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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. Sx peritonsillar abscess
Anaphylaxis
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

2. complications of otitis media
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

3. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
IV penicillin (or ampicillin)
Monosodium urate crystals (gout)
6-9MO

4. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Esophagitis - gastritis - dysphagia
110-160bpm
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

5. Dx bacterial vaginosis
Anemia
Ofloxacin OR levofloxacin +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Fluoroquinolones

6. Fe deficient anemia tx
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Bupropion - varenicline - nicotine replacement
Ferrous sulfate 325mg tid

7. Sx otitis media
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
DTaP - hepB - Hib - rotavirus - inactivated polio
5 yo - draws person - ties shoes - skips

8. Cockcroft-Gault equation
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Metronidazole or clindamycin
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Oxygen intervention 15h/d

9. parallel play
5+ rads
Pneumovax - influenza
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

10. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ask - Advise - Assess - Assist - Arrange
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

11. Smoking cessation agents
1 mo - eyes follow object to midline - vocalizes
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Nuchal translucency - serum hCG - PAPP-A
Bupropion - varenicline - nicotine replacement

12. 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)
110-160bpm
Bathing - dressing - eating - transferring - continence - toileting
Ceftriaxone 125mg IM

13. Acral lentinous melanoma
Nicotine inhaler - nasal spray - gum
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
MTX
MCC melanoma in Africans/Asians. Under nails - soles - palms.

14. IV tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anemia
Ampicillin/sulbactam AND doxycycline
Angioedema

15. Immunizations for COPD patients
= LMP + 7 days - 3 months
Pneumovax - influenza
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Lung; SCC head & neck; RCC; breast; MM; prostate

16. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Normal mental status; no other injuries; seen within 10 days of injury
Hypomagnesemia

17. Signs of rupture of membranes

18. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Calcium oxalate crystals
6 yo

19. Screened at 16-20 weeks GA for trisomy
Fe deficient anemia
Anemia
Most aggressive melanoma.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

20. Estimated delivery date (Naegele's rule)
Cataracts
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Colchicine
= LMP + 7 days - 3 months

21. MCC blindness worldwide
Prostatitis
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Cataracts
Pneumovax - influenza

22. Fetal lie
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Tuberculosis; sarcoidosis; hodgkin disease
Long axis of fetus to long axis of mother (longitudinal or transverse)
Stridor - drooling - toxic appearance

23. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Conrtaction monitoring along with fetal heart rate assessment
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)
DTaP - hepB - Hib - rotavirus - inactivated polio

24. IADL
Bathing - dressing - eating - transferring - continence - toileting
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Monosodium urate crystals (gout)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

25. Tx gonorrhea
Colchicine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Biopsy
Ceftriaxone 125mg IM

26. IV tx for PID
Clindamycin AND gentamicin
Ferrous sulfate 325mg tid
5+ rads
Cataracts

27. Tx of traveler's diarrhea
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

28. Oral tx for PID
Tuberculosis; sarcoidosis; hodgkin disease
Most aggressive melanoma.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
(ofloxacin OR levofloxacin) +/- metronidazole

29. Augments contractions
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Steroids + bronchodilators
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Oxytocin (IV)

30. dyspnea - visceral edema - hypotension
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaphylaxis
Fe deficient anemia
Conrtaction monitoring along with fetal heart rate assessment

31. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Prostatitis
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Tdap - influenza - pneumovax

32. painless - deep - subQ swelling (periorbital - circumoral - facial)
(ofloxacin OR levofloxacin) +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thiazides
Angioedema

33. 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)
Anaphylaxis
Fluoroquinolones
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

34. Emphysema - <45YO - nonsmoker
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Onset of labor until cervix dilation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Alpha-1 antitrypsin deficiency

35. Dx PID
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ofloxacin OR levofloxacin +/- metronidazole

36. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Most aggressive melanoma.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 mo - eyes follow object to midline - vocalizes

37. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
= LMP + 7 days - 3 months
Ferrous sulfate 325mg tid
Thiazdes; lithium

38. Tx acute gout
Ampicillin/sulbactam AND doxycycline
9 mo - walks - throws - 1-3 words - 1-step commands
Patch - bupropion - varenicline
Colchicine

39. Early deceleration
Ask - Advise - Assess - Assist - Arrange
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
16-18 weeks GA

40. cystoplasmic inclusions - not birefringent
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium hydroxyapatite crystals

41. Screened at 11-13 weeks GA for trisomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Nuchal translucency - serum hCG - PAPP-A
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

42. IV tx for PID
Anemia
Calcium oxalate crystals
DTaP - hepB - Hib - rotavirus - inactivated polio
Ofloxacin OR levofloxacin +/- metronidazole

43. Tx for anaphylaxis
Tuberculosis; sarcoidosis; hodgkin disease
4 yo - copies triangle - catches ball - dresses self
0.2-0.5mg aqueous EPI IM/SubQ
16-18 weeks GA

44. Nonfunctioning nodules > 1cm require _____
Bupropion - varenicline - nicotine replacement
Stridor - drooling - toxic appearance
Biopsy
(ofloxacin OR levofloxacin) +/- metronidazole

45. Tx RA (best long-term outcome)
Ask - Advise - Assess - Assist - Arrange
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
MTX
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

46. DOC for HTN in elderly
5 yo - draws person - ties shoes - skips
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Thiazides

47. social interaction
Calcium oxalate crystals
Anterior shoulder cannot readily pass below the pubic symphysis.
4 yo - copies triangle - catches ball - dresses self
(ofloxacin OR levofloxacin) +/- metronidazole

48. Tx chlamydia
Aortic aneurysm
Cataracts
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ear pain - itching - inflammation/swollen canal - exudates/discharge

49. The five A's of smoking cessation
Thiazides
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Cataracts
Ask - Advise - Assess - Assist - Arrange

50. tx shoulder dystocia