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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. writes name - counts 10 objects
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
DTaP - hepB - Hib - rotavirus - inactivated polio
Steroids + bronchodilators
5 yo - draws person - ties shoes - skips

2. IUPC (intrauterine pressure catheter)
(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)
Measures strength of contractions
Tuberculosis; sarcoidosis; hodgkin disease

3. Augments contractions
Oxytocin (IV)
After delivery until delivery of placenta and membranes <30 mins
Stridor - drooling - toxic appearance
Steroids + bronchodilators

4. MCC blindness worldwide
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Metronidazole or clindamycin
Cataracts
Ask - Advise - Assess - Assist - Arrange

5. complications of otitis media
Pneumovax - influenza
Conrtaction monitoring along with fetal heart rate assessment
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ofloxacin OR levofloxacin +/- metronidazole

6. Screening for 65-76YO male smoker
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Aortic aneurysm
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Nicotine inhaler - nasal spray - gum

7. Tx for anaphylaxis
Urinary calcium. Hyper PTH (high) >> FHH (normal)
6-9MO
Biopsy
0.2-0.5mg aqueous EPI IM/SubQ

8. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Fluoroquinolones
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

9. needles - strong negative birefringent (yellow crystals parallel light)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Short-acting + 40mg prednisone x 10-14days
Monosodium urate crystals (gout)
Ferrous sulfate 325mg tid

10. Late deceleration
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

11. Rod shaped - rhomboid - weakly positive birefringent
MTX
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Calcium pyrophosphate dehydrate crystals (pseudogout)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

12. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Fe deficient anemia
Loratadine - fexofenadine - cetirizine

13. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Patch - bupropion - varenicline
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

14. How much radiation is associated with fetal harm?
Diabetes - HTN - GN
5+ rads
110-160bpm
Angioedema

15. X-ray on knee?
Age-related sensorineural hearing loss (high frequency and speech discrimination)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

16. Pregnancy class D smoking cessation drugs
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Nicotine inhaler - nasal spray - gum

17. dyspnea - visceral edema - hypotension
Tuberculosis; sarcoidosis; hodgkin disease
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anaphylaxis

18. Immunizations for adult 65YO+
Tuberculosis; sarcoidosis; hodgkin disease
Tdap - influenza - pneumovax
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
<20lb - <1YO - Reacts to pain - Responds to noise

19. The five A's of smoking cessation
Stridor - drooling - toxic appearance
0.2-0.5mg aqueous EPI IM/SubQ
Ask - Advise - Assess - Assist - Arrange
Anaphylaxis

20. Low serum iron - low MCV - low ferritin - +stool guaiac
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
After delivery until delivery of placenta and membranes <30 mins
Fe deficient anemia
Fluoroquinolones

21. Immunizations for COPD patients
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)
Pneumovax - influenza
Measures strength of contractions
Long axis of fetus to long axis of mother (longitudinal or transverse)

22. Tx gonorrhea
Oxygen intervention 15h/d
Ceftriaxone 125mg IM
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

23. social interaction
4 yo - copies triangle - catches ball - dresses self
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Anaphylaxis

24. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
MTX
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Most aggressive melanoma.

25. Pregnancy class C smoking cessation drugs
Onset of labor until cervix dilation
Patch - bupropion - varenicline
Nuchal translucency - serum hCG - PAPP-A
Angioedema

26. Fetal heart rate range
Metronidazole or clindamycin
110-160bpm
Patch - bupropion - varenicline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

27. Lentigo Maligna
4 yo - copies triangle - catches ball - dresses self
Anemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

28. Sx epiglottitis
Stridor - drooling - toxic appearance
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ask - Advise - Assess - Assist - Arrange
NAC or IV NaHCO3

29. cystoplasmic inclusions - not birefringent
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Calcium hydroxyapatite crystals
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

30. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Anemia

31. Other causes of hypercalcemia
Thiazdes; lithium
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5+ rads
4mo - sits unsupported - hand transfer - babbles

32. bacteria causing pharyngitis
Measures strength of contractions
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

33. Signs of rupture of membranes

34. Oral tx for PID
Hypomagnesemia
(ofloxacin OR levofloxacin) +/- metronidazole
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
6 mo - pincer - crawls - cruises - mamma - dada - byebye

35. Estimated delivery date (Naegele's rule)
MTX
Fluoroquinolones
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
= LMP + 7 days - 3 months

36. Screened at 16-20 weeks GA for trisomy
Bathing - dressing - eating - transferring - continence - toileting
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ear pain - itching - inflammation/swollen canal - exudates/discharge

37. Dx bacterial rhinosinusitis
Esophagitis - gastritis - dysphagia
= LMP + 7 days - 3 months
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
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)

38. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
1 mo - eyes follow object to midline - vocalizes
Prostatitis
Metronidazole or clindamycin

39. IV tx for PID
Anterior shoulder cannot readily pass below the pubic symphysis.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(cefotetan OR cefoxitin) AND doxycycline
Calcium oxalate crystals

40. Tx GAS ifxn
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Urticaria

41. Second stage of labor
Cataracts
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Fluoroquinolones
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

42. Sx peritonsillar abscess
Tdap - influenza - pneumovax
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
16-18 weeks GA
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

43. causes of acute bronchitis
Prostatitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Biopsy
Metronidazole or clindamycin

44. 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)
9 mo - walks - throws - 1-3 words - 1-step commands
Diphenhydramine - chlorpheniramine - hydroxyzine
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

45. Tx of traveler's diarrhea
DTaP - hepB - Hib - rotavirus - inactivated polio
Steroids + bronchodilators
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

46. Tx bacterial vaginosis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
MCC melanoma. Radial growth.
Metronidazole or clindamycin
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

47. IADL
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
<20lb - <1YO - Reacts to pain - Responds to noise
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

48. Tx acute gout
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Colchicine
MTX
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

49. MONA therapy
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

50. Tx RA (best long-term outcome)
MTX
MCC melanoma. Radial growth.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide