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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.
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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. IV tx for PID
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ofloxacin OR levofloxacin +/- metronidazole
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

2. Screening for 65-76YO male smoker
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Aortic aneurysm
9 mo - walks - throws - 1-3 words - 1-step commands
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

3. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
(ofloxacin OR levofloxacin) +/- metronidazole
Tuberculosis; sarcoidosis; hodgkin disease
= LMP + 7 days - 3 months

4. group play - gender - knows name
9 mo - walks - throws - 1-3 words - 1-step commands
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Clindamycin AND gentamicin
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

5. identifies left - right
Aortic aneurysm
6 yo
Tuberculosis; sarcoidosis; hodgkin disease
Fe deficient anemia

6. Four cardinal fetal movements
Starts at contraction. caused by increased vagal tone from fetal head compression.
Flexion - internal rotation - extension - external rotation
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
(cefotetan OR cefoxitin) AND doxycycline

7. 2nd generation antihistamines
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
4 yo - copies triangle - catches ball - dresses self
110-160bpm
Loratadine - fexofenadine - cetirizine

8. Smoking cessation agents
Stridor - drooling - toxic appearance
16-18 weeks GA
Bupropion - varenicline - nicotine replacement
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

9. social interaction
Tdap - influenza - pneumovax
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
4 yo - copies triangle - catches ball - dresses self
Nicotine inhaler - nasal spray - gum

10. Early 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)
Diphenhydramine - chlorpheniramine - hydroxyzine
Starts at contraction. caused by increased vagal tone from fetal head compression.
Fluoroquinolones

11. 1st generation antihistamines
Oxytocin (IV)
Diphenhydramine - chlorpheniramine - hydroxyzine
Calcium oxalate crystals
Tuberculosis; sarcoidosis; hodgkin disease

12. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ofloxacin OR levofloxacin +/- metronidazole
Normal mental status; no other injuries; seen within 10 days of injury
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

13. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Starts at contraction. caused by increased vagal tone from fetal head compression.
MCC melanoma in Africans/Asians. Under nails - soles - palms.

14. Superficial spreading melanoma
MCC melanoma. Radial growth.
Diabetes - HTN - GN
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Alpha-1 antitrypsin deficiency

15. Fetal lie
Flexion - internal rotation - extension - external rotation
Long axis of fetus to long axis of mother (longitudinal or transverse)
Urticaria
2 mo - eyes follow object past midline - rolls over - laughs - squeals

16. Immunizations for COPD patients
Angioedema
Pneumovax - influenza
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
9 mo - walks - throws - 1-3 words - 1-step commands

17. CKD Stages
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Aortic aneurysm
Esophagitis - gastritis - dysphagia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

18. IADL
Bupropion - varenicline - nicotine replacement
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
After delivery until delivery of placenta and membranes <30 mins

19. Nodular melanoma
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Most aggressive melanoma.

20. bacteria causing pharyngitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Most aggressive melanoma.
MCC melanoma in Africans/Asians. Under nails - soles - palms.

21. Improve short-term outcomes in acute exacerbations of COPD - asthma
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Steroids + bronchodilators
MCC melanoma in Africans/Asians. Under nails - soles - palms.
IV penicillin (or ampicillin)

22. Late deceleration
Steroids + bronchodilators
Fe deficient anemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

23. Tx of traveler's diarrhea
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Age-related sensorineural hearing loss (high frequency and speech discrimination)

24. GBS tx
IV penicillin (or ampicillin)
6 yo
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

25. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium oxalate crystals
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

26. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Nicotine inhaler - nasal spray - gum
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

27. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Monosodium urate crystals (gout)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

28. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

29. Regards human face - eye contact
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
1 mo - eyes follow object to midline - vocalizes
Alpha-1 antitrypsin deficiency

30. DOC for HTN in elderly
Thiazides
= LMP + 7 days - 3 months
Tdap - influenza - pneumovax
Ferrous sulfate 325mg tid

31. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ask - Advise - Assess - Assist - Arrange
Patch - bupropion - varenicline
4mo - sits unsupported - hand transfer - babbles

32. Malignancies with hypercalcemia
Diabetes - HTN - GN
Tuberculosis; sarcoidosis; hodgkin disease
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Lung; SCC head & neck; RCC; breast; MM; prostate

33. Sx peritonsillar abscess
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Flexion - internal rotation - extension - external rotation
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

34. Augments contractions
Oxytocin (IV)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
6-9MO

35. Fetal heart rate range
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Urinary calcium. Hyper PTH (high) >> FHH (normal)
110-160bpm
(cefotetan OR cefoxitin) AND doxycycline

36. Other causes of hypercalcemia
(cefotetan OR cefoxitin) AND doxycycline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

37. writes name - counts 10 objects
Cataracts
Starts at contraction. caused by increased vagal tone from fetal head compression.
5 yo - draws person - ties shoes - skips
Calcium oxalate crystals

38. Tx bacterial vaginosis
Tuberculosis; sarcoidosis; hodgkin disease
Metronidazole or clindamycin
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Angioedema

39. Pregnancy class D smoking cessation drugs
110-160bpm
Nicotine inhaler - nasal spray - gum
Urticaria
5 yo - draws person - ties shoes - skips

40. Screened at 11-13 weeks GA for trisomy
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)
5 yo - draws person - ties shoes - skips
Monosodium urate crystals (gout)
Nuchal translucency - serum hCG - PAPP-A

41. bipyramidal - strongly positive birefringent
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
5+ rads
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Calcium oxalate crystals

42. Signs of rupture of membranes

43. Sx of hypercalcemia
3 yo - identify body part - copies square - hops - throws - past tense - story telling
MTX
Oxytocin (IV)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

44. IV tx for PID
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ofloxacin OR levofloxacin +/- metronidazole
Anemia
Ampicillin/sulbactam AND doxycycline

45. Screened at 16-20 weeks GA for trisomy
16-18 weeks GA
IV penicillin (or ampicillin)
6-9MO
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

46. Immunizations for adult 65YO+
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Tdap - influenza - pneumovax
Loratadine - fexofenadine - cetirizine
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

47. How much radiation is associated with fetal harm?
Thiazides
5+ rads
Calcium oxalate crystals
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

48. MONA therapy
Onset of labor until cervix dilation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Aortic aneurysm
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

49. Pflx for traveler's diarrhea
Diabetes - HTN - GN
Loratadine - fexofenadine - cetirizine
Fluoroquinolones
Aortic aneurysm

50. parallel play
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Loratadine - fexofenadine - cetirizine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
After delivery until delivery of placenta and membranes <30 mins