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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. Pregnancy class D smoking cessation drugs
Calcium oxalate crystals
Nicotine inhaler - nasal spray - gum
1 mo - eyes follow object to midline - vocalizes
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

2. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Alpha-1 antitrypsin deficiency
Esophagitis - gastritis - dysphagia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

3. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Diphenhydramine - chlorpheniramine - hydroxyzine
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

4. Acral lentinous melanoma
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MCC melanoma in Africans/Asians. Under nails - soles - palms.
MCC melanoma. Radial growth.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

5. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
MCC melanoma. Radial growth.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
IV penicillin (or ampicillin)

6. Mediators released in response to allergen
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Flexion - internal rotation - extension - external rotation
Calcium oxalate crystals

7. Bisphospohonates sfx
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Esophagitis - gastritis - dysphagia
Alpha-1 antitrypsin deficiency

8. bacteria causing pharyngitis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Tuberculosis; sarcoidosis; hodgkin disease
Anemia

9. Tx bacterial vaginosis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Metronidazole or clindamycin
Hypomagnesemia

10. Tx acute sinusitis
Ferrous sulfate 325mg tid
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
MCC melanoma. Radial growth.

11. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
0.2-0.5mg aqueous EPI IM/SubQ
(cefotetan OR cefoxitin) AND doxycycline

12. Optimal time for trisomy screen
Ear pain - itching - inflammation/swollen canal - exudates/discharge
16-18 weeks GA
IV penicillin (or ampicillin)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

13. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Oxygen intervention 15h/d
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
(cefotetan OR cefoxitin) AND doxycycline

14. ADL
Measures strength of contractions
Calcium hydroxyapatite crystals
Bathing - dressing - eating - transferring - continence - toileting
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

15. parallel play
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

16. Signs of rupture of membranes

17. tx shoulder dystocia

18. Tocodynamometer
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fe deficient anemia
Ask - Advise - Assess - Assist - Arrange
Conrtaction monitoring along with fetal heart rate assessment

19. Corrected serum calcium =

20. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Metronidazole or clindamycin
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6 yo

21. Sx epiglottitis
Clindamycin AND gentamicin
16-18 weeks GA
Stridor - drooling - toxic appearance
Biopsy

22. GBS tx
MCC melanoma. Radial growth.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
IV penicillin (or ampicillin)

23. Granulomatous causes of hypercalcemia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease
16-18 weeks GA
Conrtaction monitoring along with fetal heart rate assessment

24. Pregnancy class C smoking cessation drugs
Angioedema
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Patch - bupropion - varenicline
Ask - Advise - Assess - Assist - Arrange

25. Complications of GAS infxn
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Prostatitis

26. Recommended folic acid daily dose
Measures strength of contractions
NAC or IV NaHCO3
Ferrous sulfate 325mg tid
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

27. Dx bacterial vaginosis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ceftriaxone 125mg IM
Calcium pyrophosphate dehydrate crystals (pseudogout)

28. DOC for HTN in elderly
Anemia
Thiazides
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Measures strength of contractions

29. Late deceleration
= LMP + 7 days - 3 months
Esophagitis - gastritis - dysphagia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

30. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Nuchal translucency - serum hCG - PAPP-A
Loratadine - fexofenadine - cetirizine

31. Tx acute gout
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Colchicine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

32. Causes of CKD
5 yo - draws person - ties shoes - skips
IV penicillin (or ampicillin)
Diabetes - HTN - GN
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)

33. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ceftriaxone 125mg IM
9 mo - walks - throws - 1-3 words - 1-step commands
NAC or IV NaHCO3

34. IV tx for PID
Onset of labor until cervix dilation
Ofloxacin OR levofloxacin +/- metronidazole
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Prostatitis

35. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Oxytocin (IV)
(cefotetan OR cefoxitin) AND doxycycline
Ceftriaxone 125mg IM

36. complications of otitis media
Anemia
Onset of labor until cervix dilation
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

37. Tx GAS ifxn
Measures strength of contractions
Alpha-1 antitrypsin deficiency
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

38. Oral tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
(ofloxacin OR levofloxacin) +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

39. The five A's of smoking cessation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ask - Advise - Assess - Assist - Arrange
Nuchal translucency - serum hCG - PAPP-A
MCC melanoma in Africans/Asians. Under nails - soles - palms.

40. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Tuberculosis; sarcoidosis; hodgkin disease
Hypomagnesemia
DTaP - hepB - Hib - rotavirus - inactivated polio

41. Only therapy to decrease mortality in stage IV COPD
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Oxygen intervention 15h/d
(ofloxacin OR levofloxacin) +/- metronidazole
Cataracts

42. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Monosodium urate crystals (gout)
Fluoroquinolones

43. Augments contractions
Oxytocin (IV)
Starts at contraction. caused by increased vagal tone from fetal head compression.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

44. MCC blindness worldwide
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cataracts
Ask - Advise - Assess - Assist - Arrange
MTX

45. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
(ofloxacin OR levofloxacin) +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
5 yo - draws person - ties shoes - skips

46. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Oxytocin (IV)

47. Fetal heart rate range
110-160bpm
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Nicotine inhaler - nasal spray - gum
2 mo - eyes follow object past midline - rolls over - laughs - squeals

48. Fetal lie
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Long axis of fetus to long axis of mother (longitudinal or transverse)
Most aggressive melanoma.
0.2-0.5mg aqueous EPI IM/SubQ

49. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Flexion - internal rotation - extension - external rotation
Oxytocin (IV)
Ofloxacin OR levofloxacin +/- metronidazole

50. Lentigo Maligna
110-160bpm
Anemia
Monosodium urate crystals (gout)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.