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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. CKD Stages
Bupropion - varenicline - nicotine replacement
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Loratadine - fexofenadine - cetirizine
110-160bpm

2. IUPC (intrauterine pressure catheter)
Stridor - drooling - toxic appearance
Flexion - internal rotation - extension - external rotation
Measures strength of contractions
Colchicine

3. Recommendations for rear-facing car seat
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
<20lb - <1YO - Reacts to pain - Responds to noise
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

4. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Tdap - influenza - pneumovax
IV penicillin (or ampicillin)
Stridor - drooling - toxic appearance

5. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Fluoroquinolones
IV penicillin (or ampicillin)

6. Estimated delivery date (Naegele's rule)
Anemia
Anaphylaxis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
= LMP + 7 days - 3 months

7. Age by which child says 'mama' and 'dada'
6-9MO
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
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)
0.2-0.5mg aqueous EPI IM/SubQ

8. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

9. explorations
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Metronidazole or clindamycin
9 mo - walks - throws - 1-3 words - 1-step commands
Steroids + bronchodilators

10. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Bathing - dressing - eating - transferring - continence - toileting
5+ rads
Ofloxacin OR levofloxacin +/- metronidazole

11. Second stage of labor
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Urticaria
6 yo

12. Pregnancy class D smoking cessation drugs
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Nicotine inhaler - nasal spray - gum
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

13. shoulder dystocia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Anterior shoulder cannot readily pass below the pubic symphysis.
Alpha-1 antitrypsin deficiency
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

14. Pflx for traveler's diarrhea
Fluoroquinolones
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
After delivery until delivery of placenta and membranes <30 mins
Clindamycin AND gentamicin

15. writes name - counts 10 objects
Stridor - drooling - toxic appearance
Fe deficient anemia
5 yo - draws person - ties shoes - skips
Long axis of fetus to long axis of mother (longitudinal or transverse)

16. IV tx for PID
Onset of labor until cervix dilation
(cefotetan OR cefoxitin) AND doxycycline
Patch - bupropion - varenicline
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

17. X-ray on knee?
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Calcium oxalate crystals
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Pneumovax - influenza

18. Recommended folic acid daily dose
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

19. variable deceleration
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Normal mental status; no other injuries; seen within 10 days of injury
Ofloxacin OR levofloxacin +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

20. presbycusis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Age-related sensorineural hearing loss (high frequency and speech discrimination)
5+ rads

21. Screening for 65-76YO male smoker
5+ rads
Aortic aneurysm
Stridor - drooling - toxic appearance
Alpha-1 antitrypsin deficiency

22. regards hand
Alpha-1 antitrypsin deficiency
Thiazides
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
4mo - sits unsupported - hand transfer - babbles

23. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
NAC or IV NaHCO3
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
MTX

24. MONA therapy
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)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

25. Sx peritonsillar abscess
Tdap - influenza - pneumovax
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ferrous sulfate 325mg tid

26. Rod shaped - rhomboid - weakly positive birefringent
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Anemia
Nuchal translucency - serum hCG - PAPP-A
Calcium pyrophosphate dehydrate crystals (pseudogout)

27. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Oxygen intervention 15h/d
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

28. medications causing hypercalcemia
Thiazdes; lithium
DTaP - hepB - Hib - rotavirus - inactivated polio
Calcium hydroxyapatite crystals
3 yo - identify body part - copies square - hops - throws - past tense - story telling

29. bipyramidal - strongly positive birefringent
5 yo - draws person - ties shoes - skips
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Colchicine
Calcium oxalate crystals

30. Superficial spreading melanoma
= LMP + 7 days - 3 months
MCC melanoma. Radial growth.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

31. Tx RA (best long-term outcome)
MTX
Calcium oxalate crystals
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Patch - bupropion - varenicline

32. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Clindamycin AND gentamicin
0.2-0.5mg aqueous EPI IM/SubQ
Anemia

33. Sx epiglottitis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Stridor - drooling - toxic appearance
Onset of labor until cervix dilation
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

34. Tx acute sinusitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Bathing - dressing - eating - transferring - continence - toileting
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Onset of labor until cervix dilation

35. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
IV penicillin (or ampicillin)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

36. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anterior shoulder cannot readily pass below the pubic symphysis.
Thiazides

37. Tx acute gout
16-18 weeks GA
Colchicine
Alpha-1 antitrypsin deficiency
Ferrous sulfate 325mg tid

38. causes of acute bronchitis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Onset of labor until cervix dilation
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Bathing - dressing - eating - transferring - continence - toileting

39. stranger/separation anxiety
Urinary calcium. Hyper PTH (high) >> FHH (normal)
110-160bpm
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Thiazdes; lithium

40. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

41. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
IV penicillin (or ampicillin)
Fluoroquinolones
Urinary calcium. Hyper PTH (high) >> FHH (normal)

42. Signs of rupture of membranes

43. Low serum iron - low MCV - low ferritin - +stool guaiac
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Fe deficient anemia
Pneumovax - influenza

44. Nonfunctioning nodules > 1cm require _____
Biopsy
Flexion - internal rotation - extension - external rotation
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

45. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

46. tx shoulder dystocia

47. social interaction
Starts at contraction. caused by increased vagal tone from fetal head compression.
0.2-0.5mg aqueous EPI IM/SubQ
4 yo - copies triangle - catches ball - dresses self
Most aggressive melanoma.

48. dyspnea - visceral edema - hypotension
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Conrtaction monitoring along with fetal heart rate assessment
Anaphylaxis
Diabetes - HTN - GN

49. parallel play
Measures strength of contractions
4 yo - copies triangle - catches ball - dresses self
3 yo - identify body part - copies square - hops - throws - past tense - story telling
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

50. 1st generation antihistamines
Prostatitis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Diphenhydramine - chlorpheniramine - hydroxyzine
MTX