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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. Immunizations for COPD patients
Ampicillin/sulbactam AND doxycycline
Biopsy
4mo - sits unsupported - hand transfer - babbles
Pneumovax - influenza

2. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
NAC or IV NaHCO3

3. cystoplasmic inclusions - not birefringent
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
MTX
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium hydroxyapatite crystals

4. Acral lentinous melanoma
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ask - Advise - Assess - Assist - Arrange
Fluoroquinolones
MCC melanoma in Africans/Asians. Under nails - soles - palms.

5. CKD Stages
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

6. Four cardinal fetal movements
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)
Colchicine
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Flexion - internal rotation - extension - external rotation

7. Dx PID
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Angioedema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

8. Immunizations at visit for 6MO
<20lb - <1YO - Reacts to pain - Responds to noise
Ferrous sulfate 325mg tid
DTaP - hepB - Hib - rotavirus - inactivated polio
Pneumovax - influenza

9. needles - strong negative birefringent (yellow crystals parallel light)
Bupropion - varenicline - nicotine replacement
NAC or IV NaHCO3
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Monosodium urate crystals (gout)

10. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

11. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Normal mental status; no other injuries; seen within 10 days of injury
Anaphylaxis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

12. IV tx for PID
= LMP + 7 days - 3 months
Clindamycin AND gentamicin
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

13. IUPC (intrauterine pressure catheter)
Hypomagnesemia
Ofloxacin OR levofloxacin +/- metronidazole
Prostatitis
Measures strength of contractions

14. Sx epiglottitis
Anemia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Stridor - drooling - toxic appearance

15. Other causes of hypercalcemia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Urticaria

16. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
1 mo - eyes follow object to midline - vocalizes
Conrtaction monitoring along with fetal heart rate assessment
Urinary calcium. Hyper PTH (high) >> FHH (normal)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

17. Age by which child says 'mama' and 'dada'
6-9MO
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1 mo - eyes follow object to midline - vocalizes
Flexion - internal rotation - extension - external rotation

18. Fe deficient anemia tx
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Thiazides
Ferrous sulfate 325mg tid

19. dyspnea - visceral edema - hypotension
Anaphylaxis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Tuberculosis; sarcoidosis; hodgkin disease
Ofloxacin OR levofloxacin +/- metronidazole

20. Estimated delivery date (Naegele's rule)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
= LMP + 7 days - 3 months
Ferrous sulfate 325mg tid
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

21. Tx acute gout
Colchicine
9 mo - walks - throws - 1-3 words - 1-step commands
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
MTX

22. tx shoulder dystocia

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23. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Fe deficient anemia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

24. Late deceleration
Stridor - drooling - toxic appearance
Hypomagnesemia
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Bathing - dressing - eating - transferring - continence - toileting

25. Fetal heart rate range
110-160bpm
MTX
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Loratadine - fexofenadine - cetirizine

26. Superficial spreading melanoma
Metronidazole or clindamycin
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Conrtaction monitoring along with fetal heart rate assessment
MCC melanoma. Radial growth.

27. presbycusis
Ferrous sulfate 325mg tid
4 yo - copies triangle - catches ball - dresses self
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

28. 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)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
5+ rads
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. Tx chlamydia
Tuberculosis; sarcoidosis; hodgkin disease
6 yo
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ceftriaxone 125mg IM

30. Dx bacterial rhinosinusitis
6-9MO
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
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)
Bupropion - varenicline - nicotine replacement

31. Only therapy to decrease mortality in stage IV COPD
Nicotine inhaler - nasal spray - gum
3 yo - identify body part - copies square - hops - throws - past tense - story telling
5+ rads
Oxygen intervention 15h/d

32. Tx acute exacerbation COPD
Metronidazole or clindamycin
Short-acting + 40mg prednisone x 10-14days
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
2 mo - eyes follow object past midline - rolls over - laughs - squeals

33. Smoking cessation agents
Ampicillin/sulbactam AND doxycycline
Bupropion - varenicline - nicotine replacement
Long axis of fetus to long axis of mother (longitudinal or transverse)
Fe deficient anemia

34. Augments contractions
Short-acting + 40mg prednisone x 10-14days
Oxytocin (IV)
MCC melanoma. Radial growth.
Esophagitis - gastritis - dysphagia

35. Malignancies with hypercalcemia
Oxytocin (IV)
Lung; SCC head & neck; RCC; breast; MM; prostate
4 yo - copies triangle - catches ball - dresses self
Tdap - influenza - pneumovax

36. Third stage of labor
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
After delivery until delivery of placenta and membranes <30 mins
Steroids + bronchodilators
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

37. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Thiazdes; lithium
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Hypomagnesemia

38. Recommended folic acid daily dose
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Normal mental status; no other injuries; seen within 10 days of injury
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

39. variable deceleration
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Bupropion - varenicline - nicotine replacement
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Fluoroquinolones

40. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Hypomagnesemia
Patch - bupropion - varenicline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

41. parallel play
Flexion - internal rotation - extension - external rotation
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Starts at contraction. caused by increased vagal tone from fetal head compression.
Urticaria

42. medications causing hypercalcemia
Thiazdes; lithium
Calcium hydroxyapatite crystals
Ferrous sulfate 325mg tid
Colchicine

43. social interaction
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
4 yo - copies triangle - catches ball - dresses self
9 mo - walks - throws - 1-3 words - 1-step commands
Ear pain - itching - inflammation/swollen canal - exudates/discharge

44. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ask - Advise - Assess - Assist - Arrange
Urticaria
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

45. regards hand
4mo - sits unsupported - hand transfer - babbles
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Steroids + bronchodilators
0.2-0.5mg aqueous EPI IM/SubQ

46. Dx bacterial vaginosis
Hypomagnesemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anterior shoulder cannot readily pass below the pubic symphysis.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

47. Fetal lie
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Long axis of fetus to long axis of mother (longitudinal or transverse)
Anterior shoulder cannot readily pass below the pubic symphysis.
Tdap - influenza - pneumovax

48. Early deceleration
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Starts at contraction. caused by increased vagal tone from fetal head compression.
Urinary calcium. Hyper PTH (high) >> FHH (normal)

49. Bacteria causing chronic sinusitis
Clindamycin AND gentamicin
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ceftriaxone 125mg IM
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

50. Screened at 16-20 weeks GA for trisomy
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Anemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Fluoroquinolones