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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. Augments contractions
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Aortic aneurysm
Oxytocin (IV)
Clindamycin AND gentamicin

2. social interaction
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Anemia
4 yo - copies triangle - catches ball - dresses self
110-160bpm

3. Early deceleration
Clindamycin AND gentamicin
Conrtaction monitoring along with fetal heart rate assessment
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at contraction. caused by increased vagal tone from fetal head compression.

4. identifies left - right
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anterior shoulder cannot readily pass below the pubic symphysis.
Thiazdes; lithium
6 yo

5. explorations
MTX
9 mo - walks - throws - 1-3 words - 1-step commands
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

6. ADL
Bathing - dressing - eating - transferring - continence - toileting
4mo - sits unsupported - hand transfer - babbles
(ofloxacin OR levofloxacin) +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

7. IV tx for PID
3 yo - identify body part - copies square - hops - throws - past tense - story telling
5+ rads
(cefotetan OR cefoxitin) AND doxycycline
Clindamycin AND gentamicin

8. Bisphospohonates sfx
DTaP - hepB - Hib - rotavirus - inactivated polio
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Esophagitis - gastritis - dysphagia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

9. 2nd generation antihistamines
Monosodium urate crystals (gout)
Loratadine - fexofenadine - cetirizine
6-9MO
Esophagitis - gastritis - dysphagia

10. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Anterior shoulder cannot readily pass below the pubic symphysis.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

11. Screening for 65-76YO male smoker
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Aortic aneurysm
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

12. Pflx for traveler's diarrhea
Hypomagnesemia
Fluoroquinolones
Biopsy
Ferrous sulfate 325mg tid

13. Only therapy to decrease mortality in stage IV COPD
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
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)
Oxygen intervention 15h/d
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

14. medications causing hypercalcemia
Cataracts
Thiazdes; lithium
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

15. Bacteria causing chronic sinusitis
Nicotine inhaler - nasal spray - gum
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
5 yo - draws person - ties shoes - skips

16. Acral lentinous melanoma
Stridor - drooling - toxic appearance
MCC melanoma in Africans/Asians. Under nails - soles - palms.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

17. Immunizations for COPD patients
Normal mental status; no other injuries; seen within 10 days of injury
Starts at contraction. caused by increased vagal tone from fetal head compression.
Pneumovax - influenza
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

18. IUPC (intrauterine pressure catheter)
Aortic aneurysm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Measures strength of contractions
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

19. Improve short-term outcomes in acute exacerbations of COPD - asthma
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

20. tx shoulder dystocia

21. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
6 yo
Age-related sensorineural hearing loss (high frequency and speech discrimination)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

22. Superficial spreading melanoma
MCC melanoma. Radial growth.
9 mo - walks - throws - 1-3 words - 1-step commands
Clindamycin AND gentamicin
Measures strength of contractions

23. Tx for thyroid storm
MCC melanoma. Radial growth.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
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)
MTX

24. IV tx for PID
Cataracts
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ferrous sulfate 325mg tid
Clindamycin AND gentamicin

25. X-ray of ankle?
Tuberculosis; sarcoidosis; hodgkin disease
Clindamycin AND gentamicin
Thiazides
Normal mental status; no other injuries; seen within 10 days of injury

26. Tx acute exacerbation COPD
Conrtaction monitoring along with fetal heart rate assessment
Fluoroquinolones
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Short-acting + 40mg prednisone x 10-14days

27. Fetal heart rate range
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Measures strength of contractions
110-160bpm
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

28. Nonfunctioning nodules > 1cm require _____
Flexion - internal rotation - extension - external rotation
Alpha-1 antitrypsin deficiency
Biopsy
Ferrous sulfate 325mg tid

29. Regards human face - eye contact
(cefotetan OR cefoxitin) AND doxycycline
5 yo - draws person - ties shoes - skips
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
1 mo - eyes follow object to midline - vocalizes

30. First stage of labor
Onset of labor until cervix dilation
16-18 weeks GA
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

31. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Bathing - dressing - eating - transferring - continence - toileting
Ask - Advise - Assess - Assist - Arrange
Steroids + bronchodilators

32. Fe deficient anemia tx
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ferrous sulfate 325mg tid
MCC melanoma. Radial growth.
Monosodium urate crystals (gout)

33. Other causes of hypercalcemia
5+ rads
Angioedema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
(ofloxacin OR levofloxacin) +/- metronidazole

34. Recommendations for rear-facing car seat
Nicotine inhaler - nasal spray - gum
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Urticaria
<20lb - <1YO - Reacts to pain - Responds to noise

35. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Bupropion - varenicline - nicotine replacement
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

36. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

37. Unstable angina vs MI Dx tests
Bupropion - varenicline - nicotine replacement
NAC or IV NaHCO3
Anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

38. Smoking cessation agents
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Bupropion - varenicline - nicotine replacement
NAC or IV NaHCO3
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

39. Malignancies with hypercalcemia
Pneumovax - influenza
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Lung; SCC head & neck; RCC; breast; MM; prostate

40. Large - irregularly shaped - prutitic - erythematous wheals
After delivery until delivery of placenta and membranes <30 mins
Urticaria
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Biopsy

41. social smile - parent recognition
Flexion - internal rotation - extension - external rotation
2 mo - eyes follow object past midline - rolls over - laughs - squeals
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Long axis of fetus to long axis of mother (longitudinal or transverse)

42. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Alpha-1 antitrypsin deficiency
Fe deficient anemia

43. Tx acute sinusitis
Bathing - dressing - eating - transferring - continence - toileting
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Angioedema
Calcium hydroxyapatite crystals

44. Lentigo Maligna
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Diphenhydramine - chlorpheniramine - hydroxyzine

45. painless - deep - subQ swelling (periorbital - circumoral - facial)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Cataracts
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Angioedema

46. 1st generation antihistamines
Urinary calcium. Hyper PTH (high) >> FHH (normal)
MCC melanoma. Radial growth.
Diphenhydramine - chlorpheniramine - hydroxyzine
Oxytocin (IV)

47. Sx otitis media
9 mo - walks - throws - 1-3 words - 1-step commands
Nuchal translucency - serum hCG - PAPP-A
= LMP + 7 days - 3 months
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

48. causes of acute bronchitis
Nuchal translucency - serum hCG - PAPP-A
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium hydroxyapatite crystals

49. Oral tx for PID
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Starts at contraction. caused by increased vagal tone from fetal head compression.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
MCC melanoma in Africans/Asians. Under nails - soles - palms.

50. Age by which child says 'mama' and 'dada'
Ask - Advise - Assess - Assist - Arrange
6-9MO
9 mo - walks - throws - 1-3 words - 1-step commands
Loratadine - fexofenadine - cetirizine