Test your basic knowledge |

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. MCC blindness worldwide
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Cataracts
Hypomagnesemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

2. 1st generation antihistamines
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium hydroxyapatite crystals
5 yo - draws person - ties shoes - skips
Diphenhydramine - chlorpheniramine - hydroxyzine

3. Pflx for traveler's diarrhea
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ofloxacin OR levofloxacin +/- metronidazole
Fluoroquinolones

4. variable deceleration
Pneumovax - influenza
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Cataracts

5. Sx of hypercalcemia
Fluoroquinolones
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

6. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Monosodium urate crystals (gout)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

7. recognizes strangers
Cataracts
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
6 mo - pincer - crawls - cruises - mamma - dada - byebye
2 mo - eyes follow object past midline - rolls over - laughs - squeals

8. Sx otitis externa
Long axis of fetus to long axis of mother (longitudinal or transverse)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
6 yo

9. 2nd generation antihistamines
Oxygen intervention 15h/d
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Metronidazole or clindamycin
Loratadine - fexofenadine - cetirizine

10. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium pyrophosphate dehydrate crystals (pseudogout)
Hypomagnesemia

11. Tx of traveler's diarrhea
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Angioedema
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

12. Bacteria causing chronic sinusitis
Cataracts
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

13. Recommended folic acid daily dose
Ceftriaxone 125mg IM
Tuberculosis; sarcoidosis; hodgkin disease
Loratadine - fexofenadine - cetirizine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

14. Fetal lie
4mo - sits unsupported - hand transfer - babbles
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Long axis of fetus to long axis of mother (longitudinal or transverse)

15. Granulomatous causes of hypercalcemia
NAC or IV NaHCO3
Tuberculosis; sarcoidosis; hodgkin disease
Diabetes - HTN - GN
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

16. DOC for HTN in elderly
Thiazides
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

17. First stage of labor
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Metronidazole or clindamycin
Onset of labor until cervix dilation

18. Dx criteria for RA
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Thiazides
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

19. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
(ofloxacin OR levofloxacin) +/- metronidazole
= LMP + 7 days - 3 months

20. Nonfunctioning nodules > 1cm require _____
= LMP + 7 days - 3 months
<20lb - <1YO - Reacts to pain - Responds to noise
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Biopsy

21. Tx gonorrhea
Oxytocin (IV)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
5+ rads
Ceftriaxone 125mg IM

22. tx shoulder dystocia

23. Tender - boggy prostate. Dx?
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)
Prostatitis
1 mo - eyes follow object to midline - vocalizes
= LMP + 7 days - 3 months

24. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
5+ rads
4 yo - copies triangle - catches ball - dresses self
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

25. Dx bacterial rhinosinusitis
5 yo - draws person - ties shoes - skips
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)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

26. DDX for geriatric hearing impairment
NAC or IV NaHCO3
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Onset of labor until cervix dilation

27. painless - deep - subQ swelling (periorbital - circumoral - facial)
Lung; SCC head & neck; RCC; breast; MM; prostate
Calcium hydroxyapatite crystals
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Angioedema

28. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Biopsy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Diphenhydramine - chlorpheniramine - hydroxyzine
Anemia

29. bipyramidal - strongly positive birefringent
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Calcium oxalate crystals
Loratadine - fexofenadine - cetirizine

30. dyspnea - visceral edema - hypotension
Alpha-1 antitrypsin deficiency
Anaphylaxis
Biopsy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

31. X-ray on knee?
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

32. stranger/separation anxiety
Patch - bupropion - varenicline
Anterior shoulder cannot readily pass below the pubic symphysis.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

33. Signs of rupture of membranes

34. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Bathing - dressing - eating - transferring - continence - toileting
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

35. X-ray of ankle?
MCC melanoma. Radial growth.
MTX
Ceftriaxone 125mg IM
Normal mental status; no other injuries; seen within 10 days of injury

36. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

37. social interaction
Anemia
16-18 weeks GA
4 yo - copies triangle - catches ball - dresses self
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

38. Bisphospohonates sfx
Normal mental status; no other injuries; seen within 10 days of injury
6-9MO
Esophagitis - gastritis - dysphagia
Ofloxacin OR levofloxacin +/- metronidazole

39. CKD Stages
Aortic aneurysm
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Anaphylaxis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

40. The five A's of smoking cessation
Tuberculosis; sarcoidosis; hodgkin disease
6-9MO
Ask - Advise - Assess - Assist - Arrange
1 mo - eyes follow object to midline - vocalizes

41. Tocodynamometer
Metronidazole or clindamycin
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 mo - eyes follow object to midline - vocalizes
Conrtaction monitoring along with fetal heart rate assessment

42. Unstable angina vs MI Dx tests
Patch - bupropion - varenicline
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anaphylaxis
110-160bpm

43. Mediators released in response to allergen
Angioedema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Loratadine - fexofenadine - cetirizine

44. Optimal time for trisomy screen
Patch - bupropion - varenicline
16-18 weeks GA
Anaphylaxis
6 yo

45. How much radiation is associated with fetal harm?
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Nuchal translucency - serum hCG - PAPP-A
5+ rads
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

46. writes name - counts 10 objects
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Angioedema
110-160bpm
5 yo - draws person - ties shoes - skips

47. Regards human face - eye contact
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
1 mo - eyes follow object to midline - vocalizes
Pneumovax - influenza
9 mo - walks - throws - 1-3 words - 1-step commands

48. Second stage of labor
(cefotetan OR cefoxitin) AND doxycycline
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Loratadine - fexofenadine - cetirizine

49. group play - gender - knows name
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MTX
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

50. Acral lentinous melanoma
Bupropion - varenicline - nicotine replacement
<20lb - <1YO - Reacts to pain - Responds to noise
MCC melanoma in Africans/Asians. Under nails - soles - palms.
IV penicillin (or ampicillin)