis

31. Electrolyte abnormality that increases the incidence of torsades de pointes
Bupropion - varenicline - nicotine replacement
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Hypomagnesemia

32. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Colchicine
Flexion - internal rotation - extension - external rotation
Calcium oxalate crystals

33. Nodular melanoma
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Most aggressive melanoma.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium pyrophosphate dehydrate crystals (pseudogout)

34. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Anemia
Tuberculosis; sarcoidosis; hodgkin disease
(ofloxacin OR levofloxacin) +/- metronidazole

35. Oral tx for PID
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Steroids + bronchodilators
(ofloxacin OR levofloxacin) +/- metronidazole
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

36. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
1 mo - eyes follow object to midline - vocalizes
(ofloxacin OR levofloxacin) +/- metronidazole
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

37. DOC for HTN in elderly
Steroids + bronchodilators
Anemia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Thiazides

38. identifies left - right
Ceftriaxone 125mg IM
Lung; SCC head & neck; RCC; breast; MM; prostate
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
6 yo

39. 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)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Esophagitis - gastritis - dysphagia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

40. causes of acute bronchitis
Tuberculosis; sarcoidosis; hodgkin disease
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

41. Superficial spreading melanoma
5+ rads
MCC melanoma in Africans/Asians. Under nails - soles - palms.
MCC melanoma. Radial growth.
Fe deficient anemia

42. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

43. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Aortic aneurysm
Ampicillin/sulbactam AND doxycycline
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Anemia

44. Tx hyperkalemia in CKD
Most aggressive melanoma.
Aortic aneurysm
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
1 mo - eyes follow object to midline - vocalizes

45. presbycusis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Clindamycin AND gentamicin
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Age-related sensorineural hearing loss (high frequency and speech discrimination)

46. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Short-acting + 40mg prednisone x 10-14days
Bathing - dressing - eating - transferring - continence - toileting
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

47. Pregnancy class C smoking cessation drugs
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Stridor - drooling - toxic appearance
1 mo - eyes follow object to midline - vocalizes
Patch - bupropion - varenicline

48. parallel play
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Clindamycin AND gentamicin
Nicotine inhaler - nasal spray - gum
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

49. Smoking cessation agents
Fe deficient anemia
Ferrous sulfate 325mg tid
Bupropion - varenicline - nicotine replacement
Anemia

50. regards hand
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
4mo - sits unsupported - hand transfer - babbles