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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.
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. Immunizations at visit for 6MO
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Fe deficient anemia
DTaP - hepB - Hib - rotavirus - inactivated polio
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

2. presbycusis
Urticaria
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Clindamycin AND gentamicin
Ask - Advise - Assess - Assist - Arrange

3. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
6-9MO
Hypomagnesemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals

4. Immunizations for COPD patients
Pneumovax - influenza
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)
Thiazides

5. Early deceleration
4 yo - copies triangle - catches ball - dresses self
Ampicillin/sulbactam AND doxycycline
Starts at contraction. caused by increased vagal tone from fetal head compression.
Colchicine

6. IUPC (intrauterine pressure catheter)
5+ rads
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Diphenhydramine - chlorpheniramine - hydroxyzine
Measures strength of contractions

7. Tx for anaphylaxis
4mo - sits unsupported - hand transfer - babbles
0.2-0.5mg aqueous EPI IM/SubQ
Normal mental status; no other injuries; seen within 10 days of injury
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

8. Dx criteria for RA
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
IV penicillin (or ampicillin)
Diabetes - HTN - GN
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

9. Low serum iron - low MCV - low ferritin - +stool guaiac
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Fe deficient anemia
Stridor - drooling - toxic appearance

10. Causes of CKD
Diabetes - HTN - GN
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Nuchal translucency - serum hCG - PAPP-A

11. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Nuchal translucency - serum hCG - PAPP-A
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

12. stranger/separation anxiety
9 mo - walks - throws - 1-3 words - 1-step commands
Anaphylaxis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
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)

13. Screening for 65-76YO male smoker
Aortic aneurysm
DTaP - hepB - Hib - rotavirus - inactivated polio
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)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

14. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Normal mental status; no other injuries; seen within 10 days of injury

15. Superficial spreading melanoma
MCC melanoma. Radial growth.
Monosodium urate crystals (gout)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Bathing - dressing - eating - transferring - continence - toileting

16. Corrected serum calcium =

17. Sx of hypercalcemia
Cataracts
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Stridor - drooling - toxic appearance
Ask - Advise - Assess - Assist - Arrange

18. shoulder dystocia
Normal mental status; no other injuries; seen within 10 days of injury
Pneumovax - influenza
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Anterior shoulder cannot readily pass below the pubic symphysis.

19. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Ofloxacin OR levofloxacin +/- metronidazole
6-9MO
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

20. DOC for HTN in elderly
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Thiazides
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

21. Screened at 11-13 weeks GA for trisomy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Tdap - influenza - pneumovax
Nuchal translucency - serum hCG - PAPP-A

22. group play - gender - knows name
Thiazdes; lithium
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ask - Advise - Assess - Assist - Arrange
3 yo - identify body part - copies square - hops - throws - past tense - story telling

23. Oral tx for PID
Hypomagnesemia
Ofloxacin OR levofloxacin +/- metronidazole
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fluoroquinolones

24. Tocodynamometer
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Conrtaction monitoring along with fetal heart rate assessment
NAC or IV NaHCO3

25. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Short-acting + 40mg prednisone x 10-14days
After delivery until delivery of placenta and membranes <30 mins
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

26. identifies left - right
Esophagitis - gastritis - dysphagia
= LMP + 7 days - 3 months
Lung; SCC head & neck; RCC; breast; MM; prostate
6 yo

27. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Prostatitis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

28. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Calcium pyrophosphate dehydrate crystals (pseudogout)
Nicotine inhaler - nasal spray - gum
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

29. social interaction
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Starts at contraction. caused by increased vagal tone from fetal head compression.
4 yo - copies triangle - catches ball - dresses self
Conrtaction monitoring along with fetal heart rate assessment

30. explorations
Hypomagnesemia
Fluoroquinolones
9 mo - walks - throws - 1-3 words - 1-step commands
5+ rads

31. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
1 mo - eyes follow object to midline - vocalizes
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Nicotine inhaler - nasal spray - gum

32. Tx RA (best long-term outcome)
Lung; SCC head & neck; RCC; breast; MM; prostate
MTX
Anaphylaxis
Calcium pyrophosphate dehydrate crystals (pseudogout)

33. First stage of labor
Cataracts
Onset of labor until cervix dilation
Angioedema
NAC or IV NaHCO3

34. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Metronidazole or clindamycin
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Conrtaction monitoring along with fetal heart rate assessment

35. Mediators released in response to allergen
6 yo
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Lung; SCC head & neck; RCC; breast; MM; prostate
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

36. Optimal time for trisomy screen
Calcium pyrophosphate dehydrate crystals (pseudogout)
16-18 weeks GA
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.

37. X-ray of ankle?
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium hydroxyapatite crystals
Normal mental status; no other injuries; seen within 10 days of injury

38. variable deceleration
Bupropion - varenicline - nicotine replacement
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

39. How much radiation is associated with fetal harm?
Pneumovax - influenza
DTaP - hepB - Hib - rotavirus - inactivated polio
Bathing - dressing - eating - transferring - continence - toileting
5+ rads

40. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Nuchal translucency - serum hCG - PAPP-A
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

41. Tx acute gout
Monosodium urate crystals (gout)
Colchicine
MTX
6 mo - pincer - crawls - cruises - mamma - dada - byebye

42. Tx gonorrhea
Ceftriaxone 125mg IM
MCC melanoma. Radial growth.
Metronidazole or clindamycin
Angioedema

43. tx shoulder dystocia

44. Tx chlamydia
Ferrous sulfate 325mg tid
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Calcium hydroxyapatite crystals
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

45. IV tx for PID
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Clindamycin AND gentamicin
Onset of labor until cervix dilation
Ceftriaxone 125mg IM

46. Pregnancy class D smoking cessation drugs
Patch - bupropion - varenicline
Steroids + bronchodilators
Measures strength of contractions
Nicotine inhaler - nasal spray - gum

47. Dx bacterial rhinosinusitis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
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)
Ferrous sulfate 325mg tid
2 mo - eyes follow object past midline - rolls over - laughs - squeals

48. regards hand
4mo - sits unsupported - hand transfer - babbles
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Thiazdes; lithium
Biopsy

49. Smoking cessation agents
Stridor - drooling - toxic appearance
Bupropion - varenicline - nicotine replacement
Prostatitis
MCC melanoma in Africans/Asians. Under nails - soles - palms.

50. MCC blindness worldwide
Cataracts
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Bathing - dressing - eating - transferring - continence - toileting
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2