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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. Recommendations for rear-facing car seat
2 mo - eyes follow object past midline - rolls over - laughs - squeals
<20lb - <1YO - Reacts to pain - Responds to noise
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ceftriaxone 125mg IM

2. shoulder dystocia
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)
Anterior shoulder cannot readily pass below the pubic symphysis.
0.2-0.5mg aqueous EPI IM/SubQ

3. Granulomatous causes of hypercalcemia
Diphenhydramine - chlorpheniramine - hydroxyzine
4mo - sits unsupported - hand transfer - babbles
Nicotine inhaler - nasal spray - gum
Tuberculosis; sarcoidosis; hodgkin disease

4. Sx peritonsillar abscess
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Thiazdes; lithium
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

5. social interaction
4 yo - copies triangle - catches ball - dresses self
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Onset of labor until cervix dilation
Oxygen intervention 15h/d

6. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Thiazdes; lithium
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

7. Other causes of hypercalcemia
Thiazdes; lithium
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Loratadine - fexofenadine - cetirizine

8. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Esophagitis - gastritis - dysphagia
4mo - sits unsupported - hand transfer - babbles
DTaP - hepB - Hib - rotavirus - inactivated polio

9. Oral tx for PID
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Angioedema
Metronidazole or clindamycin
(ofloxacin OR levofloxacin) +/- metronidazole

10. Tx hyperkalemia in CKD
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Most aggressive melanoma.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

11. Tx of traveler's diarrhea
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Normal mental status; no other injuries; seen within 10 days of injury
Aortic aneurysm
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

12. Causes of CKD
Measures strength of contractions
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Conrtaction monitoring along with fetal heart rate assessment
Diabetes - HTN - GN

13. Immunizations for COPD patients
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Pneumovax - influenza
Normal mental status; no other injuries; seen within 10 days of injury
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

14. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thiazdes; lithium
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

15. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Stridor - drooling - toxic appearance
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
IV penicillin (or ampicillin)

16. Second stage of labor
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ceftriaxone 125mg IM
9 mo - walks - throws - 1-3 words - 1-step commands
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

17. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Calcium oxalate crystals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

18. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
0.2-0.5mg aqueous EPI IM/SubQ
Loratadine - fexofenadine - cetirizine
Nicotine inhaler - nasal spray - gum

19. Dx bacterial rhinosinusitis
Steroids + bronchodilators
Ferrous sulfate 325mg tid
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)
Tdap - influenza - pneumovax

20. Tx acute sinusitis
Urinary calcium. Hyper PTH (high) >> FHH (normal)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Onset of labor until cervix dilation
<20lb - <1YO - Reacts to pain - Responds to noise

21. DDX for geriatric hearing impairment
0.2-0.5mg aqueous EPI IM/SubQ
Ferrous sulfate 325mg tid
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

22. Tender - boggy prostate. Dx?
Ceftriaxone 125mg IM
Prostatitis
Clindamycin AND gentamicin
Colchicine

23. First stage of labor
Nicotine inhaler - nasal spray - gum
Onset of labor until cervix dilation
Aortic aneurysm
MCC melanoma in Africans/Asians. Under nails - soles - palms.

24. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Flexion - internal rotation - extension - external rotation
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

25. Optimal time for trisomy screen
6 yo
16-18 weeks GA
(ofloxacin OR levofloxacin) +/- metronidazole
110-160bpm

26. dyspnea - visceral edema - hypotension
(cefotetan OR cefoxitin) AND doxycycline
Anaphylaxis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ofloxacin OR levofloxacin +/- metronidazole

27. Immunizations for adult 65YO+
Calcium pyrophosphate dehydrate crystals (pseudogout)
Fe deficient anemia
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)
Tdap - influenza - pneumovax

28. Age by which child says 'mama' and 'dada'
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Diabetes - HTN - GN
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
6-9MO

29. The five A's of smoking cessation
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ask - Advise - Assess - Assist - Arrange
Loratadine - fexofenadine - cetirizine
Calcium oxalate crystals

30. Tx bacterial vaginosis
Metronidazole or clindamycin
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Anemia

31. regards hand
Age-related sensorineural hearing loss (high frequency and speech discrimination)
4mo - sits unsupported - hand transfer - babbles
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

32. Low serum iron - low MCV - low ferritin - +stool guaiac
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Pneumovax - influenza
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Fe deficient anemia

33. Recommended folic acid daily dose
4 yo - copies triangle - catches ball - dresses self
3 yo - identify body part - copies square - hops - throws - past tense - story telling
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Bathing - dressing - eating - transferring - continence - toileting

34. Screened at 16-20 weeks GA for trisomy
Conrtaction monitoring along with fetal heart rate assessment
Alpha-1 antitrypsin deficiency
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

35. Sx epiglottitis
4 yo - copies triangle - catches ball - dresses self
Stridor - drooling - toxic appearance
Lung; SCC head & neck; RCC; breast; MM; prostate
Onset of labor until cervix dilation

36. Fetal heart rate range
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
110-160bpm
5 yo - draws person - ties shoes - skips
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

37. Bisphospohonates sfx
NAC or IV NaHCO3
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thiazides
Esophagitis - gastritis - dysphagia

38. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Ask - Advise - Assess - Assist - Arrange
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

39. Pregnancy class C smoking cessation drugs
Loratadine - fexofenadine - cetirizine
Alpha-1 antitrypsin deficiency
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Patch - bupropion - varenicline

40. identifies left - right
6 yo
2 mo - eyes follow object past midline - rolls over - laughs - squeals
DTaP - hepB - Hib - rotavirus - inactivated polio
Cataracts

41. Tx GAS ifxn
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ear pain - itching - inflammation/swollen canal - exudates/discharge

42. Regards human face - eye contact
5 yo - draws person - ties shoes - skips
1 mo - eyes follow object to midline - vocalizes
(ofloxacin OR levofloxacin) +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise

43. Tx otitis media
Clindamycin AND gentamicin
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
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)

44. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
Colchicine
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)
1 mo - eyes follow object to midline - vocalizes

45. IADL
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
9 mo - walks - throws - 1-3 words - 1-step commands
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Flexion - internal rotation - extension - external rotation

46. parallel play
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Prostatitis

47. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Esophagitis - gastritis - dysphagia
Prostatitis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

48. Corrected serum calcium =

49. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Patch - bupropion - varenicline
Calcium hydroxyapatite crystals
Onset of labor until cervix dilation

50. presbycusis
Diphenhydramine - chlorpheniramine - hydroxyzine
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Age-related sensorineural hearing loss (high frequency and speech discrimination)