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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. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Lung; SCC head & neck; RCC; breast; MM; prostate
1 mo - eyes follow object to midline - vocalizes
NAC or IV NaHCO3
Bupropion - varenicline - nicotine replacement

2. ADL
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
5 yo - draws person - ties shoes - skips
Patch - bupropion - varenicline
Bathing - dressing - eating - transferring - continence - toileting

3. Granulomatous causes of hypercalcemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Tuberculosis; sarcoidosis; hodgkin disease
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

4. stranger/separation anxiety
Most aggressive melanoma.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Monosodium urate crystals (gout)

5. medications causing hypercalcemia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Thiazdes; lithium
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Cataracts

6. Age by which child says 'mama' and 'dada'
2 mo - eyes follow object past midline - rolls over - laughs - squeals
6-9MO
Ferrous sulfate 325mg tid
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

7. Lentigo Maligna
Tuberculosis; sarcoidosis; hodgkin disease
Lung; SCC head & neck; RCC; breast; MM; prostate
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

8. Fetal heart rate range
110-160bpm
Short-acting + 40mg prednisone x 10-14days
Long axis of fetus to long axis of mother (longitudinal or transverse)
Biopsy

9. parallel play
Ampicillin/sulbactam AND doxycycline
Thiazides
NAC or IV NaHCO3
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

10. Smoking cessation agents
Tdap - influenza - pneumovax
Diabetes - HTN - GN
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Bupropion - varenicline - nicotine replacement

11. Mediators released in response to allergen
Thiazdes; lithium
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Aortic aneurysm

12. Sx of hypercalcemia
Thiazdes; lithium
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ask - Advise - Assess - Assist - Arrange

13. bacteria causing pharyngitis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
9 mo - walks - throws - 1-3 words - 1-step commands
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

14. Tx gonorrhea
Thiazides
Ceftriaxone 125mg IM
Nuchal translucency - serum hCG - PAPP-A
Clindamycin AND gentamicin

15. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Bathing - dressing - eating - transferring - continence - toileting
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

16. group play - gender - knows name
Ampicillin/sulbactam AND doxycycline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
3 yo - identify body part - copies square - hops - throws - past tense - story telling

17. 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)
Ask - Advise - Assess - Assist - Arrange
9 mo - walks - throws - 1-3 words - 1-step commands
Nicotine inhaler - nasal spray - gum

18. Dx PID
Diphenhydramine - chlorpheniramine - hydroxyzine
Angioedema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
DTaP - hepB - Hib - rotavirus - inactivated polio

19. Tx of traveler's diarrhea
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Steroids + bronchodilators
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

20. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
Long axis of fetus to long axis of mother (longitudinal or transverse)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
IV penicillin (or ampicillin)

21. Rod shaped - rhomboid - weakly positive birefringent
Calcium oxalate crystals
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium pyrophosphate dehydrate crystals (pseudogout)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

22. Bacteria causing chronic sinusitis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Tuberculosis; sarcoidosis; hodgkin disease
Ferrous sulfate 325mg tid

23. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Bupropion - varenicline - nicotine replacement
Fe deficient anemia
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Pneumovax - influenza

24. Tx for anaphylaxis
5 yo - draws person - ties shoes - skips
Colchicine
0.2-0.5mg aqueous EPI IM/SubQ
Pneumovax - influenza

25. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
5+ rads
16-18 weeks GA

26. regards hand
0.2-0.5mg aqueous EPI IM/SubQ
Esophagitis - gastritis - dysphagia
4mo - sits unsupported - hand transfer - babbles
Short-acting + 40mg prednisone x 10-14days

27. Pflx for traveler's diarrhea
1 mo - eyes follow object to midline - vocalizes
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Fluoroquinolones
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

28. Augments contractions
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Oxytocin (IV)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

29. X-ray on knee?
Anaphylaxis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

30. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ceftriaxone 125mg IM

31. Optimal time for trisomy screen
Thiazdes; lithium
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Starts at contraction. caused by increased vagal tone from fetal head compression.
16-18 weeks GA

32. Dx bacterial rhinosinusitis
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)
Oxygen intervention 15h/d
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
(cefotetan OR cefoxitin) AND doxycycline

33. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

34. Regards human face - eye contact
MCC melanoma in Africans/Asians. Under nails - soles - palms.
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
1 mo - eyes follow object to midline - vocalizes

35. Tx otitis media
MTX
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Tuberculosis; sarcoidosis; hodgkin disease
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

36. writes name - counts 10 objects
Alpha-1 antitrypsin deficiency
Loratadine - fexofenadine - cetirizine
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5 yo - draws person - ties shoes - skips

37. social interaction
Stridor - drooling - toxic appearance
Bathing - dressing - eating - transferring - continence - toileting
4 yo - copies triangle - catches ball - dresses self
Short-acting + 40mg prednisone x 10-14days

38. Sx otitis media
DTaP - hepB - Hib - rotavirus - inactivated polio
Ask - Advise - Assess - Assist - Arrange
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
After delivery until delivery of placenta and membranes <30 mins

39. dyspnea - visceral edema - hypotension
Ofloxacin OR levofloxacin +/- metronidazole
Anaphylaxis
(cefotetan OR cefoxitin) AND doxycycline
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

40. Signs of rupture of membranes

41. Malignancies with hypercalcemia
Short-acting + 40mg prednisone x 10-14days
Lung; SCC head & neck; RCC; breast; MM; prostate
6-9MO
4mo - sits unsupported - hand transfer - babbles

42. variable deceleration
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Bupropion - varenicline - nicotine replacement
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

43. Tocodynamometer
Aortic aneurysm
Flexion - internal rotation - extension - external rotation
Conrtaction monitoring along with fetal heart rate assessment
Urticaria

44. First stage of labor
DTaP - hepB - Hib - rotavirus - inactivated polio
Onset of labor until cervix dilation
Alpha-1 antitrypsin deficiency
Esophagitis - gastritis - dysphagia

45. Nodular melanoma
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Most aggressive melanoma.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

46. Unstable angina vs MI Dx tests
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Patch - bupropion - varenicline

47. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
(cefotetan OR cefoxitin) AND doxycycline
Nuchal translucency - serum hCG - PAPP-A
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

48. Sx otitis externa
Ferrous sulfate 325mg tid
Ear pain - itching - inflammation/swollen canal - exudates/discharge
9 mo - walks - throws - 1-3 words - 1-step commands
Normal mental status; no other injuries; seen within 10 days of injury

49. Dx bacterial vaginosis
Clindamycin AND gentamicin
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Alpha-1 antitrypsin deficiency
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

50. Sx peritonsillar abscess
Stridor - drooling - toxic appearance
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Nicotine inhaler - nasal spray - gum
Calcium hydroxyapatite crystals