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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. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Conrtaction monitoring along with fetal heart rate assessment
Anemia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Lung; SCC head & neck; RCC; breast; MM; prostate

2. Complications of GAS infxn
(ofloxacin OR levofloxacin) +/- metronidazole
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
6 yo

3. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Oxygen intervention 15h/d
Ceftriaxone 125mg IM
Tdap - influenza - pneumovax

4. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
MCC melanoma. Radial growth.
1 mo - eyes follow object to midline - vocalizes
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

5. Tx hyperkalemia in CKD
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Long axis of fetus to long axis of mother (longitudinal or transverse)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

6. Pregnancy class D smoking cessation drugs
DTaP - hepB - Hib - rotavirus - inactivated polio
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nicotine inhaler - nasal spray - gum
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

7. needles - strong negative birefringent (yellow crystals parallel light)
Calcium oxalate crystals
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Monosodium urate crystals (gout)
Most aggressive melanoma.

8. Tender - boggy prostate. Dx?
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium hydroxyapatite crystals
Cataracts
Prostatitis

9. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Esophagitis - gastritis - dysphagia
Stridor - drooling - toxic appearance

10. Screening for 65-76YO male smoker
MCC melanoma. Radial growth.
Aortic aneurysm
<20lb - <1YO - Reacts to pain - Responds to noise
Fe deficient anemia

11. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Nuchal translucency - serum hCG - PAPP-A
(cefotetan OR cefoxitin) AND doxycycline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

12. ADL
110-160bpm
Short-acting + 40mg prednisone x 10-14days
Bathing - dressing - eating - transferring - continence - toileting
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

13. Sx otitis media
Fluoroquinolones
Angioedema
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
NAC or IV NaHCO3

14. IV tx for PID
After delivery until delivery of placenta and membranes <30 mins
Alpha-1 antitrypsin deficiency
Ofloxacin OR levofloxacin +/- metronidazole
NAC or IV NaHCO3

15. Oral tx for PID
Monosodium urate crystals (gout)
(ofloxacin OR levofloxacin) +/- metronidazole
0.2-0.5mg aqueous EPI IM/SubQ
Normal mental status; no other injuries; seen within 10 days of injury

16. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Clindamycin AND gentamicin
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

17. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Aortic aneurysm
Measures strength of contractions
Steroids + bronchodilators

18. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Most aggressive melanoma.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

19. GBS tx
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
IV penicillin (or ampicillin)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Conrtaction monitoring along with fetal heart rate assessment

20. Augments contractions
6 yo
Oxytocin (IV)
Clindamycin AND gentamicin
Short-acting + 40mg prednisone x 10-14days

21. Oral tx for PID
Alpha-1 antitrypsin deficiency
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
110-160bpm
Ferrous sulfate 325mg tid

22. Complications of PID
Patch - bupropion - varenicline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Aortic aneurysm

23. Rod shaped - rhomboid - weakly positive birefringent
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Onset of labor until cervix dilation
Calcium pyrophosphate dehydrate crystals (pseudogout)

24. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Oxytocin (IV)
= LMP + 7 days - 3 months

25. Tx bacterial vaginosis
Metronidazole or clindamycin
Thiazdes; lithium
NAC or IV NaHCO3
Measures strength of contractions

26. group play - gender - knows name
Diabetes - HTN - GN
(ofloxacin OR levofloxacin) +/- metronidazole
Pneumovax - influenza
3 yo - identify body part - copies square - hops - throws - past tense - story telling

27. presbycusis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Fluoroquinolones
Short-acting + 40mg prednisone x 10-14days

28. Acral lentinous melanoma
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urticaria
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
MCC melanoma in Africans/Asians. Under nails - soles - palms.

29. 2nd generation antihistamines
Metronidazole or clindamycin
Loratadine - fexofenadine - cetirizine
Short-acting + 40mg prednisone x 10-14days
Onset of labor until cervix dilation

30. Tx otitis media
110-160bpm
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
9 mo - walks - throws - 1-3 words - 1-step commands
Ampicillin/sulbactam AND doxycycline

31. Fetal lie
Ofloxacin OR levofloxacin +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment
Long axis of fetus to long axis of mother (longitudinal or transverse)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

32. Late deceleration
5+ rads
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Metronidazole or clindamycin
Diabetes - HTN - GN

33. Malignancies with hypercalcemia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Lung; SCC head & neck; RCC; breast; MM; prostate

34. Immunizations for adult 65YO+
Oxytocin (IV)
Tdap - influenza - pneumovax
Alpha-1 antitrypsin deficiency
Bupropion - varenicline - nicotine replacement

35. social interaction
Urinary calcium. Hyper PTH (high) >> FHH (normal)
MTX
Diphenhydramine - chlorpheniramine - hydroxyzine
4 yo - copies triangle - catches ball - dresses self

36. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MCC melanoma. Radial growth.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Most aggressive melanoma.

37. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ask - Advise - Assess - Assist - Arrange
Long axis of fetus to long axis of mother (longitudinal or transverse)
Most aggressive melanoma.

38. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Metronidazole or clindamycin
Aortic aneurysm
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

39. Dx criteria for RA
Anaphylaxis
MCC melanoma. Radial growth.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
6-9MO

40. Sx peritonsillar abscess
0.2-0.5mg aqueous EPI IM/SubQ
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
NAC or IV NaHCO3

41. Tocodynamometer
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Conrtaction monitoring along with fetal heart rate assessment
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Colchicine

42. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Short-acting + 40mg prednisone x 10-14days
Lung; SCC head & neck; RCC; breast; MM; prostate
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

43. medications causing hypercalcemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thiazdes; lithium
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

44. Tx for anaphylaxis
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Colchicine
0.2-0.5mg aqueous EPI IM/SubQ

45. DOC for HTN in elderly
NAC or IV NaHCO3
Thiazides
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
After delivery until delivery of placenta and membranes <30 mins

46. Low serum iron - low MCV - low ferritin - +stool guaiac
Urticaria
Fe deficient anemia
110-160bpm
Hypomagnesemia

47. Causes of CKD
Calcium pyrophosphate dehydrate crystals (pseudogout)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Diabetes - HTN - GN
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

48. How much radiation is associated with fetal harm?
5+ rads
Ampicillin/sulbactam AND doxycycline
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

49. identifies left - right
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Fluoroquinolones
Calcium pyrophosphate dehydrate crystals (pseudogout)
6 yo

50. Pflx for traveler's diarrhea
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Fluoroquinolones
Masoiditis - bacterial meningitis - brain abscess - subdural empyema