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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. complications of otitis media
Anemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Patch - bupropion - varenicline

2. MONA therapy
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ask - Advise - Assess - Assist - Arrange
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Anemia

3. identifies left - right
0.2-0.5mg aqueous EPI IM/SubQ
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6 yo
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

4. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Alpha-1 antitrypsin deficiency
Pneumovax - influenza
Steroids + bronchodilators
NAC or IV NaHCO3

5. Low serum iron - low MCV - low ferritin - +stool guaiac
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Fe deficient anemia
Ampicillin/sulbactam AND doxycycline
Lung; SCC head & neck; RCC; breast; MM; prostate

6. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Hypomagnesemia
Oxytocin (IV)

7. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Cataracts
Angioedema
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

8. Immunizations for adult 65YO+
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Conrtaction monitoring along with fetal heart rate assessment
Tdap - influenza - pneumovax
Stridor - drooling - toxic appearance

9. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Anaphylaxis

10. First stage of labor
Bathing - dressing - eating - transferring - continence - toileting
Onset of labor until cervix dilation
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

11. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ampicillin/sulbactam AND doxycycline
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

12. MCC blindness worldwide
Cataracts
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ofloxacin OR levofloxacin +/- metronidazole
MCC melanoma in Africans/Asians. Under nails - soles - palms.

13. Tx chlamydia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Pneumovax - influenza
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

14. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
16-18 weeks GA
3 yo - identify body part - copies square - hops - throws - past tense - story telling

15. 1st generation antihistamines
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Pneumovax - influenza
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Diphenhydramine - chlorpheniramine - hydroxyzine

16. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Esophagitis - gastritis - dysphagia

17. Improve short-term outcomes in acute exacerbations of COPD - asthma
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Steroids + bronchodilators
Calcium oxalate crystals

18. medications causing hypercalcemia
Thiazdes; lithium
Patch - bupropion - varenicline
Tdap - influenza - pneumovax
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

19. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
5+ rads
Thiazides
Anemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

20. Pregnancy class C smoking cessation drugs
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bathing - dressing - eating - transferring - continence - toileting
Patch - bupropion - varenicline
6-9MO

21. Dx bacterial rhinosinusitis
Ofloxacin OR levofloxacin +/- metronidazole
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Loratadine - fexofenadine - cetirizine
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)

22. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
5+ rads
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

23. Nodular melanoma
Most aggressive melanoma.
6-9MO
Ofloxacin OR levofloxacin +/- metronidazole
Urticaria

24. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Clindamycin AND gentamicin

25. Electrolyte abnormality that increases the incidence of torsades de pointes
Loratadine - fexofenadine - cetirizine
0.2-0.5mg aqueous EPI IM/SubQ
MTX
Hypomagnesemia

26. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Monosodium urate crystals (gout)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
DTaP - hepB - Hib - rotavirus - inactivated polio

27. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
16-18 weeks GA
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Biopsy

28. Screening for 65-76YO male smoker
NAC or IV NaHCO3
Aortic aneurysm
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
4 yo - copies triangle - catches ball - dresses self

29. Tx gonorrhea
Loratadine - fexofenadine - cetirizine
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ceftriaxone 125mg IM

30. Smoking cessation agents
Pneumovax - influenza
Bupropion - varenicline - nicotine replacement
Calcium oxalate crystals
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

31. Tx of traveler's diarrhea
Starts at contraction. caused by increased vagal tone from fetal head compression.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
4 yo - copies triangle - catches ball - dresses self
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

32. regards hand
3 yo - identify body part - copies square - hops - throws - past tense - story telling
After delivery until delivery of placenta and membranes <30 mins
4mo - sits unsupported - hand transfer - babbles
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

33. Pflx for traveler's diarrhea
Fluoroquinolones
Short-acting + 40mg prednisone x 10-14days
Calcium pyrophosphate dehydrate crystals (pseudogout)
Lung; SCC head & neck; RCC; breast; MM; prostate

34. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
9 mo - walks - throws - 1-3 words - 1-step commands
Calcium pyrophosphate dehydrate crystals (pseudogout)

35. Fe deficient anemia tx
Ferrous sulfate 325mg tid
DTaP - hepB - Hib - rotavirus - inactivated polio
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6 mo - pincer - crawls - cruises - mamma - dada - byebye

36. Age by which child says 'mama' and 'dada'
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6-9MO
Loratadine - fexofenadine - cetirizine
Hypomagnesemia

37. Sx otitis externa
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

38. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Calcium pyrophosphate dehydrate crystals (pseudogout)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Short-acting + 40mg prednisone x 10-14days

39. painless - deep - subQ swelling (periorbital - circumoral - facial)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Angioedema
Ceftriaxone 125mg IM
Oxygen intervention 15h/d

40. Sx epiglottitis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Stridor - drooling - toxic appearance
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

41. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

42. Acral lentinous melanoma
Bathing - dressing - eating - transferring - continence - toileting
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Onset of labor until cervix dilation
Urticaria

43. Oral tx for PID
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

44. Screened at 11-13 weeks GA for trisomy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Nuchal translucency - serum hCG - PAPP-A
Fluoroquinolones
Thiazdes; lithium

45. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Fluoroquinolones
= LMP + 7 days - 3 months

46. Signs of rupture of membranes

47. Sx otitis media
Calcium pyrophosphate dehydrate crystals (pseudogout)
Prostatitis
4 yo - copies triangle - catches ball - dresses self
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

48. social interaction
Anterior shoulder cannot readily pass below the pubic symphysis.
4 yo - copies triangle - catches ball - dresses self
Measures strength of contractions
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)

49. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
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)
Anaphylaxis

50. Tx acute sinusitis
Normal mental status; no other injuries; seen within 10 days of injury
Diphenhydramine - chlorpheniramine - hydroxyzine
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR