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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.
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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. IV tx for PID
Flexion - internal rotation - extension - external rotation
Ampicillin/sulbactam AND doxycycline
Colchicine
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)

2. Dx bacterial rhinosinusitis
Colchicine
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)
Most aggressive melanoma.
Anemia

3. Optimal time for trisomy screen
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.
16-18 weeks GA
Oxygen intervention 15h/d

4. Dx bacterial vaginosis
Metronidazole or clindamycin
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ofloxacin OR levofloxacin +/- metronidazole
Ask - Advise - Assess - Assist - Arrange

5. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Bathing - dressing - eating - transferring - continence - toileting
2 mo - eyes follow object past midline - rolls over - laughs - squeals

6. Pflx for traveler's diarrhea
5 yo - draws person - ties shoes - skips
Fluoroquinolones
Loratadine - fexofenadine - cetirizine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

7. Tx hyperkalemia in CKD
4mo - sits unsupported - hand transfer - babbles
MTX
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

8. medications causing hypercalcemia
= LMP + 7 days - 3 months
Thiazdes; lithium
DTaP - hepB - Hib - rotavirus - inactivated polio
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

9. group play - gender - knows name
Steroids + bronchodilators
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
3 yo - identify body part - copies square - hops - throws - past tense - story telling

10. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Stridor - drooling - toxic appearance
Onset of labor until cervix dilation
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

11. Tx gonorrhea
Onset of labor until cervix dilation
Ceftriaxone 125mg IM
Aortic aneurysm
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)

12. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Alpha-1 antitrypsin deficiency
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Nuchal translucency - serum hCG - PAPP-A

13. Complications of GAS infxn
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange

14. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Oxytocin (IV)
Tdap - influenza - pneumovax
Urinary calcium. Hyper PTH (high) >> FHH (normal)

15. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Bathing - dressing - eating - transferring - continence - toileting
Monosodium urate crystals (gout)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

16. Immunizations at visit for 6MO
Most aggressive melanoma.
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads
6 mo - pincer - crawls - cruises - mamma - dada - byebye

17. MCC blindness worldwide
Patch - bupropion - varenicline
Hypomagnesemia
Cataracts
Alpha-1 antitrypsin deficiency

18. identifies left - right
Measures strength of contractions
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
6 yo

19. Recommended folic acid daily dose
Flexion - internal rotation - extension - external rotation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Conrtaction monitoring along with fetal heart rate assessment
Starts at contraction. caused by increased vagal tone from fetal head compression.

20. Oral tx for PID
Colchicine
Ferrous sulfate 325mg tid
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
(ofloxacin OR levofloxacin) +/- metronidazole

21. Nonfunctioning nodules > 1cm require _____
Biopsy
Hypomagnesemia
Calcium oxalate crystals
Ofloxacin OR levofloxacin +/- metronidazole

22. tx shoulder dystocia

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23. DOC for HTN in elderly
Tdap - influenza - pneumovax
Thiazides
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Prostatitis

24. Tx GAS ifxn
Bathing - dressing - eating - transferring - continence - toileting
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
3 yo - identify body part - copies square - hops - throws - past tense - story telling

25. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Thiazides
Measures strength of contractions
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

26. IADL
Urticaria
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Bathing - dressing - eating - transferring - continence - toileting
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

27. Tx bacterial vaginosis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Alpha-1 antitrypsin deficiency
Metronidazole or clindamycin
Diphenhydramine - chlorpheniramine - hydroxyzine

28. Malignancies with hypercalcemia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
MTX
Cataracts
Lung; SCC head & neck; RCC; breast; MM; prostate

29. ADL
Bathing - dressing - eating - transferring - continence - toileting
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Calcium pyrophosphate dehydrate crystals (pseudogout)
Normal mental status; no other injuries; seen within 10 days of injury

30. 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)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Metronidazole or clindamycin
Ferrous sulfate 325mg tid

31. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Angioedema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Thiazdes; lithium

32. Age by which child says 'mama' and 'dada'
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
6-9MO
5 yo - draws person - ties shoes - skips
Esophagitis - gastritis - dysphagia

33. Regards human face - eye contact
Bupropion - varenicline - nicotine replacement
IV penicillin (or ampicillin)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
1 mo - eyes follow object to midline - vocalizes

34. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
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)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

35. Smoking cessation agents
Anaphylaxis
Bupropion - varenicline - nicotine replacement
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

36. Causes of CKD
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Diabetes - HTN - GN
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
4 yo - copies triangle - catches ball - dresses self

37. Tocodynamometer
Most aggressive melanoma.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Conrtaction monitoring along with fetal heart rate assessment
Ampicillin/sulbactam AND doxycycline

38. MONA therapy
Pneumovax - influenza
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Normal mental status; no other injuries; seen within 10 days of injury
Starts at contraction. caused by increased vagal tone from fetal head compression.

39. regards hand
Steroids + bronchodilators
4mo - sits unsupported - hand transfer - babbles
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

40. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Calcium hydroxyapatite crystals
0.2-0.5mg aqueous EPI IM/SubQ
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

41. Augments contractions
Normal mental status; no other injuries; seen within 10 days of injury
Oxytocin (IV)
Ofloxacin OR levofloxacin +/- metronidazole
Esophagitis - gastritis - dysphagia

42. Tx otitis media
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
0.2-0.5mg aqueous EPI IM/SubQ
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

43. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ferrous sulfate 325mg tid

44. Tx acute gout
DTaP - hepB - Hib - rotavirus - inactivated polio
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Colchicine

45. Oral tx for PID
Starts at contraction. caused by increased vagal tone from fetal head compression.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)
After delivery until delivery of placenta and membranes <30 mins

46. Immunizations for adult 65YO+
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)
Tdap - influenza - pneumovax
Esophagitis - gastritis - dysphagia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

47. Fetal heart rate range
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
110-160bpm
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

48. Sx otitis media
NAC or IV NaHCO3
Clindamycin AND gentamicin
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

49. dyspnea - visceral edema - hypotension
Anaphylaxis
Calcium pyrophosphate dehydrate crystals (pseudogout)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Cataracts

50. Sx peritonsillar abscess
Oxytocin (IV)
16-18 weeks GA
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption