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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. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
(ofloxacin OR levofloxacin) +/- metronidazole
Tuberculosis; sarcoidosis; hodgkin disease
Calcium hydroxyapatite crystals

2. complications of otitis media
MCC melanoma in Africans/Asians. Under nails - soles - palms.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
DTaP - hepB - Hib - rotavirus - inactivated polio
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

3. Pregnancy class D smoking cessation drugs
Thiazdes; lithium
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Fluoroquinolones
Nicotine inhaler - nasal spray - gum

4. Optimal time for trisomy screen
Ampicillin/sulbactam AND doxycycline
16-18 weeks GA
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
NAC or IV NaHCO3

5. Tx acute gout
Colchicine
Biopsy
Diabetes - HTN - GN
1 mo - eyes follow object to midline - vocalizes

6. Tx for anaphylaxis
Biopsy
Stridor - drooling - toxic appearance
Steroids + bronchodilators
0.2-0.5mg aqueous EPI IM/SubQ

7. Low serum iron - low MCV - low ferritin - +stool guaiac
4mo - sits unsupported - hand transfer - babbles
Fe deficient anemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
IV penicillin (or ampicillin)

8. IUPC (intrauterine pressure catheter)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Measures strength of contractions
Conrtaction monitoring along with fetal heart rate assessment
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

9. tx shoulder dystocia

10. Dx bacterial vaginosis
Steroids + bronchodilators
9 mo - walks - throws - 1-3 words - 1-step commands
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Conrtaction monitoring along with fetal heart rate assessment

11. X-ray on knee?
Anemia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
5+ rads
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

12. Age by which child says 'mama' and 'dada'
Thiazdes; lithium
6-9MO
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

13. How much radiation is associated with fetal harm?
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
5+ rads
Onset of labor until cervix dilation
= LMP + 7 days - 3 months

14. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Monosodium urate crystals (gout)
Calcium oxalate crystals
9 mo - walks - throws - 1-3 words - 1-step commands

15. Fe deficient anemia tx
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ferrous sulfate 325mg tid
Ofloxacin OR levofloxacin +/- metronidazole
Calcium hydroxyapatite crystals

16. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Patch - bupropion - varenicline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Age-related sensorineural hearing loss (high frequency and speech discrimination)

17. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Ask - Advise - Assess - Assist - Arrange
Tdap - influenza - pneumovax
Anaphylaxis

18. Oral tx for PID
Thiazides
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium oxalate crystals
Patch - bupropion - varenicline

19. First stage of labor
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Onset of labor until cervix dilation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

20. bipyramidal - strongly positive birefringent
6 yo
Ferrous sulfate 325mg tid
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals

21. recognizes strangers
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(ofloxacin OR levofloxacin) +/- metronidazole
0.2-0.5mg aqueous EPI IM/SubQ
6 mo - pincer - crawls - cruises - mamma - dada - byebye

22. CKD Stages
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
(ofloxacin OR levofloxacin) +/- metronidazole
Measures strength of contractions

23. Rod shaped - rhomboid - weakly positive birefringent
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Nuchal translucency - serum hCG - PAPP-A
Esophagitis - gastritis - dysphagia
Calcium pyrophosphate dehydrate crystals (pseudogout)

24. identifies left - right
6 yo
Starts at contraction. caused by increased vagal tone from fetal head compression.
16-18 weeks GA
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

25. Fetal heart rate range
110-160bpm
Flexion - internal rotation - extension - external rotation
Calcium oxalate crystals
Tdap - influenza - pneumovax

26. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Short-acting + 40mg prednisone x 10-14days
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Calcium oxalate crystals
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

27. Tx of traveler's diarrhea
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
<20lb - <1YO - Reacts to pain - Responds to noise

28. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
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)

29. Tx otitis media
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

30. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Oxytocin (IV)
NAC or IV NaHCO3
Steroids + bronchodilators
MTX

31. Sx otitis externa
Bupropion - varenicline - nicotine replacement
Fe deficient anemia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Most aggressive melanoma.

32. bacteria causing pharyngitis
Nicotine inhaler - nasal spray - gum
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Fluoroquinolones

33. Tx hyperkalemia in CKD
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Metronidazole or clindamycin
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

34. Superficial spreading melanoma
Anterior shoulder cannot readily pass below the pubic symphysis.
Oxytocin (IV)
MCC melanoma. Radial growth.
Flexion - internal rotation - extension - external rotation

35. Unstable angina vs MI Dx tests
Oxytocin (IV)
Colchicine
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Nicotine inhaler - nasal spray - gum

36. Cockcroft-Gault equation
Ask - Advise - Assess - Assist - Arrange
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Diphenhydramine - chlorpheniramine - hydroxyzine
5+ rads

37. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Aortic aneurysm
0.2-0.5mg aqueous EPI IM/SubQ
<20lb - <1YO - Reacts to pain - Responds to noise

38. Complications of PID
Colchicine
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)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

39. Electrolyte abnormality that increases the incidence of torsades de pointes
Esophagitis - gastritis - dysphagia
0.2-0.5mg aqueous EPI IM/SubQ
Nicotine inhaler - nasal spray - gum
Hypomagnesemia

40. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Steroids + bronchodilators
Tuberculosis; sarcoidosis; hodgkin disease

41. Four cardinal fetal movements
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
9 mo - walks - throws - 1-3 words - 1-step commands
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Flexion - internal rotation - extension - external rotation

42. cystoplasmic inclusions - not birefringent
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium hydroxyapatite crystals
5 yo - draws person - ties shoes - skips

43. Corrected serum calcium =

44. social interaction
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Steroids + bronchodilators
Normal mental status; no other injuries; seen within 10 days of injury
4 yo - copies triangle - catches ball - dresses self

45. 1st generation antihistamines
Flexion - internal rotation - extension - external rotation
Calcium oxalate crystals
Diphenhydramine - chlorpheniramine - hydroxyzine
Calcium hydroxyapatite crystals

46. Only therapy to decrease mortality in stage IV COPD
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ampicillin/sulbactam AND doxycycline
Calcium hydroxyapatite crystals
Oxygen intervention 15h/d

47. Nonfunctioning nodules > 1cm require _____
Biopsy
Ceftriaxone 125mg IM
Aortic aneurysm
Alpha-1 antitrypsin deficiency

48. Sx otitis media
IV penicillin (or ampicillin)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
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)

49. IV tx for PID
Clindamycin AND gentamicin
Hypomagnesemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
0.2-0.5mg aqueous EPI IM/SubQ

50. IV tx for PID
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Tdap - influenza - pneumovax
Ampicillin/sulbactam AND doxycycline
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae