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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. Lentigo Maligna
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anaphylaxis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

2. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Clindamycin AND gentamicin
DTaP - hepB - Hib - rotavirus - inactivated polio
MTX

3. parallel play
Loratadine - fexofenadine - cetirizine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Diabetes - HTN - GN
110-160bpm

4. Other causes of hypercalcemia
Calcium hydroxyapatite crystals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Bupropion - varenicline - nicotine replacement
IV penicillin (or ampicillin)

5. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anterior shoulder cannot readily pass below the pubic symphysis.
MTX

6. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Calcium hydroxyapatite crystals
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Oxygen intervention 15h/d

7. Oral tx for PID
Short-acting + 40mg prednisone x 10-14days
Stridor - drooling - toxic appearance
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
5+ rads

8. Tx of traveler's diarrhea
5+ rads
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

9. How much radiation is associated with fetal harm?
Flexion - internal rotation - extension - external rotation
5+ rads
= LMP + 7 days - 3 months
Diabetes - HTN - GN

10. bipyramidal - strongly positive birefringent
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Calcium oxalate crystals
1 mo - eyes follow object to midline - vocalizes
0.2-0.5mg aqueous EPI IM/SubQ

11. Dx PID
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Hypomagnesemia
9 mo - walks - throws - 1-3 words - 1-step commands

12. Optimal time for trisomy screen
16-18 weeks GA
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Cataracts
Hypomagnesemia

13. DOC for HTN in elderly
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Thiazides
Ofloxacin OR levofloxacin +/- metronidazole
NAC or IV NaHCO3

14. Tx otitis media
1 mo - eyes follow object to midline - vocalizes
Monosodium urate crystals (gout)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

15. Complications of PID
MTX
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Aortic aneurysm
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

16. Tx for anaphylaxis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
DTaP - hepB - Hib - rotavirus - inactivated polio
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
0.2-0.5mg aqueous EPI IM/SubQ

17. Cockcroft-Gault equation
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(cefotetan OR cefoxitin) AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ceftriaxone 125mg IM

18. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
0.2-0.5mg aqueous EPI IM/SubQ
6-9MO

19. Early deceleration
Ceftriaxone 125mg IM
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Starts at contraction. caused by increased vagal tone from fetal head compression.

20. tx shoulder dystocia

21. Sx otitis media
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Nuchal translucency - serum hCG - PAPP-A
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

22. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Oxygen intervention 15h/d
9 mo - walks - throws - 1-3 words - 1-step commands

23. bacteria causing pharyngitis
Loratadine - fexofenadine - cetirizine
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Diphenhydramine - chlorpheniramine - hydroxyzine

24. Screened at 11-13 weeks GA for trisomy
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
1 mo - eyes follow object to midline - vocalizes
Nuchal translucency - serum hCG - PAPP-A
Bupropion - varenicline - nicotine replacement

25. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Urinary calcium. Hyper PTH (high) >> FHH (normal)

26. explorations
Biopsy
= LMP + 7 days - 3 months
Nuchal translucency - serum hCG - PAPP-A
9 mo - walks - throws - 1-3 words - 1-step commands

27. Fetal lie
Ofloxacin OR levofloxacin +/- metronidazole
Tuberculosis; sarcoidosis; hodgkin disease
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Long axis of fetus to long axis of mother (longitudinal or transverse)

28. Oral tx for PID
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ampicillin/sulbactam AND doxycycline
(ofloxacin OR levofloxacin) +/- metronidazole
Tdap - influenza - pneumovax

29. Large - irregularly shaped - prutitic - erythematous wheals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Urticaria
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)
Ampicillin/sulbactam AND doxycycline

30. Tx hyperkalemia in CKD
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Aortic aneurysm
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

31. Emphysema - <45YO - nonsmoker
Cataracts
Alpha-1 antitrypsin deficiency
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Conrtaction monitoring along with fetal heart rate assessment

32. Second stage of labor
4mo - sits unsupported - hand transfer - babbles
MCC melanoma. Radial growth.
Onset of labor until cervix dilation
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

33. Immunizations for COPD patients
Measures strength of contractions
Ampicillin/sulbactam AND doxycycline
Pneumovax - influenza
DTaP - hepB - Hib - rotavirus - inactivated polio

34. Dx criteria for RA
Ask - Advise - Assess - Assist - Arrange
4mo - sits unsupported - hand transfer - babbles
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
DTaP - hepB - Hib - rotavirus - inactivated polio

35. Tx acute exacerbation COPD
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Short-acting + 40mg prednisone x 10-14days
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anemia

36. Malignancies with hypercalcemia
Ferrous sulfate 325mg tid
MTX
Lung; SCC head & neck; RCC; breast; MM; prostate
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

37. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium hydroxyapatite crystals
4mo - sits unsupported - hand transfer - babbles

38. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
Prostatitis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

39. Unstable angina vs MI Dx tests
Metronidazole or clindamycin
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Biopsy
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

40. Corrected serum calcium =

41. variable deceleration
(ofloxacin OR levofloxacin) +/- metronidazole
6 yo
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Oxytocin (IV)

42. Tender - boggy prostate. Dx?
5+ rads
Fe deficient anemia
Prostatitis
Normal mental status; no other injuries; seen within 10 days of injury

43. writes name - counts 10 objects
<20lb - <1YO - Reacts to pain - Responds to noise
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ear pain - itching - inflammation/swollen canal - exudates/discharge
5 yo - draws person - ties shoes - skips

44. Improve short-term outcomes in acute exacerbations of COPD - asthma
<20lb - <1YO - Reacts to pain - Responds to noise
Long axis of fetus to long axis of mother (longitudinal or transverse)
Steroids + bronchodilators
6 yo

45. Tx chlamydia
Normal mental status; no other injuries; seen within 10 days of injury
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
0.2-0.5mg aqueous EPI IM/SubQ

46. Tocodynamometer
(ofloxacin OR levofloxacin) +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
Conrtaction monitoring along with fetal heart rate assessment
Metronidazole or clindamycin

47. Recommendations for rear-facing car seat
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)
<20lb - <1YO - Reacts to pain - Responds to noise
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
MCC melanoma. Radial growth.

48. Dx bacterial vaginosis
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ofloxacin OR levofloxacin +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

49. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
5 yo - draws person - ties shoes - skips
Diphenhydramine - chlorpheniramine - hydroxyzine
Oxytocin (IV)

50. Bacteria causing chronic sinusitis
Ampicillin/sulbactam AND doxycycline
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Short-acting + 40mg prednisone x 10-14days
(cefotetan OR cefoxitin) AND doxycycline