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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. social interaction
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
4 yo - copies triangle - catches ball - dresses self
0.2-0.5mg aqueous EPI IM/SubQ
Nuchal translucency - serum hCG - PAPP-A

2. Dx criteria for RA
Angioedema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

3. Unstable angina vs MI Dx tests
Cataracts
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Nuchal translucency - serum hCG - PAPP-A
Starts at contraction. caused by increased vagal tone from fetal head compression.

4. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Nuchal translucency - serum hCG - PAPP-A

5. Large - irregularly shaped - prutitic - erythematous wheals
Diabetes - HTN - GN
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Urticaria
Bupropion - varenicline - nicotine replacement

6. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Normal mental status; no other injuries; seen within 10 days of injury

7. Tocodynamometer
Nuchal translucency - serum hCG - PAPP-A
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Conrtaction monitoring along with fetal heart rate assessment

8. Superficial spreading melanoma
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MCC melanoma. Radial growth.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

9. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

10. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Clindamycin AND gentamicin
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

11. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
MTX
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

12. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Cataracts
Biopsy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anemia

13. Tx chlamydia
Ferrous sulfate 325mg tid
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
5 yo - draws person - ties shoes - skips
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

14. Age by which child says 'mama' and 'dada'
6-9MO
Flexion - internal rotation - extension - external rotation
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

15. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
(cefotetan OR cefoxitin) AND doxycycline
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Tdap - influenza - pneumovax

16. Pregnancy class C smoking cessation drugs
Tuberculosis; sarcoidosis; hodgkin disease
Nuchal translucency - serum hCG - PAPP-A
Patch - bupropion - varenicline
Normal mental status; no other injuries; seen within 10 days of injury

17. Tx acute exacerbation COPD
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Short-acting + 40mg prednisone x 10-14days
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

18. Tx hyperkalemia in CKD
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Patch - bupropion - varenicline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ampicillin/sulbactam AND doxycycline

19. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Biopsy
1 mo - eyes follow object to midline - vocalizes
Ferrous sulfate 325mg tid

20. Causes of CKD
Diabetes - HTN - GN
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Pneumovax - influenza
Thiazides

21. Tx otitis media
Bupropion - varenicline - nicotine replacement
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium hydroxyapatite crystals

22. Tx bacterial vaginosis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Metronidazole or clindamycin
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

23. IV tx for PID
Loratadine - fexofenadine - cetirizine
(cefotetan OR cefoxitin) AND doxycycline
110-160bpm
MCC melanoma in Africans/Asians. Under nails - soles - palms.

24. variable deceleration
Most aggressive melanoma.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
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.

25. Low serum iron - low MCV - low ferritin - +stool guaiac
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
16-18 weeks GA
Alpha-1 antitrypsin deficiency
Fe deficient anemia

26. Tx of traveler's diarrhea
MCC melanoma in Africans/Asians. Under nails - soles - palms.
5+ rads
Alpha-1 antitrypsin deficiency
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

27. Tender - boggy prostate. Dx?
Prostatitis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
6 yo
3 yo - identify body part - copies square - hops - throws - past tense - story telling

28. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
MCC melanoma. Radial growth.
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

29. Corrected serum calcium =

30. Tx GAS ifxn
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaphylaxis
Tdap - influenza - pneumovax

31. DOC for HTN in elderly
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Calcium hydroxyapatite crystals
Thiazides
(cefotetan OR cefoxitin) AND doxycycline

32. painless - deep - subQ swelling (periorbital - circumoral - facial)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diphenhydramine - chlorpheniramine - hydroxyzine
Angioedema
MCC melanoma in Africans/Asians. Under nails - soles - palms.

33. MCC blindness worldwide
Ampicillin/sulbactam AND doxycycline
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cataracts
Most aggressive melanoma.

34. Optimal time for trisomy screen
16-18 weeks GA
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Calcium oxalate crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

35. Screening for 65-76YO male smoker
Short-acting + 40mg prednisone x 10-14days
5+ rads
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Aortic aneurysm

36. Tx gonorrhea
Hypomagnesemia
Ceftriaxone 125mg IM
9 mo - walks - throws - 1-3 words - 1-step commands
= LMP + 7 days - 3 months

37. Screened at 16-20 weeks GA for trisomy
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ceftriaxone 125mg IM

38. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Urinary calcium. Hyper PTH (high) >> FHH (normal)

39. Immunizations for COPD patients
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Clindamycin AND gentamicin
Pneumovax - influenza

40. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

41. Nodular melanoma
6-9MO
Most aggressive melanoma.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

42. DDX for geriatric hearing impairment
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
4mo - sits unsupported - hand transfer - babbles
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lung; SCC head & neck; RCC; breast; MM; prostate

43. social smile - parent recognition
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Flexion - internal rotation - extension - external rotation
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Diabetes - HTN - GN

44. GBS tx
IV penicillin (or ampicillin)
Angioedema
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
4 yo - copies triangle - catches ball - dresses self

45. Regards human face - eye contact
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Steroids + bronchodilators
1 mo - eyes follow object to midline - vocalizes
Ceftriaxone 125mg IM

46. needles - strong negative birefringent (yellow crystals parallel light)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ceftriaxone 125mg IM
Fe deficient anemia
Monosodium urate crystals (gout)

47. Sx otitis media
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Onset of labor until cervix dilation
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Anterior shoulder cannot readily pass below the pubic symphysis.

48. Cockcroft-Gault equation
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
6 yo
Tuberculosis; sarcoidosis; hodgkin disease
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

49. First stage of labor
= LMP + 7 days - 3 months
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Cataracts
Onset of labor until cervix dilation

50. Granulomatous causes of hypercalcemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Tuberculosis; sarcoidosis; hodgkin disease
MTX
Most aggressive melanoma.