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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.
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. Malignancies with hypercalcemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Lung; SCC head & neck; RCC; breast; MM; prostate
Ofloxacin OR levofloxacin +/- metronidazole
Measures strength of contractions

2. Signs of rupture of membranes

3. Superficial spreading melanoma
MCC melanoma. Radial growth.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Measures strength of contractions
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

4. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
NAC or IV NaHCO3

5. Optimal time for trisomy screen
Fe deficient anemia
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
16-18 weeks GA
Urinary calcium. Hyper PTH (high) >> FHH (normal)

6. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
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)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Colchicine

7. Dx PID
Anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

8. cystoplasmic inclusions - not birefringent
Anterior shoulder cannot readily pass below the pubic symphysis.
IV penicillin (or ampicillin)
Calcium hydroxyapatite crystals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

9. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium hydroxyapatite crystals
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

10. ADL
Bathing - dressing - eating - transferring - continence - toileting
MCC melanoma. Radial growth.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Long axis of fetus to long axis of mother (longitudinal or transverse)

11. Corrected serum calcium =

12. Cockcroft-Gault equation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ofloxacin OR levofloxacin +/- metronidazole
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

13. Oral tx for PID
= LMP + 7 days - 3 months
Ceftriaxone 125mg IM
(ofloxacin OR levofloxacin) +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise

14. Tx RA (best long-term outcome)
MTX
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Nicotine inhaler - nasal spray - gum

15. Dx criteria for RA
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

16. tx shoulder dystocia

17. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ofloxacin OR levofloxacin +/- metronidazole
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
6 mo - pincer - crawls - cruises - mamma - dada - byebye

18. Tx chlamydia
Bathing - dressing - eating - transferring - continence - toileting
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Nuchal translucency - serum hCG - PAPP-A

19. writes name - counts 10 objects
Metronidazole or clindamycin
Esophagitis - gastritis - dysphagia
Cataracts
5 yo - draws person - ties shoes - skips

20. Unstable angina vs MI Dx tests
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Most aggressive melanoma.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
After delivery until delivery of placenta and membranes <30 mins

21. causes of acute bronchitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anterior shoulder cannot readily pass below the pubic symphysis.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

22. regards hand
9 mo - walks - throws - 1-3 words - 1-step commands
4mo - sits unsupported - hand transfer - babbles
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

23. Third stage of labor
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
After delivery until delivery of placenta and membranes <30 mins
Flexion - internal rotation - extension - external rotation

24. Smoking cessation agents
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Oxygen intervention 15h/d
Bupropion - varenicline - nicotine replacement
Short-acting + 40mg prednisone x 10-14days

25. Tx for thyroid storm
Oxytocin (IV)
Anemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
5+ rads

26. How much radiation is associated with fetal harm?
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
5+ rads
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Nuchal translucency - serum hCG - PAPP-A

27. Dx bacterial rhinosinusitis
Calcium hydroxyapatite crystals
Patch - bupropion - varenicline
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)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

28. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
0.2-0.5mg aqueous EPI IM/SubQ
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. IV tx for PID
Prostatitis
Ofloxacin OR levofloxacin +/- metronidazole
5+ rads
Colchicine

30. IV tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Flexion - internal rotation - extension - external rotation
(cefotetan OR cefoxitin) AND doxycycline
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

31. Estimated delivery date (Naegele's rule)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
= LMP + 7 days - 3 months

32. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
MCC melanoma. Radial growth.
Oxytocin (IV)
Starts at contraction. caused by increased vagal tone from fetal head compression.

33. Early deceleration
Calcium oxalate crystals
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Cataracts
Starts at contraction. caused by increased vagal tone from fetal head compression.

34. Augments contractions
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Oxytocin (IV)
Stridor - drooling - toxic appearance
MCC melanoma in Africans/Asians. Under nails - soles - palms.

35. Large - irregularly shaped - prutitic - erythematous wheals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Urticaria
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Nuchal translucency - serum hCG - PAPP-A

36. Tx otitis media
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
MCC melanoma. Radial growth.

37. parallel play
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
4 yo - copies triangle - catches ball - dresses self
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
5+ rads

38. Causes of CKD
Diabetes - HTN - GN
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Colchicine
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

39. social interaction
4 yo - copies triangle - catches ball - dresses self
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Urticaria
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

40. medications causing hypercalcemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Thiazdes; lithium

41. Four cardinal fetal movements
Thiazides
Flexion - internal rotation - extension - external rotation
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
(cefotetan OR cefoxitin) AND doxycycline

42. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Flexion - internal rotation - extension - external rotation

43. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Angioedema
16-18 weeks GA
NAC or IV NaHCO3

44. Pflx for traveler's diarrhea
5 yo - draws person - ties shoes - skips
Fluoroquinolones
Tdap - influenza - pneumovax
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

45. Regards human face - eye contact
Fe deficient anemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
1 mo - eyes follow object to midline - vocalizes
Metronidazole or clindamycin

46. Immunizations for COPD patients
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Pneumovax - influenza
5+ rads
Loratadine - fexofenadine - cetirizine

47. Other causes of hypercalcemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Bathing - dressing - eating - transferring - continence - toileting
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

48. Mediators released in response to allergen
Thiazides
Monosodium urate crystals (gout)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

49. GBS tx
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
After delivery until delivery of placenta and membranes <30 mins
NAC or IV NaHCO3
IV penicillin (or ampicillin)

50. IV tx for PID
Prostatitis
Oxygen intervention 15h/d
Clindamycin AND gentamicin
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once