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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. Late deceleration
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Bupropion - varenicline - nicotine replacement
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Fluoroquinolones

2. Superficial spreading melanoma
MCC melanoma. Radial growth.
Thiazdes; lithium
Measures strength of contractions
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

3. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ask - Advise - Assess - Assist - Arrange

4. IV tx for PID
0.2-0.5mg aqueous EPI IM/SubQ
Oxygen intervention 15h/d
6-9MO
(cefotetan OR cefoxitin) AND doxycycline

5. Tx GAS ifxn
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ferrous sulfate 325mg tid
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

6. medications causing hypercalcemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Patch - bupropion - varenicline
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thiazdes; lithium

7. Pregnancy class C smoking cessation drugs
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Fluoroquinolones
Oxygen intervention 15h/d
Patch - bupropion - varenicline

8. MONA therapy
Measures strength of contractions
3 yo - identify body part - copies square - hops - throws - past tense - story telling
MCC melanoma. Radial growth.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

9. Tx otitis media
6 yo
Pneumovax - influenza
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

10. parallel play
MCC melanoma in Africans/Asians. Under nails - soles - palms.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MTX
Hypomagnesemia

11. Dx bacterial rhinosinusitis
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Prostatitis
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)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

12. Tender - boggy prostate. Dx?
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Prostatitis

13. stranger/separation anxiety
Patch - bupropion - varenicline
Thiazides
Steroids + bronchodilators
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

14. Recommendations for rear-facing car seat
Pneumovax - influenza
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
<20lb - <1YO - Reacts to pain - Responds to noise
Biopsy

15. Early deceleration
Normal mental status; no other injuries; seen within 10 days of injury
Nuchal translucency - serum hCG - PAPP-A
1 mo - eyes follow object to midline - vocalizes
Starts at contraction. caused by increased vagal tone from fetal head compression.

16. Augments contractions
6 yo
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Oxytocin (IV)
1 mo - eyes follow object to midline - vocalizes

17. Fe deficient anemia tx
Ferrous sulfate 325mg tid
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

18. tx shoulder dystocia

19. Nodular melanoma
Most aggressive melanoma.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

20. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anemia
Urticaria
Esophagitis - gastritis - dysphagia

21. explorations
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
9 mo - walks - throws - 1-3 words - 1-step commands
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Colchicine

22. Sx otitis externa
Tdap - influenza - pneumovax
Hypomagnesemia
Ask - Advise - Assess - Assist - Arrange
Ear pain - itching - inflammation/swollen canal - exudates/discharge

23. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Oxytocin (IV)
Onset of labor until cervix dilation
Age-related sensorineural hearing loss (high frequency and speech discrimination)

24. MCC blindness worldwide
Biopsy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
<20lb - <1YO - Reacts to pain - Responds to noise
Cataracts

25. Optimal time for trisomy screen
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Clindamycin AND gentamicin
16-18 weeks GA

26. bipyramidal - strongly positive birefringent
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Calcium oxalate crystals
Ceftriaxone 125mg IM
16-18 weeks GA

27. Screening for 65-76YO male smoker
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Aortic aneurysm
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

28. Unstable angina vs MI Dx tests
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
= LMP + 7 days - 3 months
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

29. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Most aggressive melanoma.
Metronidazole or clindamycin
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

30. cystoplasmic inclusions - not birefringent
MCC melanoma in Africans/Asians. Under nails - soles - palms.
MCC melanoma. Radial growth.
Calcium hydroxyapatite crystals
Diabetes - HTN - GN

31. Only therapy to decrease mortality in stage IV COPD
<20lb - <1YO - Reacts to pain - Responds to noise
Oxygen intervention 15h/d
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1 mo - eyes follow object to midline - vocalizes

32. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Thiazides
Flexion - internal rotation - extension - external rotation
4mo - sits unsupported - hand transfer - babbles

33. Lentigo Maligna
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Fe deficient anemia
Ofloxacin OR levofloxacin +/- metronidazole

34. writes name - counts 10 objects
Fluoroquinolones
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Diabetes - HTN - GN
5 yo - draws person - ties shoes - skips

35. Sx peritonsillar abscess
Diphenhydramine - chlorpheniramine - hydroxyzine
Tdap - influenza - pneumovax
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ampicillin/sulbactam AND doxycycline

36. Tx bacterial vaginosis
Metronidazole or clindamycin
Cataracts
Ask - Advise - Assess - Assist - Arrange
Fe deficient anemia

37. X-ray of ankle?
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Normal mental status; no other injuries; seen within 10 days of injury
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)
6 yo

38. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Normal mental status; no other injuries; seen within 10 days of injury
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Diabetes - HTN - GN
Anemia

39. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Measures strength of contractions
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

40. needles - strong negative birefringent (yellow crystals parallel light)
After delivery until delivery of placenta and membranes <30 mins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Monosodium urate crystals (gout)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

41. complications of otitis media
Cataracts
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Hypomagnesemia
Ampicillin/sulbactam AND doxycycline

42. 2nd generation antihistamines
Oxytocin (IV)
Diphenhydramine - chlorpheniramine - hydroxyzine
Ampicillin/sulbactam AND doxycycline
Loratadine - fexofenadine - cetirizine

43. Tx of traveler's diarrhea
DTaP - hepB - Hib - rotavirus - inactivated polio
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Onset of labor until cervix dilation

44. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
4 yo - copies triangle - catches ball - dresses self
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
<20lb - <1YO - Reacts to pain - Responds to noise

45. Causes of CKD
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
<20lb - <1YO - Reacts to pain - Responds to noise
Diabetes - HTN - GN
Fluoroquinolones

46. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
4mo - sits unsupported - hand transfer - babbles

47. Corrected serum calcium =

48. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Starts at contraction. caused by increased vagal tone from fetal head compression.
Steroids + bronchodilators
6-9MO

49. IUPC (intrauterine pressure catheter)
Angioedema
Measures strength of contractions
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Clindamycin AND gentamicin

50. Immunizations at visit for 6MO
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
DTaP - hepB - Hib - rotavirus - inactivated polio
(cefotetan OR cefoxitin) AND doxycycline
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)