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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. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Prostatitis
Tdap - influenza - pneumovax

2. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Oxygen intervention 15h/d
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

3. Oral tx for PID
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)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
(ofloxacin OR levofloxacin) +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

4. Rod shaped - rhomboid - weakly positive birefringent
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Alpha-1 antitrypsin deficiency
Calcium pyrophosphate dehydrate crystals (pseudogout)

5. bipyramidal - strongly positive birefringent
IV penicillin (or ampicillin)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Steroids + bronchodilators
Calcium oxalate crystals

6. Third stage of labor
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
After delivery until delivery of placenta and membranes <30 mins
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

7. Lentigo Maligna
Anaphylaxis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Patch - bupropion - varenicline
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

8. Malignancies with hypercalcemia
16-18 weeks GA
Lung; SCC head & neck; RCC; breast; MM; prostate
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

9. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ofloxacin OR levofloxacin +/- metronidazole

10. Pregnancy class D smoking cessation drugs
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Monosodium urate crystals (gout)
Nicotine inhaler - nasal spray - gum
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

11. X-ray of ankle?
Flexion - internal rotation - extension - external rotation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Normal mental status; no other injuries; seen within 10 days of injury
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

12. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
IV penicillin (or ampicillin)
NAC or IV NaHCO3
Nicotine inhaler - nasal spray - gum

13. Immunizations for adult 65YO+
Calcium pyrophosphate dehydrate crystals (pseudogout)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Tdap - influenza - pneumovax
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

14. Tx acute gout
Ferrous sulfate 325mg tid
Colchicine
9 mo - walks - throws - 1-3 words - 1-step commands
Urticaria

15. Bacteria causing chronic sinusitis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Nicotine inhaler - nasal spray - gum
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Bathing - dressing - eating - transferring - continence - toileting

16. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
110-160bpm
16-18 weeks GA

17. Early deceleration
(cefotetan OR cefoxitin) AND doxycycline
Starts at contraction. caused by increased vagal tone from fetal head compression.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
MTX

18. Dx bacterial vaginosis
Anemia
MCC melanoma. Radial growth.
Thiazdes; lithium
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

19. Sx epiglottitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Diabetes - HTN - GN
Stridor - drooling - toxic appearance
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

20. Tx gonorrhea
Diphenhydramine - chlorpheniramine - hydroxyzine
Ceftriaxone 125mg IM
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

21. IV tx for PID
Pneumovax - influenza
Ofloxacin OR levofloxacin +/- metronidazole
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Nicotine inhaler - nasal spray - gum

22. ADL
Bathing - dressing - eating - transferring - continence - toileting
Thiazides
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anaphylaxis

23. Mediators released in response to allergen
Colchicine
Urticaria
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Metronidazole or clindamycin

24. Bisphospohonates sfx
Ask - Advise - Assess - Assist - Arrange
Esophagitis - gastritis - dysphagia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anemia

25. Tocodynamometer
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Conrtaction monitoring along with fetal heart rate assessment
Measures strength of contractions

26. Screening for 65-76YO male smoker
Bupropion - varenicline - nicotine replacement
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
= LMP + 7 days - 3 months
Aortic aneurysm

27. recognizes strangers
Short-acting + 40mg prednisone x 10-14days
Nicotine inhaler - nasal spray - gum
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Fluoroquinolones

28. painless - deep - subQ swelling (periorbital - circumoral - facial)
6-9MO
Measures strength of contractions
Angioedema
Tuberculosis; sarcoidosis; hodgkin disease

29. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ear pain - itching - inflammation/swollen canal - exudates/discharge
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

30. Immunizations at visit for 6MO
Diphenhydramine - chlorpheniramine - hydroxyzine
110-160bpm
MCC melanoma in Africans/Asians. Under nails - soles - palms.
DTaP - hepB - Hib - rotavirus - inactivated polio

31. medications causing hypercalcemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Esophagitis - gastritis - dysphagia
Thiazdes; lithium
Measures strength of contractions

32. Optimal time for trisomy screen
5+ rads
16-18 weeks GA
Ask - Advise - Assess - Assist - Arrange
Nicotine inhaler - nasal spray - gum

33. Dx bacterial rhinosinusitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thiazides
Esophagitis - gastritis - dysphagia
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)

34. MONA therapy
Prostatitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Lung; SCC head & neck; RCC; breast; MM; prostate

35. Acral lentinous melanoma
Anaphylaxis
6 yo
MCC melanoma in Africans/Asians. Under nails - soles - palms.
IV penicillin (or ampicillin)

36. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anterior shoulder cannot readily pass below the pubic symphysis.
After delivery until delivery of placenta and membranes <30 mins
Oxygen intervention 15h/d

37. Sx peritonsillar abscess
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Flexion - internal rotation - extension - external rotation
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

38. Nodular melanoma
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Diabetes - HTN - GN
DTaP - hepB - Hib - rotavirus - inactivated polio
Most aggressive melanoma.

39. Causes of CKD
MTX
Diabetes - HTN - GN
Metronidazole or clindamycin
Diphenhydramine - chlorpheniramine - hydroxyzine

40. Low serum iron - low MCV - low ferritin - +stool guaiac
Steroids + bronchodilators
Fe deficient anemia
Calcium oxalate crystals
Loratadine - fexofenadine - cetirizine

41. stranger/separation anxiety
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Esophagitis - gastritis - dysphagia

42. Tender - boggy prostate. Dx?
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Thiazides
Prostatitis

43. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Anaphylaxis
Age-related sensorineural hearing loss (high frequency and speech discrimination)

44. Tx of traveler's diarrhea
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
5+ rads
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

45. IV tx for PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
(ofloxacin OR levofloxacin) +/- metronidazole
Ask - Advise - Assess - Assist - Arrange
(cefotetan OR cefoxitin) AND doxycycline

46. How much radiation is associated with fetal harm?
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5+ rads
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

47. Fetal heart rate range
<20lb - <1YO - Reacts to pain - Responds to noise
Fe deficient anemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
110-160bpm

48. Emphysema - <45YO - nonsmoker
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Diabetes - HTN - GN
Metronidazole or clindamycin
Alpha-1 antitrypsin deficiency

49. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Nuchal translucency - serum hCG - PAPP-A
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium oxalate crystals

50. complications of otitis media
Measures strength of contractions
Diphenhydramine - chlorpheniramine - hydroxyzine
Thiazides
Masoiditis - bacterial meningitis - brain abscess - subdural empyema