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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. Tx gonorrhea
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ceftriaxone 125mg IM
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

2. stranger/separation anxiety
Normal mental status; no other injuries; seen within 10 days of injury
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

3. Late deceleration
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ferrous sulfate 325mg tid
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

4. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Nuchal translucency - serum hCG - PAPP-A
(ofloxacin OR levofloxacin) +/- metronidazole
5 yo - draws person - ties shoes - skips

5. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Biopsy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Tdap - influenza - pneumovax
1 mo - eyes follow object to midline - vocalizes

6. Bacteria causing chronic sinusitis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

7. Tx chlamydia
Calcium hydroxyapatite crystals
Nicotine inhaler - nasal spray - gum
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

8. X-ray on knee?
Conrtaction monitoring along with fetal heart rate assessment
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

9. Early deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Starts at contraction. caused by increased vagal tone from fetal head compression.
Diabetes - HTN - GN
Clindamycin AND gentamicin

10. explorations
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Loratadine - fexofenadine - cetirizine
Short-acting + 40mg prednisone x 10-14days
9 mo - walks - throws - 1-3 words - 1-step commands

11. Estimated delivery date (Naegele's rule)
5+ rads
Nuchal translucency - serum hCG - PAPP-A
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
= LMP + 7 days - 3 months

12. Cockcroft-Gault equation
IV penicillin (or ampicillin)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

13. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Urinary calcium. Hyper PTH (high) >> FHH (normal)
(ofloxacin OR levofloxacin) +/- metronidazole
1 mo - eyes follow object to midline - vocalizes

14. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Ampicillin/sulbactam AND doxycycline
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Onset of labor until cervix dilation

15. GBS tx
NAC or IV NaHCO3
IV penicillin (or ampicillin)
Ofloxacin OR levofloxacin +/- metronidazole
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

16. MONA therapy
Short-acting + 40mg prednisone x 10-14days
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

17. Signs of rupture of membranes

18. Corrected serum calcium =

19. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Oxygen intervention 15h/d
Prostatitis
Calcium pyrophosphate dehydrate crystals (pseudogout)

20. Pflx for traveler's diarrhea
Metronidazole or clindamycin
Flexion - internal rotation - extension - external rotation
Fluoroquinolones
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

21. Screening for 65-76YO male smoker
Tuberculosis; sarcoidosis; hodgkin disease
Nicotine inhaler - nasal spray - gum
Aortic aneurysm
Prostatitis

22. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Monosodium urate crystals (gout)
Onset of labor until cervix dilation

23. Second stage of labor
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
1 mo - eyes follow object to midline - vocalizes
Esophagitis - gastritis - dysphagia

24. Dx PID
Cataracts
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
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

25. ADL
Ear pain - itching - inflammation/swollen canal - exudates/discharge
DTaP - hepB - Hib - rotavirus - inactivated polio
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Bathing - dressing - eating - transferring - continence - toileting

26. Nodular melanoma
Most aggressive melanoma.
Ampicillin/sulbactam AND doxycycline
4mo - sits unsupported - hand transfer - babbles
Ferrous sulfate 325mg tid

27. Only therapy to decrease mortality in stage IV COPD
Calcium oxalate crystals
Onset of labor until cervix dilation
Oxygen intervention 15h/d
Lung; SCC head & neck; RCC; breast; MM; prostate

28. variable deceleration
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Steroids + bronchodilators
MCC melanoma in Africans/Asians. Under nails - soles - palms.

29. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
0.2-0.5mg aqueous EPI IM/SubQ
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

30. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Conrtaction monitoring along with fetal heart rate assessment
<20lb - <1YO - Reacts to pain - Responds to noise
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

31. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Diphenhydramine - chlorpheniramine - hydroxyzine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Prostatitis

32. Acral lentinous melanoma
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ampicillin/sulbactam AND doxycycline
MCC melanoma in Africans/Asians. Under nails - soles - palms.
NAC or IV NaHCO3

33. MCC blindness worldwide
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Patch - bupropion - varenicline
Cataracts
6 mo - pincer - crawls - cruises - mamma - dada - byebye

34. regards hand
4mo - sits unsupported - hand transfer - babbles
Anaphylaxis
Steroids + bronchodilators
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

35. Large - irregularly shaped - prutitic - erythematous wheals
Most aggressive melanoma.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Esophagitis - gastritis - dysphagia
Urticaria

36. Causes of CKD
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ferrous sulfate 325mg tid
Diabetes - HTN - GN
Nicotine inhaler - nasal spray - gum

37. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium oxalate crystals
Clindamycin AND gentamicin

38. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
4 yo - copies triangle - catches ball - dresses self
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

39. bipyramidal - strongly positive birefringent
Urticaria
Calcium oxalate crystals
Loratadine - fexofenadine - cetirizine
Urinary calcium. Hyper PTH (high) >> FHH (normal)

40. Augments contractions
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Oxytocin (IV)
Loratadine - fexofenadine - cetirizine
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

41. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Hypomagnesemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Oxytocin (IV)

42. Complications of GAS infxn
Diabetes - HTN - GN
NAC or IV NaHCO3
Diphenhydramine - chlorpheniramine - hydroxyzine
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

43. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Measures strength of contractions
NAC or IV NaHCO3
(ofloxacin OR levofloxacin) +/- metronidazole

44. DOC for HTN in elderly
Conrtaction monitoring along with fetal heart rate assessment
Thiazides
Calcium hydroxyapatite crystals
Oxytocin (IV)

45. Screened at 11-13 weeks GA for trisomy
Anemia
Nuchal translucency - serum hCG - PAPP-A
MTX
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

46. Sx epiglottitis
Most aggressive melanoma.
(cefotetan OR cefoxitin) AND doxycycline
After delivery until delivery of placenta and membranes <30 mins
Stridor - drooling - toxic appearance

47. Fetal heart rate range
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
110-160bpm
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
(cefotetan OR cefoxitin) AND doxycycline

48. Pregnancy class D smoking cessation drugs
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Nicotine inhaler - nasal spray - gum
Hypomagnesemia
Fe deficient anemia

49. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Nicotine inhaler - nasal spray - gum
Lung; SCC head & neck; RCC; breast; MM; prostate

50. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Anemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn