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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. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Anterior shoulder cannot readily pass below the pubic symphysis.
Prostatitis
Ofloxacin OR levofloxacin +/- metronidazole
NAC or IV NaHCO3

2. The five A's of smoking cessation
Thiazides
Steroids + bronchodilators
Ask - Advise - Assess - Assist - Arrange
Lung; SCC head & neck; RCC; breast; MM; prostate

3. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Tdap - influenza - pneumovax
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ampicillin/sulbactam AND doxycycline
Anemia

4. Age by which child says 'mama' and 'dada'
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
(cefotetan OR cefoxitin) AND doxycycline
6-9MO
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

5. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
5+ rads

6. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Conrtaction monitoring along with fetal heart rate assessment

7. Tender - boggy prostate. Dx?
Prostatitis
Oxytocin (IV)
Thiazides
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

8. Recommended folic acid daily dose
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Long axis of fetus to long axis of mother (longitudinal or transverse)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ofloxacin OR levofloxacin +/- metronidazole

9. bacteria causing pharyngitis
Diphenhydramine - chlorpheniramine - hydroxyzine
Diabetes - HTN - GN
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Calcium hydroxyapatite crystals

10. Rod shaped - rhomboid - weakly positive birefringent
5 yo - draws person - ties shoes - skips
Clindamycin AND gentamicin
Calcium pyrophosphate dehydrate crystals (pseudogout)
Bupropion - varenicline - nicotine replacement

11. medications causing hypercalcemia
Colchicine
Thiazdes; lithium
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Fluoroquinolones

12. Tx GAS ifxn
Tuberculosis; sarcoidosis; hodgkin disease
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
MTX
Colchicine

13. Superficial spreading melanoma
MTX
Starts at contraction. caused by increased vagal tone from fetal head compression.
MCC melanoma. Radial growth.
Fe deficient anemia

14. Tx gonorrhea
Ampicillin/sulbactam AND doxycycline
Ceftriaxone 125mg IM
Pneumovax - influenza
Anaphylaxis

15. Electrolyte abnormality that increases the incidence of torsades de pointes
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Tdap - influenza - pneumovax
Hypomagnesemia
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

16. Improve short-term outcomes in acute exacerbations of COPD - asthma
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Steroids + bronchodilators
4mo - sits unsupported - hand transfer - babbles

17. IUPC (intrauterine pressure catheter)
Aortic aneurysm
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Measures strength of contractions

18. Only therapy to decrease mortality in stage IV COPD
Fe deficient anemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Oxygen intervention 15h/d
Thiazdes; lithium

19. painless - deep - subQ swelling (periorbital - circumoral - facial)
MTX
Angioedema
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

20. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Biopsy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
MTX

21. Tx bacterial vaginosis
Metronidazole or clindamycin
Hypomagnesemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

22. Tx for thyroid storm
Cataracts
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

23. regards hand
Aortic aneurysm
Diabetes - HTN - GN
4mo - sits unsupported - hand transfer - babbles
Hypomagnesemia

24. Granulomatous causes of hypercalcemia
Hypomagnesemia
Colchicine
Tuberculosis; sarcoidosis; hodgkin disease
Aortic aneurysm

25. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
NAC or IV NaHCO3
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

26. How much radiation is associated with fetal harm?
Pneumovax - influenza
5+ rads
MTX
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

27. MONA therapy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Stridor - drooling - toxic appearance
= LMP + 7 days - 3 months
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

28. Oral tx for PID
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Clindamycin AND gentamicin
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

29. Low serum iron - low MCV - low ferritin - +stool guaiac
5 yo - draws person - ties shoes - skips
Ampicillin/sulbactam AND doxycycline
Fe deficient anemia
Measures strength of contractions

30. IV tx for PID
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bathing - dressing - eating - transferring - continence - toileting
Ampicillin/sulbactam AND doxycycline
Short-acting + 40mg prednisone x 10-14days

31. social interaction
Ear pain - itching - inflammation/swollen canal - exudates/discharge
4 yo - copies triangle - catches ball - dresses self
Ceftriaxone 125mg IM
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

32. Dx bacterial vaginosis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
5+ rads

33. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
4mo - sits unsupported - hand transfer - babbles
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

34. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Loratadine - fexofenadine - cetirizine
Diabetes - HTN - GN
Hypomagnesemia

35. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Colchicine
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
<20lb - <1YO - Reacts to pain - Responds to noise

36. writes name - counts 10 objects
Patch - bupropion - varenicline
Ferrous sulfate 325mg tid
5 yo - draws person - ties shoes - skips
Flexion - internal rotation - extension - external rotation

37. Four cardinal fetal movements
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ceftriaxone 125mg IM
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Flexion - internal rotation - extension - external rotation

38. group play - gender - knows name
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
Aortic aneurysm
Cataracts

39. Dx criteria for RA
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ceftriaxone 125mg IM
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

40. Signs of rupture of membranes

41. Malignancies with hypercalcemia
Fe deficient anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Lung; SCC head & neck; RCC; breast; MM; prostate
Urticaria

42. Augments contractions
Nicotine inhaler - nasal spray - gum
Oxytocin (IV)
Starts at contraction. caused by increased vagal tone from fetal head compression.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

43. GBS tx
IV penicillin (or ampicillin)
Fe deficient anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

44. tx shoulder dystocia

45. IV tx for PID
Fe deficient anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ofloxacin OR levofloxacin +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment

46. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ofloxacin OR levofloxacin +/- metronidazole
IV penicillin (or ampicillin)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

47. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Metronidazole or clindamycin
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

48. variable deceleration
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)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

49. Second stage of labor
Conrtaction monitoring along with fetal heart rate assessment
= LMP + 7 days - 3 months
Flexion - internal rotation - extension - external rotation
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

50. CKD Stages
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anemia