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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. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Prostatitis
Diabetes - HTN - GN
Long axis of fetus to long axis of mother (longitudinal or transverse)

2. presbycusis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
110-160bpm
Age-related sensorineural hearing loss (high frequency and speech discrimination)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

3. medications causing hypercalcemia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
NAC or IV NaHCO3
Thiazdes; lithium

4. Rod shaped - rhomboid - weakly positive birefringent
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Calcium pyrophosphate dehydrate crystals (pseudogout)
Loratadine - fexofenadine - cetirizine
MCC melanoma. Radial growth.

5. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Steroids + bronchodilators
Cataracts
Calcium pyrophosphate dehydrate crystals (pseudogout)

6. Bisphospohonates sfx
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Short-acting + 40mg prednisone x 10-14days
Loratadine - fexofenadine - cetirizine
Esophagitis - gastritis - dysphagia

7. parallel play
Ceftriaxone 125mg IM
Ferrous sulfate 325mg tid
16-18 weeks GA
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

8. dyspnea - visceral edema - hypotension
4mo - sits unsupported - hand transfer - babbles
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaphylaxis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

9. Signs of rupture of membranes

10. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Hypomagnesemia
Fluoroquinolones
Fe deficient anemia

11. First stage of labor
Onset of labor until cervix dilation
Nicotine inhaler - nasal spray - gum
Esophagitis - gastritis - dysphagia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

12. Tx chlamydia
Ceftriaxone 125mg IM
Loratadine - fexofenadine - cetirizine
(ofloxacin OR levofloxacin) +/- metronidazole
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

13. Estimated delivery date (Naegele's rule)
Ask - Advise - Assess - Assist - Arrange
(cefotetan OR cefoxitin) AND doxycycline
Oxygen intervention 15h/d
= LMP + 7 days - 3 months

14. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
9 mo - walks - throws - 1-3 words - 1-step commands
Lung; SCC head & neck; RCC; breast; MM; prostate

15. IV tx for PID
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ofloxacin OR levofloxacin +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

16. causes of acute bronchitis
Cataracts
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Calcium pyrophosphate dehydrate crystals (pseudogout)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

17. Bacteria causing chronic sinusitis
Clindamycin AND gentamicin
Metronidazole or clindamycin
Short-acting + 40mg prednisone x 10-14days
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

18. Malignancies with hypercalcemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Lung; SCC head & neck; RCC; breast; MM; prostate
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium hydroxyapatite crystals

19. CKD Stages
NAC or IV NaHCO3
Monosodium urate crystals (gout)
Ferrous sulfate 325mg tid
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

20. Corrected serum calcium =

21. Recommendations for rear-facing car seat
5 yo - draws person - ties shoes - skips
<20lb - <1YO - Reacts to pain - Responds to noise
Loratadine - fexofenadine - cetirizine
Oxytocin (IV)

22. ADL
Lung; SCC head & neck; RCC; breast; MM; prostate
Long axis of fetus to long axis of mother (longitudinal or transverse)
Measures strength of contractions
Bathing - dressing - eating - transferring - continence - toileting

23. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Pneumovax - influenza
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

24. Tocodynamometer
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Steroids + bronchodilators
Aortic aneurysm
Conrtaction monitoring along with fetal heart rate assessment

25. Complications of GAS infxn
Fluoroquinolones
Esophagitis - gastritis - dysphagia
Tuberculosis; sarcoidosis; hodgkin disease
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

26. Electrolyte abnormality that increases the incidence of torsades de pointes
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Calcium pyrophosphate dehydrate crystals (pseudogout)
Hypomagnesemia
DTaP - hepB - Hib - rotavirus - inactivated polio

27. Sx of hypercalcemia
Most aggressive melanoma.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

28. Mediators released in response to allergen
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ceftriaxone 125mg IM
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

29. 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)
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

30. IUPC (intrauterine pressure catheter)
After delivery until delivery of placenta and membranes <30 mins
Anemia
= LMP + 7 days - 3 months
Measures strength of contractions

31. Screening for 65-76YO male smoker
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Tdap - influenza - pneumovax
Aortic aneurysm
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

32. Large - irregularly shaped - prutitic - erythematous wheals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Bupropion - varenicline - nicotine replacement
Urticaria
Starts at contraction. caused by increased vagal tone from fetal head compression.

33. Tx GAS ifxn
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
After delivery until delivery of placenta and membranes <30 mins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

34. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Steroids + bronchodilators
Ampicillin/sulbactam AND doxycycline
110-160bpm

35. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
0.2-0.5mg aqueous EPI IM/SubQ
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

36. Cockcroft-Gault equation
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Bupropion - varenicline - nicotine replacement
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

37. Tx bacterial vaginosis
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Onset of labor until cervix dilation
Metronidazole or clindamycin
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

38. How much radiation is associated with fetal harm?
Fluoroquinolones
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
5+ rads

39. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
9 mo - walks - throws - 1-3 words - 1-step commands
Short-acting + 40mg prednisone x 10-14days
Anaphylaxis

40. DOC for HTN in elderly
MCC melanoma. Radial growth.
Thiazides
Ask - Advise - Assess - Assist - Arrange
Diphenhydramine - chlorpheniramine - hydroxyzine

41. X-ray of ankle?
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Biopsy
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Normal mental status; no other injuries; seen within 10 days of injury

42. recognizes strangers
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
110-160bpm
6 mo - pincer - crawls - cruises - mamma - dada - byebye
0.2-0.5mg aqueous EPI IM/SubQ

43. Tx for anaphylaxis
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
After delivery until delivery of placenta and membranes <30 mins

44. Tx RA (best long-term outcome)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
MTX
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Long axis of fetus to long axis of mother (longitudinal or transverse)

45. Four cardinal fetal movements
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ampicillin/sulbactam AND doxycycline
Urticaria
Flexion - internal rotation - extension - external rotation

46. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
Alpha-1 antitrypsin deficiency
2 mo - eyes follow object past midline - rolls over - laughs - squeals
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

47. The five A's of smoking cessation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange
Flexion - internal rotation - extension - external rotation

48. Pregnancy class D smoking cessation drugs
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MCC melanoma. Radial growth.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Nicotine inhaler - nasal spray - gum

49. Fe deficient anemia tx
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)
Lung; SCC head & neck; RCC; breast; MM; prostate
Hypomagnesemia

50. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Long axis of fetus to long axis of mother (longitudinal or transverse)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Patch - bupropion - varenicline