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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. bacteria causing pharyngitis
<20lb - <1YO - Reacts to pain - Responds to noise
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
5 yo - draws person - ties shoes - skips
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

2. Nonfunctioning nodules > 1cm require _____
Prostatitis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Biopsy
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

3. Early deceleration
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Onset of labor until cervix dilation
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

4. Screening for 65-76YO male smoker
Short-acting + 40mg prednisone x 10-14days
Cataracts
16-18 weeks GA
Aortic aneurysm

5. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Clindamycin AND gentamicin
NAC or IV NaHCO3
Pneumovax - influenza
Calcium pyrophosphate dehydrate crystals (pseudogout)

6. Sx otitis media
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Aortic aneurysm
Clindamycin AND gentamicin
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

7. Dx PID
2 mo - eyes follow object past midline - rolls over - laughs - squeals
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Angioedema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

8. painless - deep - subQ swelling (periorbital - circumoral - facial)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Esophagitis - gastritis - dysphagia
Angioedema
Nicotine inhaler - nasal spray - gum

9. ADL
Diabetes - HTN - GN
Monosodium urate crystals (gout)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Bathing - dressing - eating - transferring - continence - toileting

10. tx shoulder dystocia

11. dyspnea - visceral edema - hypotension
Most aggressive melanoma.
Fe deficient anemia
= LMP + 7 days - 3 months
Anaphylaxis

12. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Lung; SCC head & neck; RCC; breast; MM; prostate

13. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Tdap - influenza - pneumovax
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

14. Large - irregularly shaped - prutitic - erythematous wheals
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Urticaria
Angioedema
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

15. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
DTaP - hepB - Hib - rotavirus - inactivated polio
Anaphylaxis

16. Tx acute sinusitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Nuchal translucency - serum hCG - PAPP-A
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

17. Tx chlamydia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

18. medications causing hypercalcemia
Thiazdes; lithium
After delivery until delivery of placenta and membranes <30 mins
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Oxygen intervention 15h/d

19. Regards human face - eye contact
Tuberculosis; sarcoidosis; hodgkin disease
1 mo - eyes follow object to midline - vocalizes
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

20. Tx bacterial vaginosis
<20lb - <1YO - Reacts to pain - Responds to noise
Patch - bupropion - varenicline
NAC or IV NaHCO3
Metronidazole or clindamycin

21. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
4 yo - copies triangle - catches ball - dresses self
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium oxalate crystals

22. Tx for anaphylaxis
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)
0.2-0.5mg aqueous EPI IM/SubQ
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Conrtaction monitoring along with fetal heart rate assessment

23. Tx for thyroid storm
Diphenhydramine - chlorpheniramine - hydroxyzine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

24. Late deceleration
6 mo - pincer - crawls - cruises - mamma - dada - byebye
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Colchicine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

25. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
5+ rads
Short-acting + 40mg prednisone x 10-14days
Clindamycin AND gentamicin

26. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Tuberculosis; sarcoidosis; hodgkin disease
<20lb - <1YO - Reacts to pain - Responds to noise
Clindamycin AND gentamicin

27. needles - strong negative birefringent (yellow crystals parallel light)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Alpha-1 antitrypsin deficiency
Monosodium urate crystals (gout)

28. Four cardinal fetal movements
MTX
Flexion - internal rotation - extension - external rotation
Ear pain - itching - inflammation/swollen canal - exudates/discharge
After delivery until delivery of placenta and membranes <30 mins

29. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Long axis of fetus to long axis of mother (longitudinal or transverse)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

30. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Short-acting + 40mg prednisone x 10-14days
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

31. Immunizations at visit for 6MO
Bathing - dressing - eating - transferring - continence - toileting
DTaP - hepB - Hib - rotavirus - inactivated polio
Bupropion - varenicline - nicotine replacement
Prostatitis

32. Fetal lie
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

33. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Calcium oxalate crystals

34. Tx otitis media
5+ rads
(ofloxacin OR levofloxacin) +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

35. group play - gender - knows name
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Oxygen intervention 15h/d
3 yo - identify body part - copies square - hops - throws - past tense - story telling
DTaP - hepB - Hib - rotavirus - inactivated polio

36. Recommended folic acid daily dose
Normal mental status; no other injuries; seen within 10 days of injury
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
NAC or IV NaHCO3
3 yo - identify body part - copies square - hops - throws - past tense - story telling

37. 1st generation antihistamines
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Diphenhydramine - chlorpheniramine - hydroxyzine
0.2-0.5mg aqueous EPI IM/SubQ

38. Sx otitis externa
5+ rads
DTaP - hepB - Hib - rotavirus - inactivated polio
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. identifies left - right
Fe deficient anemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
DTaP - hepB - Hib - rotavirus - inactivated polio
6 yo

40. IV tx for PID
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Fluoroquinolones
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)
(cefotetan OR cefoxitin) AND doxycycline

41. Immunizations for COPD patients
Loratadine - fexofenadine - cetirizine
<20lb - <1YO - Reacts to pain - Responds to noise
Pneumovax - influenza
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

42. Fetal heart rate range
Oxytocin (IV)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
110-160bpm
NAC or IV NaHCO3

43. parallel play
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
IV penicillin (or ampicillin)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

44. GBS tx
IV penicillin (or ampicillin)
Calcium oxalate crystals
DTaP - hepB - Hib - rotavirus - inactivated polio
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

45. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Lung; SCC head & neck; RCC; breast; MM; prostate

46. Malignancies with hypercalcemia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Angioedema
Lung; SCC head & neck; RCC; breast; MM; prostate
Normal mental status; no other injuries; seen within 10 days of injury

47. Emphysema - <45YO - nonsmoker
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Alpha-1 antitrypsin deficiency
Diabetes - HTN - GN
Normal mental status; no other injuries; seen within 10 days of injury

48. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anterior shoulder cannot readily pass below the pubic symphysis.
Bathing - dressing - eating - transferring - continence - toileting

49. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Stridor - drooling - toxic appearance
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Clindamycin AND gentamicin

50. complications of otitis media
0.2-0.5mg aqueous EPI IM/SubQ
Angioedema
6-9MO
Masoiditis - bacterial meningitis - brain abscess - subdural empyema