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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. Tx RA (best long-term outcome)
9 mo - walks - throws - 1-3 words - 1-step commands
Fluoroquinolones
IV penicillin (or ampicillin)
MTX

2. IV tx for PID
Ampicillin/sulbactam AND doxycycline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
DTaP - hepB - Hib - rotavirus - inactivated polio
Lung; SCC head & neck; RCC; breast; MM; prostate

3. Corrected serum calcium =

4. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Ampicillin/sulbactam AND doxycycline
Anemia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

5. Tx acute gout
Colchicine
Angioedema
Prostatitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

6. Tx GAS ifxn
Esophagitis - gastritis - dysphagia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
= LMP + 7 days - 3 months
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

7. Causes of CKD
Diabetes - HTN - GN
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Oxytocin (IV)
Prostatitis

8. Lentigo Maligna
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
(ofloxacin OR levofloxacin) +/- metronidazole
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Loratadine - fexofenadine - cetirizine

9. recognizes strangers
Angioedema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
2 mo - eyes follow object past midline - rolls over - laughs - squeals
6 mo - pincer - crawls - cruises - mamma - dada - byebye

10. MONA therapy
Oxytocin (IV)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

11. Electrolyte abnormality that increases the incidence of torsades de pointes
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Onset of labor until cervix dilation
16-18 weeks GA
Hypomagnesemia

12. Four cardinal fetal movements
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Normal mental status; no other injuries; seen within 10 days of injury
Flexion - internal rotation - extension - external rotation
Oxytocin (IV)

13. shoulder dystocia
Metronidazole or clindamycin
Pneumovax - influenza
Anterior shoulder cannot readily pass below the pubic symphysis.
Nuchal translucency - serum hCG - PAPP-A

14. Bacteria causing chronic sinusitis
Metronidazole or clindamycin
Thiazdes; lithium
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

15. social smile - parent recognition
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Oxytocin (IV)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Short-acting + 40mg prednisone x 10-14days

16. bacteria causing pharyngitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
4mo - sits unsupported - hand transfer - babbles
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Starts at contraction. caused by increased vagal tone from fetal head compression.

17. Unstable angina vs MI Dx tests
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
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)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

18. First stage of labor
Onset of labor until cervix dilation
Alpha-1 antitrypsin deficiency
Anterior shoulder cannot readily pass below the pubic symphysis.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

19. Malignancies with hypercalcemia
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
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)
Lung; SCC head & neck; RCC; breast; MM; prostate
6 yo

20. Signs of rupture of membranes

21. medications causing hypercalcemia
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thiazdes; lithium
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
After delivery until delivery of placenta and membranes <30 mins

22. Sx of hypercalcemia
Colchicine
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Aortic aneurysm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

23. complications of otitis media
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anterior shoulder cannot readily pass below the pubic symphysis.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

24. Superficial spreading melanoma
<20lb - <1YO - Reacts to pain - Responds to noise
MCC melanoma. Radial growth.
Aortic aneurysm
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

25. Tx bacterial vaginosis
Metronidazole or clindamycin
Angioedema
Stridor - drooling - toxic appearance
MTX

26. Nonfunctioning nodules > 1cm require _____
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Biopsy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Alpha-1 antitrypsin deficiency

27. ADL
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Esophagitis - gastritis - dysphagia
Bathing - dressing - eating - transferring - continence - toileting
Calcium oxalate crystals

28. Late deceleration
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
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
Fluoroquinolones

29. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

30. Sx epiglottitis
6 yo
Metronidazole or clindamycin
Stridor - drooling - toxic appearance
Biopsy

31. Pregnancy class C smoking cessation drugs
Anaphylaxis
16-18 weeks GA
Thiazides
Patch - bupropion - varenicline

32. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Flexion - internal rotation - extension - external rotation
Conrtaction monitoring along with fetal heart rate assessment
5 yo - draws person - ties shoes - skips

33. tx shoulder dystocia

34. Tx hyperkalemia in CKD
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Tuberculosis; sarcoidosis; hodgkin disease
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

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

36. How much radiation is associated with fetal harm?
DTaP - hepB - Hib - rotavirus - inactivated polio
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5+ rads
Patch - bupropion - varenicline

37. Recommendations for rear-facing car seat
Ofloxacin OR levofloxacin +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment
Anaphylaxis
<20lb - <1YO - Reacts to pain - Responds to noise

38. Cockcroft-Gault equation
Ferrous sulfate 325mg tid
Nuchal translucency - serum hCG - PAPP-A
Ofloxacin OR levofloxacin +/- metronidazole
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

39. Tx chlamydia
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Anterior shoulder cannot readily pass below the pubic symphysis.

40. 1st generation antihistamines
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Diphenhydramine - chlorpheniramine - hydroxyzine
Aortic aneurysm
Bupropion - varenicline - nicotine replacement

41. Tx otitis media
Starts at contraction. caused by increased vagal tone from fetal head compression.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
(ofloxacin OR levofloxacin) +/- metronidazole
Stridor - drooling - toxic appearance

42. 2nd generation antihistamines
Most aggressive melanoma.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Starts at contraction. caused by increased vagal tone from fetal head compression.
Loratadine - fexofenadine - cetirizine

43. presbycusis
Hypomagnesemia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Anemia

44. Tx for thyroid storm
2 mo - eyes follow object past midline - rolls over - laughs - squeals
MTX
(ofloxacin OR levofloxacin) +/- metronidazole
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

45. IUPC (intrauterine pressure catheter)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Angioedema
Measures strength of contractions
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

46. IV tx for PID
Angioedema
Pneumovax - influenza
(cefotetan OR cefoxitin) AND doxycycline
Anemia

47. dyspnea - visceral edema - hypotension
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
(cefotetan OR cefoxitin) AND doxycycline
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anaphylaxis

48. Immunizations at visit for 6MO
4mo - sits unsupported - hand transfer - babbles
5 yo - draws person - ties shoes - skips
After delivery until delivery of placenta and membranes <30 mins
DTaP - hepB - Hib - rotavirus - inactivated polio

49. Bisphospohonates sfx
Flexion - internal rotation - extension - external rotation
Prostatitis
Esophagitis - gastritis - dysphagia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

50. Regards human face - eye contact
Metronidazole or clindamycin
Diphenhydramine - chlorpheniramine - hydroxyzine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1 mo - eyes follow object to midline - vocalizes