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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. Augments contractions
Pneumovax - influenza
Oxytocin (IV)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
MTX

2. Tender - boggy prostate. Dx?
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Prostatitis
Anemia

3. Other causes of hypercalcemia
Monosodium urate crystals (gout)
(ofloxacin OR levofloxacin) +/- metronidazole
Angioedema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

4. X-ray on knee?
4mo - sits unsupported - hand transfer - babbles
Tdap - influenza - pneumovax
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

5. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Flexion - internal rotation - extension - external rotation
IV penicillin (or ampicillin)
Anemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

6. Tx GAS ifxn
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)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Normal mental status; no other injuries; seen within 10 days of injury
Diabetes - HTN - GN

7. Fe deficient anemia tx
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ferrous sulfate 325mg tid
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

8. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Conrtaction monitoring along with fetal heart rate assessment

9. Causes of CKD
(ofloxacin OR levofloxacin) +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)
MTX
Diabetes - HTN - GN

10. DDX for geriatric hearing impairment
Starts at contraction. caused by increased vagal tone from fetal head compression.
MTX
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

11. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium oxalate crystals
Long axis of fetus to long axis of mother (longitudinal or transverse)

12. painless - deep - subQ swelling (periorbital - circumoral - facial)
5+ rads
Angioedema
Ferrous sulfate 325mg tid
Nuchal translucency - serum hCG - PAPP-A

13. Acral lentinous melanoma
Nicotine inhaler - nasal spray - gum
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
9 mo - walks - throws - 1-3 words - 1-step commands
MCC melanoma in Africans/Asians. Under nails - soles - palms.

14. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Flexion - internal rotation - extension - external rotation
Colchicine
Bupropion - varenicline - nicotine replacement

15. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
1 mo - eyes follow object to midline - vocalizes
Ceftriaxone 125mg IM
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

16. Smoking cessation agents
Biopsy
Ofloxacin OR levofloxacin +/- metronidazole
Bupropion - varenicline - nicotine replacement
Patch - bupropion - varenicline

17. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ampicillin/sulbactam AND doxycycline
4 yo - copies triangle - catches ball - dresses self

18. medications causing hypercalcemia
5 yo - draws person - ties shoes - skips
Thiazdes; lithium
Most aggressive melanoma.
Anaphylaxis

19. Rod shaped - rhomboid - weakly positive birefringent
(ofloxacin OR levofloxacin) +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6-9MO
Calcium pyrophosphate dehydrate crystals (pseudogout)

20. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Starts at contraction. caused by increased vagal tone from fetal head compression.
Urticaria

21. identifies left - right
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
6 yo
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium oxalate crystals

22. recognizes strangers
Bathing - dressing - eating - transferring - continence - toileting
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxygen intervention 15h/d

23. Oral tx for PID
Nicotine inhaler - nasal spray - gum
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
Urticaria

24. parallel play
Diphenhydramine - chlorpheniramine - hydroxyzine
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
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

25. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
<20lb - <1YO - Reacts to pain - Responds to noise
Onset of labor until cervix dilation
(cefotetan OR cefoxitin) AND doxycycline

26. Second stage of labor
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ask - Advise - Assess - Assist - Arrange
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

27. Tx gonorrhea
Ceftriaxone 125mg IM
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Flexion - internal rotation - extension - external rotation

28. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ferrous sulfate 325mg tid
1 mo - eyes follow object to midline - vocalizes
Urinary calcium. Hyper PTH (high) >> FHH (normal)

29. Low serum iron - low MCV - low ferritin - +stool guaiac
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Fe deficient anemia
Ask - Advise - Assess - Assist - Arrange

30. Dx bacterial vaginosis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Conrtaction monitoring along with fetal heart rate assessment
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

31. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
5 yo - draws person - ties shoes - skips
Anterior shoulder cannot readily pass below the pubic symphysis.
Tuberculosis; sarcoidosis; hodgkin disease

32. Signs of rupture of membranes

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33. Nonfunctioning nodules > 1cm require _____
Loratadine - fexofenadine - cetirizine
Diphenhydramine - chlorpheniramine - hydroxyzine
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Biopsy

34. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ampicillin/sulbactam AND doxycycline
After delivery until delivery of placenta and membranes <30 mins

35. Unstable angina vs MI Dx tests
Calcium oxalate crystals
Anaphylaxis
Cataracts
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

36. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
0.2-0.5mg aqueous EPI IM/SubQ
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

37. Fetal heart rate range
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Diphenhydramine - chlorpheniramine - hydroxyzine
110-160bpm
Starts at contraction. caused by increased vagal tone from fetal head compression.

38. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
4 yo - copies triangle - catches ball - dresses self
Bupropion - varenicline - nicotine replacement
Oxytocin (IV)

39. Recommended folic acid daily dose
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Calcium oxalate crystals
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

40. Early deceleration
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Most aggressive melanoma.
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxygen intervention 15h/d

41. Pregnancy class D smoking cessation drugs
Steroids + bronchodilators
Nicotine inhaler - nasal spray - gum
(cefotetan OR cefoxitin) AND doxycycline
Lung; SCC head & neck; RCC; breast; MM; prostate

42. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Patch - bupropion - varenicline
Urinary calcium. Hyper PTH (high) >> FHH (normal)
(cefotetan OR cefoxitin) AND doxycycline

43. Age by which child says 'mama' and 'dada'
Most aggressive melanoma.
6-9MO
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

44. needles - strong negative birefringent (yellow crystals parallel light)
Short-acting + 40mg prednisone x 10-14days
4 yo - copies triangle - catches ball - dresses self
Monosodium urate crystals (gout)
Oxytocin (IV)

45. Sx epiglottitis
Stridor - drooling - toxic appearance
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
MTX

46. Sx of hypercalcemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Esophagitis - gastritis - dysphagia

47. bacteria causing pharyngitis
Bupropion - varenicline - nicotine replacement
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

48. Screening for 65-76YO male smoker
After delivery until delivery of placenta and membranes <30 mins
Bathing - dressing - eating - transferring - continence - toileting
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Aortic aneurysm

49. Superficial spreading melanoma
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
MCC melanoma. Radial growth.

50. The five A's of smoking cessation
Alpha-1 antitrypsin deficiency
Bathing - dressing - eating - transferring - continence - toileting
Ask - Advise - Assess - Assist - Arrange
Lung; SCC head & neck; RCC; breast; MM; prostate