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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. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Monosodium urate crystals (gout)
1 mo - eyes follow object to midline - vocalizes
Oxytocin (IV)
Anemia

2. Pregnancy class C smoking cessation drugs
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium hydroxyapatite crystals
Patch - bupropion - varenicline
(cefotetan OR cefoxitin) AND doxycycline

3. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
4 yo - copies triangle - catches ball - dresses self
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Fe deficient anemia

4. painless - deep - subQ swelling (periorbital - circumoral - facial)
Flexion - internal rotation - extension - external rotation
Thiazides
Angioedema
Aortic aneurysm

5. Pregnancy class D smoking cessation drugs
9 mo - walks - throws - 1-3 words - 1-step commands
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Nicotine inhaler - nasal spray - gum
Stridor - drooling - toxic appearance

6. Fe deficient anemia tx
4mo - sits unsupported - hand transfer - babbles
4 yo - copies triangle - catches ball - dresses self
Ferrous sulfate 325mg tid
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

7. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Alpha-1 antitrypsin deficiency
3 yo - identify body part - copies square - hops - throws - past tense - story telling

8. Low serum iron - low MCV - low ferritin - +stool guaiac
Anterior shoulder cannot readily pass below the pubic symphysis.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Fe deficient anemia
Onset of labor until cervix dilation

9. Tx of traveler's diarrhea
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
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

10. Lentigo Maligna
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Steroids + bronchodilators
Calcium hydroxyapatite crystals
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

11. stranger/separation anxiety
Thiazdes; lithium
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

12. First stage of labor
Onset of labor until cervix dilation
Esophagitis - gastritis - dysphagia
Colchicine
6 yo

13. Dx criteria for RA
NAC or IV NaHCO3
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
2 mo - eyes follow object past midline - rolls over - laughs - squeals
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

14. Estimated delivery date (Naegele's rule)
Fe deficient anemia
Diphenhydramine - chlorpheniramine - hydroxyzine
6 yo
= LMP + 7 days - 3 months

15. GBS tx
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Prostatitis
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

16. Dx bacterial vaginosis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Steroids + bronchodilators
Colchicine

17. bipyramidal - strongly positive birefringent
(cefotetan OR cefoxitin) AND doxycycline
Ceftriaxone 125mg IM
Measures strength of contractions
Calcium oxalate crystals

18. Age by which child says 'mama' and 'dada'
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
6-9MO
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

19. dyspnea - visceral edema - hypotension
Metronidazole or clindamycin
Anaphylaxis
Anterior shoulder cannot readily pass below the pubic symphysis.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

20. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
(ofloxacin OR levofloxacin) +/- metronidazole
Bathing - dressing - eating - transferring - continence - toileting
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Calcium pyrophosphate dehydrate crystals (pseudogout)

21. Causes of CKD
Diabetes - HTN - GN
110-160bpm
Patch - bupropion - varenicline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

22. complications of otitis media
Measures strength of contractions
Calcium hydroxyapatite crystals
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anaphylaxis

23. Oral tx for PID
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
(ofloxacin OR levofloxacin) +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Tdap - influenza - pneumovax

24. Bacteria causing chronic sinusitis
Angioedema
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
1 mo - eyes follow object to midline - vocalizes
Oxygen intervention 15h/d

25. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

26. Pflx for traveler's diarrhea
Fluoroquinolones
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
1 mo - eyes follow object to midline - vocalizes

27. Fetal heart rate range
MTX
Diabetes - HTN - GN
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
110-160bpm

28. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
4 yo - copies triangle - catches ball - dresses self
Thiazdes; lithium
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)

29. 2nd generation antihistamines
Nicotine inhaler - nasal spray - gum
Loratadine - fexofenadine - cetirizine
Stridor - drooling - toxic appearance
NAC or IV NaHCO3

30. recognizes strangers
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Calcium hydroxyapatite crystals
2 mo - eyes follow object past midline - rolls over - laughs - squeals
6 mo - pincer - crawls - cruises - mamma - dada - byebye

31. Regards human face - eye contact
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 mo - eyes follow object to midline - vocalizes
Anaphylaxis

32. Tender - boggy prostate. Dx?
Prostatitis
Bupropion - varenicline - nicotine replacement
Long axis of fetus to long axis of mother (longitudinal or transverse)
Tuberculosis; sarcoidosis; hodgkin disease

33. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
(ofloxacin OR levofloxacin) +/- metronidazole
Onset of labor until cervix dilation
Steroids + bronchodilators

34. Nodular melanoma
Most aggressive melanoma.
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)
After delivery until delivery of placenta and membranes <30 mins
DTaP - hepB - Hib - rotavirus - inactivated polio

35. Four cardinal fetal movements
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
(cefotetan OR cefoxitin) AND doxycycline
4 yo - copies triangle - catches ball - dresses self
Flexion - internal rotation - extension - external rotation

36. needles - strong negative birefringent (yellow crystals parallel light)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Monosodium urate crystals (gout)
16-18 weeks GA
Fluoroquinolones

37. Recommended folic acid daily dose
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)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Pneumovax - influenza

38. presbycusis
Calcium hydroxyapatite crystals
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Measures strength of contractions
Hypomagnesemia

39. Early deceleration
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Starts at contraction. caused by increased vagal tone from fetal head compression.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

40. The five A's of smoking cessation
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ask - Advise - Assess - Assist - Arrange
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

41. bacteria causing pharyngitis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Calcium pyrophosphate dehydrate crystals (pseudogout)

42. Superficial spreading melanoma
Anterior shoulder cannot readily pass below the pubic symphysis.
MCC melanoma. Radial growth.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
IV penicillin (or ampicillin)

43. Rod shaped - rhomboid - weakly positive birefringent
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Calcium pyrophosphate dehydrate crystals (pseudogout)
6 yo
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

44. Tx hyperkalemia in CKD
Tdap - influenza - pneumovax
(cefotetan OR cefoxitin) AND doxycycline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
DTaP - hepB - Hib - rotavirus - inactivated polio

45. Screened at 16-20 weeks GA for trisomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

46. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Clindamycin AND gentamicin
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

47. Tx GAS ifxn
Monosodium urate crystals (gout)
MCC melanoma. Radial growth.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Fe deficient anemia

48. Augments contractions
Ask - Advise - Assess - Assist - Arrange
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Oxytocin (IV)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

49. Other causes of hypercalcemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cataracts
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

50. medications causing hypercalcemia
Thiazdes; lithium
Fe deficient anemia
Ceftriaxone 125mg IM
Age-related sensorineural hearing loss (high frequency and speech discrimination)