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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. Other causes of hypercalcemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Short-acting + 40mg prednisone x 10-14days
Stridor - drooling - toxic appearance

2. Pregnancy class D smoking cessation drugs
Alpha-1 antitrypsin deficiency
6-9MO
Nicotine inhaler - nasal spray - gum
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

3. Sx of hypercalcemia
<20lb - <1YO - Reacts to pain - Responds to noise
Nicotine inhaler - nasal spray - gum
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ferrous sulfate 325mg tid

4. Sx otitis media
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
0.2-0.5mg aqueous EPI IM/SubQ
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

5. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Diabetes - HTN - GN
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Monosodium urate crystals (gout)

6. Granulomatous causes of hypercalcemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease
Thiazdes; lithium
16-18 weeks GA

7. group play - gender - knows name
Thiazides
9 mo - walks - throws - 1-3 words - 1-step commands
3 yo - identify body part - copies square - hops - throws - past tense - story telling
= LMP + 7 days - 3 months

8. tx shoulder dystocia

9. Acral lentinous melanoma
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ask - Advise - Assess - Assist - Arrange
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Onset of labor until cervix dilation

10. Improve short-term outcomes in acute exacerbations of COPD - asthma
Ask - Advise - Assess - Assist - Arrange
Steroids + bronchodilators
IV penicillin (or ampicillin)
Metronidazole or clindamycin

11. Nodular melanoma
Urticaria
Oxytocin (IV)
Most aggressive melanoma.
Angioedema

12. regards hand
4mo - sits unsupported - hand transfer - babbles
Ampicillin/sulbactam AND doxycycline
Conrtaction monitoring along with fetal heart rate assessment
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

13. Estimated delivery date (Naegele's rule)
Patch - bupropion - varenicline
Hypomagnesemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
= LMP + 7 days - 3 months

14. Tx bacterial vaginosis
5+ rads
<20lb - <1YO - Reacts to pain - Responds to noise
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Metronidazole or clindamycin

15. Nonfunctioning nodules > 1cm require _____
Ampicillin/sulbactam AND doxycycline
Nicotine inhaler - nasal spray - gum
Biopsy
Pneumovax - influenza

16. Causes of CKD
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Diabetes - HTN - GN
NAC or IV NaHCO3
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

17. Screening for 65-76YO male smoker
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Aortic aneurysm
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

18. Pflx for traveler's diarrhea
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Fluoroquinolones
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

19. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Patch - bupropion - varenicline
<20lb - <1YO - Reacts to pain - Responds to noise
= LMP + 7 days - 3 months

20. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
NAC or IV NaHCO3
Biopsy
Anterior shoulder cannot readily pass below the pubic symphysis.

21. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Starts at contraction. caused by increased vagal tone from fetal head compression.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

22. Signs of rupture of membranes

23. IV tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Onset of labor until cervix dilation
(cefotetan OR cefoxitin) AND doxycycline
NAC or IV NaHCO3

24. Early deceleration
Stridor - drooling - toxic appearance
Nicotine inhaler - nasal spray - gum
Fe deficient anemia
Starts at contraction. caused by increased vagal tone from fetal head compression.

25. X-ray of ankle?
16-18 weeks GA
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Bupropion - varenicline - nicotine replacement
Normal mental status; no other injuries; seen within 10 days of injury

26. Sx epiglottitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stridor - drooling - toxic appearance
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

27. Dx PID
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Fluoroquinolones
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Esophagitis - gastritis - dysphagia

28. Tx acute gout
MTX
Colchicine
Fluoroquinolones
9 mo - walks - throws - 1-3 words - 1-step commands

29. identifies left - right
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
6 yo
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

30. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

31. Augments contractions
Oxytocin (IV)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(cefotetan OR cefoxitin) AND doxycycline
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

32. variable deceleration
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
4 yo - copies triangle - catches ball - dresses self
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

33. Mediators released in response to allergen
Hypomagnesemia
5 yo - draws person - ties shoes - skips
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
16-18 weeks GA

34. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
5+ rads
Ask - Advise - Assess - Assist - Arrange

35. Age by which child says 'mama' and 'dada'
4mo - sits unsupported - hand transfer - babbles
NAC or IV NaHCO3
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
6-9MO

36. Superficial spreading melanoma
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
MCC melanoma. Radial growth.
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

37. Late deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Most aggressive melanoma.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

38. Bisphospohonates sfx
MTX
Esophagitis - gastritis - dysphagia
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)
= LMP + 7 days - 3 months

39. Tx otitis media
Pneumovax - influenza
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Oxygen intervention 15h/d
3 yo - identify body part - copies square - hops - throws - past tense - story telling

40. Complications of GAS infxn
Calcium oxalate crystals
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

41. How much radiation is associated with fetal harm?
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6-9MO
5+ rads
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

42. writes name - counts 10 objects
Tdap - influenza - pneumovax
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
5 yo - draws person - ties shoes - skips
MTX

43. Electrolyte abnormality that increases the incidence of torsades de pointes
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Hypomagnesemia
DTaP - hepB - Hib - rotavirus - inactivated polio
Ceftriaxone 125mg IM

44. IV tx for PID
Ask - Advise - Assess - Assist - Arrange
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ampicillin/sulbactam AND doxycycline
Oxytocin (IV)

45. Cockcroft-Gault equation
Biopsy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
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)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

46. presbycusis
Bupropion - varenicline - nicotine replacement
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
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)

47. Large - irregularly shaped - prutitic - erythematous wheals
Tuberculosis; sarcoidosis; hodgkin disease
Urticaria
6-9MO
Tdap - influenza - pneumovax

48. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Urticaria
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

49. Sx peritonsillar abscess
<20lb - <1YO - Reacts to pain - Responds to noise
Starts at contraction. caused by increased vagal tone from fetal head compression.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

50. dyspnea - visceral edema - hypotension
6-9MO
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anaphylaxis
Angioedema