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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. Nonfunctioning nodules > 1cm require _____
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Biopsy
Anterior shoulder cannot readily pass below the pubic symphysis.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

2. Other causes of hypercalcemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxygen intervention 15h/d
MTX

3. needles - strong negative birefringent (yellow crystals parallel light)
(cefotetan OR cefoxitin) AND doxycycline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Monosodium urate crystals (gout)

4. social smile - parent recognition
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Fe deficient anemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals

5. 1st generation antihistamines
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Diphenhydramine - chlorpheniramine - hydroxyzine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

6. Optimal time for trisomy screen
4 yo - copies triangle - catches ball - dresses self
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
16-18 weeks GA
Anterior shoulder cannot readily pass below the pubic symphysis.

7. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Aortic aneurysm
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Age-related sensorineural hearing loss (high frequency and speech discrimination)

8. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
9 mo - walks - throws - 1-3 words - 1-step commands
Esophagitis - gastritis - dysphagia

9. Smoking cessation agents
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Bupropion - varenicline - nicotine replacement
Monosodium urate crystals (gout)
Nuchal translucency - serum hCG - PAPP-A

10. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
Fe deficient anemia
Biopsy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

11. tx shoulder dystocia

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12. cystoplasmic inclusions - not birefringent
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium hydroxyapatite crystals
Anaphylaxis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

13. Screened at 16-20 weeks GA for trisomy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium pyrophosphate dehydrate crystals (pseudogout)
Bupropion - varenicline - nicotine replacement
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

14. How much radiation is associated with fetal harm?
Long axis of fetus to long axis of mother (longitudinal or transverse)
5+ rads
Normal mental status; no other injuries; seen within 10 days of injury
Most aggressive melanoma.

15. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MCC melanoma. Radial growth.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

16. Immunizations for adult 65YO+
5+ rads
Anaphylaxis
After delivery until delivery of placenta and membranes <30 mins
Tdap - influenza - pneumovax

17. Sx otitis media
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Urticaria

18. Sx otitis externa
(cefotetan OR cefoxitin) AND doxycycline
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

19. Screening for 65-76YO male smoker
Cataracts
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Aortic aneurysm
Measures strength of contractions

20. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ferrous sulfate 325mg tid
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

21. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thiazdes; lithium
6-9MO
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

22. Tx otitis media
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Aortic aneurysm
NAC or IV NaHCO3
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

23. explorations
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
9 mo - walks - throws - 1-3 words - 1-step commands
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Tdap - influenza - pneumovax

24. DDX for geriatric hearing impairment
Thiazdes; lithium
IV penicillin (or ampicillin)
Most aggressive melanoma.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

25. Bisphospohonates sfx
Bupropion - varenicline - nicotine replacement
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Loratadine - fexofenadine - cetirizine
Esophagitis - gastritis - dysphagia

26. DOC for HTN in elderly
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thiazides
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
3 yo - identify body part - copies square - hops - throws - past tense - story telling

27. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Lung; SCC head & neck; RCC; breast; MM; prostate
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
6 yo

28. social interaction
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
NAC or IV NaHCO3
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
4 yo - copies triangle - catches ball - dresses self

29. X-ray on knee?
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Conrtaction monitoring along with fetal heart rate assessment

30. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
110-160bpm
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Lung; SCC head & neck; RCC; breast; MM; prostate

31. Pregnancy class C smoking cessation drugs
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Patch - bupropion - varenicline
Anemia
Cataracts

32. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
DTaP - hepB - Hib - rotavirus - inactivated polio
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

33. ADL
Conrtaction monitoring along with fetal heart rate assessment
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Bathing - dressing - eating - transferring - continence - toileting
Lung; SCC head & neck; RCC; breast; MM; prostate

34. Dx bacterial vaginosis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

35. Dx bacterial rhinosinusitis
Flexion - internal rotation - extension - external rotation
NAC or IV NaHCO3
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)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

36. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Prostatitis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

37. Tocodynamometer
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Conrtaction monitoring along with fetal heart rate assessment

38. causes of acute bronchitis
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)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ceftriaxone 125mg IM

39. Augments contractions
Oxytocin (IV)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
6 yo
Stridor - drooling - toxic appearance

40. Tx acute gout
Colchicine
Onset of labor until cervix dilation
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Urticaria

41. Low serum iron - low MCV - low ferritin - +stool guaiac
Ampicillin/sulbactam AND doxycycline
Fe deficient anemia
Prostatitis
MTX

42. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(ofloxacin OR levofloxacin) +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Flexion - internal rotation - extension - external rotation

43. IV tx for PID
6 mo - pincer - crawls - cruises - mamma - dada - byebye
5 yo - draws person - ties shoes - skips
Angioedema
Ampicillin/sulbactam AND doxycycline

44. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anemia
NAC or IV NaHCO3
Ferrous sulfate 325mg tid

45. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ceftriaxone 125mg IM
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance

46. MCC blindness worldwide
110-160bpm
Cataracts
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

47. recognizes strangers
Flexion - internal rotation - extension - external rotation
Ampicillin/sulbactam AND doxycycline
Thiazdes; lithium
6 mo - pincer - crawls - cruises - mamma - dada - byebye

48. Tx RA (best long-term outcome)
MTX
Ofloxacin OR levofloxacin +/- metronidazole
Flexion - internal rotation - extension - external rotation
1 mo - eyes follow object to midline - vocalizes

49. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nuchal translucency - serum hCG - PAPP-A
IV penicillin (or ampicillin)
Alpha-1 antitrypsin deficiency

50. Tx chlamydia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Nicotine inhaler - nasal spray - gum
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Thiazdes; lithium