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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. Immunizations for adult 65YO+
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Tdap - influenza - pneumovax
MTX
Ear pain - itching - inflammation/swollen canal - exudates/discharge

2. Late deceleration
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
After delivery until delivery of placenta and membranes <30 mins
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

3. Granulomatous causes of hypercalcemia
Thiazdes; lithium
Tuberculosis; sarcoidosis; hodgkin disease
NAC or IV NaHCO3
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

4. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Oxygen intervention 15h/d

5. explorations
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Long axis of fetus to long axis of mother (longitudinal or transverse)
9 mo - walks - throws - 1-3 words - 1-step commands

6. Screening for 65-76YO male smoker
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Normal mental status; no other injuries; seen within 10 days of injury
Aortic aneurysm
Measures strength of contractions

7. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Thiazides
0.2-0.5mg aqueous EPI IM/SubQ
Anemia
DTaP - hepB - Hib - rotavirus - inactivated polio

8. Optimal time for trisomy screen
Nicotine inhaler - nasal spray - gum
IV penicillin (or ampicillin)
Flexion - internal rotation - extension - external rotation
16-18 weeks GA

9. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Calcium pyrophosphate dehydrate crystals (pseudogout)
NAC or IV NaHCO3
Diabetes - HTN - GN
(cefotetan OR cefoxitin) AND doxycycline

10. Pregnancy class C smoking cessation drugs
Hypomagnesemia
<20lb - <1YO - Reacts to pain - Responds to noise
Patch - bupropion - varenicline
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

11. Bisphospohonates sfx
Alpha-1 antitrypsin deficiency
Esophagitis - gastritis - dysphagia
(ofloxacin OR levofloxacin) +/- metronidazole
5+ rads

12. First stage of labor
Colchicine
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Onset of labor until cervix dilation
4 yo - copies triangle - catches ball - dresses self

13. Fetal lie
Pneumovax - influenza
Urticaria
Long axis of fetus to long axis of mother (longitudinal or transverse)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

14. Pregnancy class D smoking cessation drugs
Ceftriaxone 125mg IM
Nicotine inhaler - nasal spray - gum
Pneumovax - influenza
Colchicine

15. Cockcroft-Gault equation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Biopsy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

16. recognizes strangers
Ampicillin/sulbactam AND doxycycline
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
6 mo - pincer - crawls - cruises - mamma - dada - byebye

17. Screened at 16-20 weeks GA for trisomy
4 yo - copies triangle - catches ball - dresses self
<20lb - <1YO - Reacts to pain - Responds to noise
Fe deficient anemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

18. Tx for thyroid storm
6 yo
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thiazides
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

19. Improve short-term outcomes in acute exacerbations of COPD - asthma
Thiazides
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Steroids + bronchodilators

20. Second stage of labor
Nuchal translucency - serum hCG - PAPP-A
Tdap - influenza - pneumovax
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

21. GBS tx
Long axis of fetus to long axis of mother (longitudinal or transverse)
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)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
IV penicillin (or ampicillin)

22. Tx gonorrhea
Anemia
Monosodium urate crystals (gout)
IV penicillin (or ampicillin)
Ceftriaxone 125mg IM

23. Only therapy to decrease mortality in stage IV COPD
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxygen intervention 15h/d
MCC melanoma. Radial growth.

24. The five A's of smoking cessation
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Ask - Advise - Assess - Assist - Arrange
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

25. Lentigo Maligna
Tdap - influenza - pneumovax
Nuchal translucency - serum hCG - PAPP-A
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Hypomagnesemia

26. regards hand
4mo - sits unsupported - hand transfer - babbles
5+ rads
Bupropion - varenicline - nicotine replacement
Colchicine

27. Tx GAS ifxn
Prostatitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
6-9MO
Clindamycin AND gentamicin

28. X-ray of ankle?
Most aggressive melanoma.
Normal mental status; no other injuries; seen within 10 days of injury
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Diabetes - HTN - GN

29. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
9 mo - walks - throws - 1-3 words - 1-step commands
Calcium oxalate crystals
Stridor - drooling - toxic appearance

30. needles - strong negative birefringent (yellow crystals parallel light)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Esophagitis - gastritis - dysphagia
Onset of labor until cervix dilation
Monosodium urate crystals (gout)

31. Signs of rupture of membranes

32. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Esophagitis - gastritis - dysphagia
Ear pain - itching - inflammation/swollen canal - exudates/discharge

33. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Stridor - drooling - toxic appearance
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Normal mental status; no other injuries; seen within 10 days of injury

34. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Tdap - influenza - pneumovax
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Short-acting + 40mg prednisone x 10-14days

35. presbycusis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fluoroquinolones
Age-related sensorineural hearing loss (high frequency and speech discrimination)

36. variable deceleration
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Esophagitis - gastritis - dysphagia

37. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Cataracts
Short-acting + 40mg prednisone x 10-14days

38. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Tuberculosis; sarcoidosis; hodgkin disease
Nuchal translucency - serum hCG - PAPP-A
Prostatitis

39. Dx bacterial rhinosinusitis
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
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)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Bathing - dressing - eating - transferring - continence - toileting

40. medications causing hypercalcemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Thiazdes; lithium
Conrtaction monitoring along with fetal heart rate assessment
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

41. Electrolyte abnormality that increases the incidence of torsades de pointes
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
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Hypomagnesemia

42. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
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)

43. Sx otitis media
(cefotetan OR cefoxitin) AND doxycycline
Ofloxacin OR levofloxacin +/- metronidazole
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Anaphylaxis

44. Nonfunctioning nodules > 1cm require _____
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Biopsy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Lung; SCC head & neck; RCC; breast; MM; prostate

45. Corrected serum calcium =

46. Tx bacterial vaginosis
Ask - Advise - Assess - Assist - Arrange
Metronidazole or clindamycin
9 mo - walks - throws - 1-3 words - 1-step commands
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

47. Superficial spreading melanoma
MCC melanoma. Radial growth.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Most aggressive melanoma.

48. Augments contractions
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Oxytocin (IV)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

49. Rod shaped - rhomboid - weakly positive birefringent
4 yo - copies triangle - catches ball - dresses self
Anaphylaxis
Calcium pyrophosphate dehydrate crystals (pseudogout)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

50. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Urinary calcium. Hyper PTH (high) >> FHH (normal)
= LMP + 7 days - 3 months
5 yo - draws person - ties shoes - skips