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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. X-ray on knee?
Diphenhydramine - chlorpheniramine - hydroxyzine
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Thiazides
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

2. Other causes of hypercalcemia
Long axis of fetus to long axis of mother (longitudinal or transverse)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ceftriaxone 125mg IM
Steroids + bronchodilators

3. Signs of rupture of membranes

4. IV tx for PID
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ampicillin/sulbactam AND doxycycline
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Starts at contraction. caused by increased vagal tone from fetal head compression.

5. needles - strong negative birefringent (yellow crystals parallel light)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Monosodium urate crystals (gout)
Lung; SCC head & neck; RCC; breast; MM; prostate
IV penicillin (or ampicillin)

6. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

7. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Fe deficient anemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Anaphylaxis

8. Tx acute gout
Colchicine
3 yo - identify body part - copies square - hops - throws - past tense - story telling
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Alpha-1 antitrypsin deficiency

9. Screening for 65-76YO male smoker
(ofloxacin OR levofloxacin) +/- metronidazole
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Flexion - internal rotation - extension - external rotation
Aortic aneurysm

10. IV tx for PID
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Normal mental status; no other injuries; seen within 10 days of injury
Bathing - dressing - eating - transferring - continence - toileting
Ofloxacin OR levofloxacin +/- metronidazole

11. Pregnancy class D smoking cessation drugs
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ofloxacin OR levofloxacin +/- metronidazole
Nicotine inhaler - nasal spray - gum
Prostatitis

12. identifies left - right
Nuchal translucency - serum hCG - PAPP-A
6 yo
Bupropion - varenicline - nicotine replacement
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

13. Third stage of labor
4 yo - copies triangle - catches ball - dresses self
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
After delivery until delivery of placenta and membranes <30 mins
Cataracts

14. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(ofloxacin OR levofloxacin) +/- metronidazole
Normal mental status; no other injuries; seen within 10 days of injury

15. Tx acute exacerbation COPD
Anterior shoulder cannot readily pass below the pubic symphysis.
Short-acting + 40mg prednisone x 10-14days
Biopsy
(cefotetan OR cefoxitin) AND doxycycline

16. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Alpha-1 antitrypsin deficiency
Monosodium urate crystals (gout)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

17. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA

18. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Nicotine inhaler - nasal spray - gum
Diabetes - HTN - GN

19. Lentigo Maligna
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Most aggressive melanoma.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

20. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Diphenhydramine - chlorpheniramine - hydroxyzine
= LMP + 7 days - 3 months
DTaP - hepB - Hib - rotavirus - inactivated polio

21. Pflx for traveler's diarrhea
Biopsy
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Ceftriaxone 125mg IM
Fluoroquinolones

22. MCC blindness worldwide
Cataracts
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
(ofloxacin OR levofloxacin) +/- metronidazole

23. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Normal mental status; no other injuries; seen within 10 days of injury
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Lung; SCC head & neck; RCC; breast; MM; prostate

24. Fe deficient anemia tx
Anterior shoulder cannot readily pass below the pubic symphysis.
Ferrous sulfate 325mg tid
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Cataracts

25. Tocodynamometer
Esophagitis - gastritis - dysphagia
MCC melanoma. Radial growth.
Patch - bupropion - varenicline
Conrtaction monitoring along with fetal heart rate assessment

26. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
<20lb - <1YO - Reacts to pain - Responds to noise
0.2-0.5mg aqueous EPI IM/SubQ
Colchicine

27. social interaction
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Bathing - dressing - eating - transferring - continence - toileting
4 yo - copies triangle - catches ball - dresses self

28. painless - deep - subQ swelling (periorbital - circumoral - facial)
9 mo - walks - throws - 1-3 words - 1-step commands
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Angioedema

29. Dx criteria for RA
Ampicillin/sulbactam AND doxycycline
Esophagitis - gastritis - dysphagia
Clindamycin AND gentamicin
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

30. presbycusis
6-9MO
Long axis of fetus to long axis of mother (longitudinal or transverse)
1 mo - eyes follow object to midline - vocalizes
Age-related sensorineural hearing loss (high frequency and speech discrimination)

31. IADL
Monosodium urate crystals (gout)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
4 yo - copies triangle - catches ball - dresses self
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

32. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Biopsy
Aortic aneurysm
6 yo
Urinary calcium. Hyper PTH (high) >> FHH (normal)

33. cystoplasmic inclusions - not birefringent
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium hydroxyapatite crystals
Ceftriaxone 125mg IM
Ask - Advise - Assess - Assist - Arrange

34. Tx GAS ifxn
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Lung; SCC head & neck; RCC; breast; MM; prostate

35. Causes of CKD
Diabetes - HTN - GN
Bupropion - varenicline - nicotine replacement
Calcium oxalate crystals
Calcium pyrophosphate dehydrate crystals (pseudogout)

36. Cockcroft-Gault equation
Biopsy
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

37. Tx gonorrhea
4 yo - copies triangle - catches ball - dresses self
Ceftriaxone 125mg IM
1 mo - eyes follow object to midline - vocalizes
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

38. regards hand
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
4mo - sits unsupported - hand transfer - babbles
Cataracts
Oxygen intervention 15h/d

39. Dx PID
Cataracts
Calcium hydroxyapatite crystals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

40. Tx bacterial vaginosis
Metronidazole or clindamycin
Oxytocin (IV)
Ask - Advise - Assess - Assist - Arrange
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

41. Sx otitis externa
Patch - bupropion - varenicline
Hypomagnesemia
(ofloxacin OR levofloxacin) +/- metronidazole
Ear pain - itching - inflammation/swollen canal - exudates/discharge

42. Complications of GAS infxn
Nicotine inhaler - nasal spray - gum
Clindamycin AND gentamicin
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Most aggressive melanoma.

43. Oral tx for PID
Cataracts
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

44. Nonfunctioning nodules > 1cm require _____
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Biopsy
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

45. Screened at 11-13 weeks GA for trisomy
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Nuchal translucency - serum hCG - PAPP-A
9 mo - walks - throws - 1-3 words - 1-step commands

46. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Nicotine inhaler - nasal spray - gum
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Short-acting + 40mg prednisone x 10-14days

47. Dx bacterial rhinosinusitis
Flexion - internal rotation - extension - external rotation
Diphenhydramine - chlorpheniramine - hydroxyzine
(cefotetan OR cefoxitin) AND doxycycline
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)

48. shoulder dystocia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Anterior shoulder cannot readily pass below the pubic symphysis.
Onset of labor until cervix dilation
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

49. Tx for anaphylaxis
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)
Oxygen intervention 15h/d
Prostatitis
0.2-0.5mg aqueous EPI IM/SubQ

50. MONA therapy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium oxalate crystals
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors