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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. regards hand
Nuchal translucency - serum hCG - PAPP-A
4mo - sits unsupported - hand transfer - babbles
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

2. Rod shaped - rhomboid - weakly positive birefringent
Calcium hydroxyapatite crystals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

3. IV tx for PID
Thiazides
Ofloxacin OR levofloxacin +/- metronidazole
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Measures strength of contractions

4. Tx otitis media
(cefotetan OR cefoxitin) AND doxycycline
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Short-acting + 40mg prednisone x 10-14days

5. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Thiazides
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ampicillin/sulbactam AND doxycycline

6. Age by which child says 'mama' and 'dada'
(ofloxacin OR levofloxacin) +/- metronidazole
6-9MO
MCC melanoma. Radial growth.
IV penicillin (or ampicillin)

7. stranger/separation anxiety
Anemia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

8. Nonfunctioning nodules > 1cm require _____
(ofloxacin OR levofloxacin) +/- metronidazole
Ferrous sulfate 325mg tid
Lung; SCC head & neck; RCC; breast; MM; prostate
Biopsy

9. GBS tx
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
4mo - sits unsupported - hand transfer - babbles
6 mo - pincer - crawls - cruises - mamma - dada - byebye
IV penicillin (or ampicillin)

10. social interaction
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Stridor - drooling - toxic appearance
Tuberculosis; sarcoidosis; hodgkin disease
4 yo - copies triangle - catches ball - dresses self

11. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
NAC or IV NaHCO3
Prostatitis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

12. Bacteria causing chronic sinusitis
Tdap - influenza - pneumovax
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urticaria

13. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
DTaP - hepB - Hib - rotavirus - inactivated polio

14. Late deceleration
Normal mental status; no other injuries; seen within 10 days of injury
Nuchal translucency - serum hCG - PAPP-A
Patch - bupropion - varenicline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

15. Tx acute sinusitis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium oxalate crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

16. social smile - parent recognition
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
Flexion - internal rotation - extension - external rotation
2 mo - eyes follow object past midline - rolls over - laughs - squeals

17. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Diphenhydramine - chlorpheniramine - hydroxyzine
Cataracts
Thiazides

18. Sx epiglottitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Stridor - drooling - toxic appearance
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

19. MCC blindness worldwide
Thiazides
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Cataracts
Calcium hydroxyapatite crystals

20. CKD Stages
6 mo - pincer - crawls - cruises - mamma - dada - byebye
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
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

21. Tx for anaphylaxis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Biopsy
Oxygen intervention 15h/d
0.2-0.5mg aqueous EPI IM/SubQ

22. Emphysema - <45YO - nonsmoker
Ceftriaxone 125mg IM
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Alpha-1 antitrypsin deficiency
4mo - sits unsupported - hand transfer - babbles

23. Screening for 65-76YO male smoker
Aortic aneurysm
6 yo
Long axis of fetus to long axis of mother (longitudinal or transverse)
Most aggressive melanoma.

24. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Anaphylaxis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urticaria

25. presbycusis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Alpha-1 antitrypsin deficiency
Normal mental status; no other injuries; seen within 10 days of injury
Age-related sensorineural hearing loss (high frequency and speech discrimination)

26. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Loratadine - fexofenadine - cetirizine
Ask - Advise - Assess - Assist - Arrange
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

27. Unstable angina vs MI Dx tests
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Measures strength of contractions
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

28. Immunizations for COPD patients
Calcium pyrophosphate dehydrate crystals (pseudogout)
(ofloxacin OR levofloxacin) +/- metronidazole
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Pneumovax - influenza

29. IADL
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Bathing - dressing - eating - transferring - continence - toileting
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

30. The five A's of smoking cessation
Colchicine
1 mo - eyes follow object to midline - vocalizes
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ask - Advise - Assess - Assist - Arrange

31. shoulder dystocia
4 yo - copies triangle - catches ball - dresses self
Urticaria
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Anterior shoulder cannot readily pass below the pubic symphysis.

32. Oral tx for PID
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(ofloxacin OR levofloxacin) +/- metronidazole
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

33. Tx hyperkalemia in CKD
DTaP - hepB - Hib - rotavirus - inactivated polio
Bathing - dressing - eating - transferring - continence - toileting
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
6 mo - pincer - crawls - cruises - mamma - dada - byebye

34. bacteria causing pharyngitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Normal mental status; no other injuries; seen within 10 days of injury

35. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

36. First stage of labor
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Onset of labor until cervix dilation
1 mo - eyes follow object to midline - vocalizes
Thiazides

37. group play - gender - knows name
DTaP - hepB - Hib - rotavirus - inactivated polio
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Bathing - dressing - eating - transferring - continence - toileting

38. Augments contractions
Long axis of fetus to long axis of mother (longitudinal or transverse)
Short-acting + 40mg prednisone x 10-14days
Oxytocin (IV)
0.2-0.5mg aqueous EPI IM/SubQ

39. Immunizations at visit for 6MO
Thiazdes; lithium
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
DTaP - hepB - Hib - rotavirus - inactivated polio
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

40. Malignancies with hypercalcemia
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Esophagitis - gastritis - dysphagia
Lung; SCC head & neck; RCC; breast; MM; prostate

41. Nodular melanoma
Most aggressive melanoma.
DTaP - hepB - Hib - rotavirus - inactivated polio
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

42. Dx bacterial vaginosis
NAC or IV NaHCO3
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Fluoroquinolones

43. Third stage of labor
Steroids + bronchodilators
After delivery until delivery of placenta and membranes <30 mins
5 yo - draws person - ties shoes - skips
Anterior shoulder cannot readily pass below the pubic symphysis.

44. Superficial spreading melanoma
Stridor - drooling - toxic appearance
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
MCC melanoma. Radial growth.
0.2-0.5mg aqueous EPI IM/SubQ

45. MONA therapy
DTaP - hepB - Hib - rotavirus - inactivated polio
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

46. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Conrtaction monitoring along with fetal heart rate assessment
Urinary calcium. Hyper PTH (high) >> FHH (normal)

47. Lentigo Maligna
Ceftriaxone 125mg IM
Bathing - dressing - eating - transferring - continence - toileting
Colchicine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

48. Tender - boggy prostate. Dx?
Anemia
Prostatitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

49. IV tx for PID
= LMP + 7 days - 3 months
(cefotetan OR cefoxitin) AND doxycycline
Bupropion - varenicline - nicotine replacement
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

50. Dx criteria for RA
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Oxytocin (IV)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level