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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. Screened at 16-20 weeks GA for trisomy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

2. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease
5+ rads
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

3. Bacteria causing chronic sinusitis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
MCC melanoma. Radial growth.
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

4. dyspnea - visceral edema - hypotension
Anaphylaxis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Oxygen intervention 15h/d
MCC melanoma. Radial growth.

5. Tx acute sinusitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Tdap - influenza - pneumovax

6. Late deceleration
Calcium pyrophosphate dehydrate crystals (pseudogout)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
IV penicillin (or ampicillin)
Ampicillin/sulbactam AND doxycycline

7. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
5 yo - draws person - ties shoes - skips
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Diabetes - HTN - GN

8. Tx acute gout
<20lb - <1YO - Reacts to pain - Responds to noise
Angioedema
Colchicine
After delivery until delivery of placenta and membranes <30 mins

9. DOC for HTN in elderly
Thiazides
Hypomagnesemia
110-160bpm
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

10. needles - strong negative birefringent (yellow crystals parallel light)
Cataracts
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Tdap - influenza - pneumovax
Monosodium urate crystals (gout)

11. Tender - boggy prostate. Dx?
Prostatitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
(cefotetan OR cefoxitin) AND doxycycline

12. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
4 yo - copies triangle - catches ball - dresses self
MTX
Most aggressive melanoma.

13. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Cataracts

14. Early deceleration
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)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Prostatitis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

15. Bisphospohonates sfx
Anemia
Esophagitis - gastritis - dysphagia
Bupropion - varenicline - nicotine replacement
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

16. Nodular melanoma
= LMP + 7 days - 3 months
Angioedema
Onset of labor until cervix dilation
Most aggressive melanoma.

17. Signs of rupture of membranes

18. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
Biopsy
Bathing - dressing - eating - transferring - continence - toileting
9 mo - walks - throws - 1-3 words - 1-step commands

19. Tx RA (best long-term outcome)
Diphenhydramine - chlorpheniramine - hydroxyzine
Prostatitis
0.2-0.5mg aqueous EPI IM/SubQ
MTX

20. Regards human face - eye contact
5+ rads
Measures strength of contractions
1 mo - eyes follow object to midline - vocalizes
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

21. Tx bacterial vaginosis
DTaP - hepB - Hib - rotavirus - inactivated polio
Thiazides
Fluoroquinolones
Metronidazole or clindamycin

22. writes name - counts 10 objects
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
5 yo - draws person - ties shoes - skips
Anemia
Patch - bupropion - varenicline

23. Unstable angina vs MI Dx tests
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye

24. group play - gender - knows name
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Flexion - internal rotation - extension - external rotation
Nicotine inhaler - nasal spray - gum

25. causes of acute bronchitis
16-18 weeks GA
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Onset of labor until cervix dilation

26. Recommended folic acid daily dose
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)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Esophagitis - gastritis - dysphagia

27. presbycusis
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Age-related sensorineural hearing loss (high frequency and speech discrimination)
1 mo - eyes follow object to midline - vocalizes
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

28. MCC blindness worldwide
Cataracts
6-9MO
= LMP + 7 days - 3 months
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

29. First stage of labor
Diphenhydramine - chlorpheniramine - hydroxyzine
After delivery until delivery of placenta and membranes <30 mins
Onset of labor until cervix dilation
Clindamycin AND gentamicin

30. Sx epiglottitis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Stridor - drooling - toxic appearance
Onset of labor until cervix dilation
Cataracts

31. CKD Stages
Ask - Advise - Assess - Assist - Arrange
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Tuberculosis; sarcoidosis; hodgkin disease
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

32. Sx peritonsillar abscess
Oxygen intervention 15h/d
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Calcium hydroxyapatite crystals

33. Only therapy to decrease mortality in stage IV COPD
4 yo - copies triangle - catches ball - dresses self
Oxygen intervention 15h/d
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)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

34. Tx for thyroid storm
9 mo - walks - throws - 1-3 words - 1-step commands
1 mo - eyes follow object to midline - vocalizes
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

35. Tx hyperkalemia in CKD
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Measures strength of contractions
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

36. DDX for geriatric hearing impairment
Flexion - internal rotation - extension - external rotation
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Prostatitis

37. Dx bacterial rhinosinusitis
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Fe deficient anemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
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)

38. Tx GAS ifxn
Calcium hydroxyapatite crystals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Oxygen intervention 15h/d
Stridor - drooling - toxic appearance

39. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Colchicine
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

40. Complications of PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
16-18 weeks GA
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

41. Oral tx for PID
Steroids + bronchodilators
Patch - bupropion - varenicline
(ofloxacin OR levofloxacin) +/- metronidazole
Nuchal translucency - serum hCG - PAPP-A

42. Sx of hypercalcemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

43. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Alpha-1 antitrypsin deficiency
Aortic aneurysm

44. GBS tx
IV penicillin (or ampicillin)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Lung; SCC head & neck; RCC; breast; MM; prostate
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)

45. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Fe deficient anemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(ofloxacin OR levofloxacin) +/- metronidazole

46. social interaction
6 yo
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
4 yo - copies triangle - catches ball - dresses self

47. Four cardinal fetal movements
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ampicillin/sulbactam AND doxycycline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Flexion - internal rotation - extension - external rotation

48. IV tx for PID
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ampicillin/sulbactam AND doxycycline
Calcium pyrophosphate dehydrate crystals (pseudogout)

49. Dx bacterial vaginosis
Onset of labor until cervix dilation
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Short-acting + 40mg prednisone x 10-14days

50. Nonfunctioning nodules > 1cm require _____
Biopsy
Esophagitis - gastritis - dysphagia
Bupropion - varenicline - nicotine replacement
Lung; SCC head & neck; RCC; breast; MM; prostate