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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. Tocodynamometer
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaphylaxis
Conrtaction monitoring along with fetal heart rate assessment
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

2. IUPC (intrauterine pressure catheter)
Measures strength of contractions
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Calcium hydroxyapatite crystals

3. Fe deficient anemia tx
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Nuchal translucency - serum hCG - PAPP-A
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ferrous sulfate 325mg tid

4. Estimated delivery date (Naegele's rule)
Onset of labor until cervix dilation
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
= LMP + 7 days - 3 months

5. Augments contractions
Thiazides
Anterior shoulder cannot readily pass below the pubic symphysis.
Oxytocin (IV)
6 yo

6. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
DTaP - hepB - Hib - rotavirus - inactivated polio
0.2-0.5mg aqueous EPI IM/SubQ
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

7. Improve short-term outcomes in acute exacerbations of COPD - asthma
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators

8. Dx PID
Calcium hydroxyapatite crystals
IV penicillin (or ampicillin)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

9. social smile - parent recognition
Aortic aneurysm
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Biopsy
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

10. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Normal mental status; no other injuries; seen within 10 days of injury
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Urticaria

11. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
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)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Oxygen intervention 15h/d

12. Age by which child says 'mama' and 'dada'
Anemia
DTaP - hepB - Hib - rotavirus - inactivated polio
6-9MO
Clindamycin AND gentamicin

13. 2nd generation antihistamines
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Cataracts
Loratadine - fexofenadine - cetirizine
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

14. ADL
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Cataracts
Bathing - dressing - eating - transferring - continence - toileting

15. Nonfunctioning nodules > 1cm require _____
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
110-160bpm
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Biopsy

16. The five A's of smoking cessation
MTX
Stridor - drooling - toxic appearance
Oxytocin (IV)
Ask - Advise - Assess - Assist - Arrange

17. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Calcium hydroxyapatite crystals
Ear pain - itching - inflammation/swollen canal - exudates/discharge
IV penicillin (or ampicillin)

18. stranger/separation anxiety
Anemia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

19. Other causes of hypercalcemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Monosodium urate crystals (gout)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

20. Nodular melanoma
Anemia
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Most aggressive melanoma.
Nuchal translucency - serum hCG - PAPP-A

21. Rod shaped - rhomboid - weakly positive birefringent
Tuberculosis; sarcoidosis; hodgkin disease
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ferrous sulfate 325mg tid
Calcium pyrophosphate dehydrate crystals (pseudogout)

22. How much radiation is associated with fetal harm?
5+ rads
Hypomagnesemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Urinary calcium. Hyper PTH (high) >> FHH (normal)

23. Four cardinal fetal movements
4mo - sits unsupported - hand transfer - babbles
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Flexion - internal rotation - extension - external rotation
3 yo - identify body part - copies square - hops - throws - past tense - story telling

24. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Normal mental status; no other injuries; seen within 10 days of injury
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

25. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
(cefotetan OR cefoxitin) AND doxycycline
Fluoroquinolones
Nicotine inhaler - nasal spray - gum

26. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
<20lb - <1YO - Reacts to pain - Responds to noise
Nicotine inhaler - nasal spray - gum
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

27. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Ferrous sulfate 325mg tid
Tdap - influenza - pneumovax
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

28. Tx gonorrhea
Anaphylaxis
Ceftriaxone 125mg IM
Calcium pyrophosphate dehydrate crystals (pseudogout)
Calcium hydroxyapatite crystals

29. Granulomatous causes of hypercalcemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Fluoroquinolones
Tuberculosis; sarcoidosis; hodgkin disease
IV penicillin (or ampicillin)

30. Fetal lie
Biopsy
Long axis of fetus to long axis of mother (longitudinal or transverse)
MCC melanoma. Radial growth.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

31. Corrected serum calcium =

32. Emphysema - <45YO - nonsmoker
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Alpha-1 antitrypsin deficiency
Thiazdes; lithium
Thiazides

33. GBS tx
IV penicillin (or ampicillin)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Angioedema
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

34. bipyramidal - strongly positive birefringent
Fluoroquinolones
110-160bpm
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium oxalate crystals

35. MONA therapy
Measures strength of contractions
Nuchal translucency - serum hCG - PAPP-A
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Pneumovax - influenza

36. medications causing hypercalcemia
Thiazdes; lithium
Onset of labor until cervix dilation
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

37. Cockcroft-Gault equation
Diphenhydramine - chlorpheniramine - hydroxyzine
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
4mo - sits unsupported - hand transfer - babbles
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

38. Tx hyperkalemia in CKD
Biopsy
Pneumovax - influenza
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
<20lb - <1YO - Reacts to pain - Responds to noise

39. social interaction
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Metronidazole or clindamycin
Tdap - influenza - pneumovax
4 yo - copies triangle - catches ball - dresses self

40. Tx of traveler's diarrhea
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium oxalate crystals

41. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Monosodium urate crystals (gout)
1 mo - eyes follow object to midline - vocalizes
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

42. IV tx for PID
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Short-acting + 40mg prednisone x 10-14days
Hypomagnesemia
Ofloxacin OR levofloxacin +/- metronidazole

43. recognizes strangers
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
6 yo
6 mo - pincer - crawls - cruises - mamma - dada - byebye

44. Signs of rupture of membranes

45. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Conrtaction monitoring along with fetal heart rate assessment
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

46. Tx acute gout
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
16-18 weeks GA
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Colchicine

47. Superficial spreading melanoma
MCC melanoma. Radial growth.
NAC or IV NaHCO3
Conrtaction monitoring along with fetal heart rate assessment
DTaP - hepB - Hib - rotavirus - inactivated polio

48. writes name - counts 10 objects
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
110-160bpm
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
5 yo - draws person - ties shoes - skips

49. Sx otitis media
Anaphylaxis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
NAC or IV NaHCO3

50. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
MCC melanoma. Radial growth.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors