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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. writes name - counts 10 objects
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5 yo - draws person - ties shoes - skips

2. dyspnea - visceral edema - hypotension
9 mo - walks - throws - 1-3 words - 1-step commands
Long axis of fetus to long axis of mother (longitudinal or transverse)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaphylaxis

3. Sx peritonsillar abscess
Stridor - drooling - toxic appearance
(cefotetan OR cefoxitin) AND doxycycline
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

4. Screening for 65-76YO male smoker
Fluoroquinolones
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Aortic aneurysm
Fe deficient anemia

5. Age by which child says 'mama' and 'dada'
Onset of labor until cervix dilation
Biopsy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
6-9MO

6. tx shoulder dystocia

7. Superficial spreading melanoma
Flexion - internal rotation - extension - external rotation
MCC melanoma. Radial growth.
Bathing - dressing - eating - transferring - continence - toileting
4 yo - copies triangle - catches ball - dresses self

8. Granulomatous causes of hypercalcemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Tuberculosis; sarcoidosis; hodgkin disease
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ear pain - itching - inflammation/swollen canal - exudates/discharge

9. Estimated delivery date (Naegele's rule)
Normal mental status; no other injuries; seen within 10 days of injury
= LMP + 7 days - 3 months
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Oxygen intervention 15h/d

10. CKD Stages
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Clindamycin AND gentamicin

11. First stage of labor
Calcium hydroxyapatite crystals
IV penicillin (or ampicillin)
Onset of labor until cervix dilation
Stridor - drooling - toxic appearance

12. Tx otitis media
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Conrtaction monitoring along with fetal heart rate assessment
MCC melanoma in Africans/Asians. Under nails - soles - palms.

13. Tx GAS ifxn
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Steroids + bronchodilators
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

14. social interaction
4 yo - copies triangle - catches ball - dresses self
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Loratadine - fexofenadine - cetirizine
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

15. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Pneumovax - influenza
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid

16. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Onset of labor until cervix dilation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

17. 2nd generation antihistamines
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Loratadine - fexofenadine - cetirizine
110-160bpm
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

18. Dx criteria for RA
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Patch - bupropion - varenicline
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

19. 1st generation antihistamines
Nuchal translucency - serum hCG - PAPP-A
Diphenhydramine - chlorpheniramine - hydroxyzine
Clindamycin AND gentamicin
110-160bpm

20. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Oxygen intervention 15h/d
Urticaria
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)

21. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
5+ rads
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Oxytocin (IV)

22. Immunizations for COPD patients
Stridor - drooling - toxic appearance
Starts at contraction. caused by increased vagal tone from fetal head compression.
Pneumovax - influenza
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

23. Mediators released in response to allergen
Most aggressive melanoma.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
9 mo - walks - throws - 1-3 words - 1-step commands
Loratadine - fexofenadine - cetirizine

24. Low serum iron - low MCV - low ferritin - +stool guaiac
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Fe deficient anemia
Ferrous sulfate 325mg tid
Pneumovax - influenza

25. Tx RA (best long-term outcome)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Normal mental status; no other injuries; seen within 10 days of injury
NAC or IV NaHCO3
MTX

26. Only therapy to decrease mortality in stage IV COPD
Flexion - internal rotation - extension - external rotation
Ask - Advise - Assess - Assist - Arrange
Oxygen intervention 15h/d
Urinary calcium. Hyper PTH (high) >> FHH (normal)

27. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Urticaria
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Short-acting + 40mg prednisone x 10-14days

28. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
<20lb - <1YO - Reacts to pain - Responds to noise
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

29. Early deceleration
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Starts at contraction. caused by increased vagal tone from fetal head compression.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

30. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
NAC or IV NaHCO3
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

31. Pregnancy class D smoking cessation drugs
IV penicillin (or ampicillin)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Nicotine inhaler - nasal spray - gum
Bupropion - varenicline - nicotine replacement

32. Tx bacterial vaginosis
Nicotine inhaler - nasal spray - gum
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Metronidazole or clindamycin

33. Large - irregularly shaped - prutitic - erythematous wheals
Angioedema
5+ rads
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Urticaria

34. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
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)
Colchicine
MCC melanoma. Radial growth.

35. IV tx for PID
Ampicillin/sulbactam AND doxycycline
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
2 mo - eyes follow object past midline - rolls over - laughs - squeals

36. IUPC (intrauterine pressure catheter)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Measures strength of contractions
1 mo - eyes follow object to midline - vocalizes

37. Augments contractions
Oxytocin (IV)
Ofloxacin OR levofloxacin +/- metronidazole
Ceftriaxone 125mg IM
Bathing - dressing - eating - transferring - continence - toileting

38. explorations
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
9 mo - walks - throws - 1-3 words - 1-step commands
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

39. Dx bacterial rhinosinusitis
Thiazdes; lithium
Ampicillin/sulbactam AND doxycycline
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)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

40. Bacteria causing chronic sinusitis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ask - Advise - Assess - Assist - Arrange
Short-acting + 40mg prednisone x 10-14days
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

41. Acral lentinous melanoma
6-9MO
Loratadine - fexofenadine - cetirizine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MCC melanoma in Africans/Asians. Under nails - soles - palms.

42. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Diabetes - HTN - GN

43. social smile - parent recognition
Biopsy
Lung; SCC head & neck; RCC; breast; MM; prostate
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

44. Pregnancy class C smoking cessation drugs
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
0.2-0.5mg aqueous EPI IM/SubQ
Aortic aneurysm
Patch - bupropion - varenicline

45. X-ray on knee?
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
6 yo
Age-related sensorineural hearing loss (high frequency and speech discrimination)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

46. Fetal lie
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Pneumovax - influenza

47. regards hand
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
6 yo
Fluoroquinolones
4mo - sits unsupported - hand transfer - babbles

48. Immunizations for adult 65YO+
<20lb - <1YO - Reacts to pain - Responds to noise
Ferrous sulfate 325mg tid
Tdap - influenza - pneumovax
Long axis of fetus to long axis of mother (longitudinal or transverse)

49. Dx PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium hydroxyapatite crystals
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

50. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
<20lb - <1YO - Reacts to pain - Responds to noise
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)