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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. Pflx for traveler's diarrhea
Fluoroquinolones
Biopsy
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Colchicine

2. Second stage of labor
NAC or IV NaHCO3
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

3. GBS tx
Prostatitis
Calcium hydroxyapatite crystals
IV penicillin (or ampicillin)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

4. bipyramidal - strongly positive birefringent
Fe deficient anemia
Calcium oxalate crystals
0.2-0.5mg aqueous EPI IM/SubQ
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

5. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
16-18 weeks GA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

6. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Colchicine
Hypomagnesemia
MCC melanoma in Africans/Asians. Under nails - soles - palms.

7. Tender - boggy prostate. Dx?
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Prostatitis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Patch - bupropion - varenicline

8. Large - irregularly shaped - prutitic - erythematous wheals
DTaP - hepB - Hib - rotavirus - inactivated polio
Urticaria
Ask - Advise - Assess - Assist - Arrange
Loratadine - fexofenadine - cetirizine

9. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
0.2-0.5mg aqueous EPI IM/SubQ
Long axis of fetus to long axis of mother (longitudinal or transverse)
NAC or IV NaHCO3
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

10. Signs of rupture of membranes

11. Tx gonorrhea
Ceftriaxone 125mg IM
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
MCC melanoma. Radial growth.
Prostatitis

12. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nuchal translucency - serum hCG - PAPP-A
= LMP + 7 days - 3 months
Short-acting + 40mg prednisone x 10-14days

13. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Fe deficient anemia
Nicotine inhaler - nasal spray - gum
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

14. Bisphospohonates sfx
NAC or IV NaHCO3
Esophagitis - gastritis - dysphagia
Urticaria
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

15. Causes of CKD
Metronidazole or clindamycin
DTaP - hepB - Hib - rotavirus - inactivated polio
Diabetes - HTN - GN
Calcium oxalate crystals

16. IV tx for PID
Colchicine
Ofloxacin OR levofloxacin +/- metronidazole
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
<20lb - <1YO - Reacts to pain - Responds to noise

17. variable deceleration
Onset of labor until cervix dilation
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
1 mo - eyes follow object to midline - vocalizes
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

18. Dx bacterial vaginosis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium oxalate crystals
2 mo - eyes follow object past midline - rolls over - laughs - squeals

19. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Diabetes - HTN - GN
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Anterior shoulder cannot readily pass below the pubic symphysis.

20. Fetal heart rate range
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
110-160bpm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Steroids + bronchodilators

21. Age by which child says 'mama' and 'dada'
6-9MO
5 yo - draws person - ties shoes - skips
Alpha-1 antitrypsin deficiency
Anemia

22. Tx for anaphylaxis
4mo - sits unsupported - hand transfer - babbles
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
0.2-0.5mg aqueous EPI IM/SubQ

23. recognizes strangers
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diabetes - HTN - GN
6 mo - pincer - crawls - cruises - mamma - dada - byebye
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

24. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
MTX
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

25. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Alpha-1 antitrypsin deficiency
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

26. dyspnea - visceral edema - hypotension
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Urticaria
Metronidazole or clindamycin
Anaphylaxis

27. shoulder dystocia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Anterior shoulder cannot readily pass below the pubic symphysis.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Conrtaction monitoring along with fetal heart rate assessment

28. Tx of traveler's diarrhea
Esophagitis - gastritis - dysphagia
DTaP - hepB - Hib - rotavirus - inactivated polio
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

29. DDX for geriatric hearing impairment
Ofloxacin OR levofloxacin +/- metronidazole
Esophagitis - gastritis - dysphagia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
9 mo - walks - throws - 1-3 words - 1-step commands

30. identifies left - right
6 yo
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fluoroquinolones
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

31. How much radiation is associated with fetal harm?
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
= LMP + 7 days - 3 months
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
5+ rads

32. Low serum iron - low MCV - low ferritin - +stool guaiac
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
9 mo - walks - throws - 1-3 words - 1-step commands
Fe deficient anemia
Conrtaction monitoring along with fetal heart rate assessment

33. painless - deep - subQ swelling (periorbital - circumoral - facial)
IV penicillin (or ampicillin)
Angioedema
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diphenhydramine - chlorpheniramine - hydroxyzine

34. Electrolyte abnormality that increases the incidence of torsades de pointes
Starts at contraction. caused by increased vagal tone from fetal head compression.
Hypomagnesemia
Onset of labor until cervix dilation
Flexion - internal rotation - extension - external rotation

35. Tx bacterial vaginosis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Alpha-1 antitrypsin deficiency
Metronidazole or clindamycin
Age-related sensorineural hearing loss (high frequency and speech discrimination)

36. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
(cefotetan OR cefoxitin) AND doxycycline
110-160bpm
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

37. Tx otitis media
Loratadine - fexofenadine - cetirizine
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Cataracts
Diphenhydramine - chlorpheniramine - hydroxyzine

38. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Anemia
Steroids + bronchodilators

39. needles - strong negative birefringent (yellow crystals parallel light)
Short-acting + 40mg prednisone x 10-14days
Monosodium urate crystals (gout)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Nicotine inhaler - nasal spray - gum

40. Sx epiglottitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Stridor - drooling - toxic appearance
<20lb - <1YO - Reacts to pain - Responds to noise
3 yo - identify body part - copies square - hops - throws - past tense - story telling

41. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Diabetes - HTN - GN
MCC melanoma. Radial growth.
Nuchal translucency - serum hCG - PAPP-A

42. Estimated delivery date (Naegele's rule)
1 mo - eyes follow object to midline - vocalizes
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
= LMP + 7 days - 3 months
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

43. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
4mo - sits unsupported - hand transfer - babbles
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ampicillin/sulbactam AND doxycycline

44. MONA therapy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Alpha-1 antitrypsin deficiency
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

45. Optimal time for trisomy screen
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
16-18 weeks GA
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

46. Bacteria causing chronic sinusitis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
<20lb - <1YO - Reacts to pain - Responds to noise

47. Cockcroft-Gault equation
Angioedema
4 yo - copies triangle - catches ball - dresses self
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Tdap - influenza - pneumovax

48. Tx RA (best long-term outcome)
Cataracts
Anterior shoulder cannot readily pass below the pubic symphysis.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MTX

49. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Nicotine inhaler - nasal spray - gum
Colchicine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

50. Tx hyperkalemia in CKD
Anterior shoulder cannot readily pass below the pubic symphysis.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Short-acting + 40mg prednisone x 10-14days