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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. Fe deficient anemia tx
MCC melanoma in Africans/Asians. Under nails - soles - palms.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ferrous sulfate 325mg tid

2. Tx gonorrhea
Loratadine - fexofenadine - cetirizine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
IV penicillin (or ampicillin)
Ceftriaxone 125mg IM

3. presbycusis
NAC or IV NaHCO3
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Anemia
Tuberculosis; sarcoidosis; hodgkin disease

4. Age by which child says 'mama' and 'dada'
Diphenhydramine - chlorpheniramine - hydroxyzine
Ask - Advise - Assess - Assist - Arrange
6-9MO
9 mo - walks - throws - 1-3 words - 1-step commands

5. How much radiation is associated with fetal harm?
Steroids + bronchodilators
Hypomagnesemia
9 mo - walks - throws - 1-3 words - 1-step commands
5+ rads

6. Bacteria causing chronic sinusitis
Patch - bupropion - varenicline
Ampicillin/sulbactam AND doxycycline
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

7. Tx otitis media
Pneumovax - influenza
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

8. bipyramidal - strongly positive birefringent
5+ rads
Calcium oxalate crystals
Ofloxacin OR levofloxacin +/- metronidazole
Hypomagnesemia

9. Tx RA (best long-term outcome)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MTX
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

10. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
MTX
Diphenhydramine - chlorpheniramine - hydroxyzine
4 yo - copies triangle - catches ball - dresses self

11. writes name - counts 10 objects
Alpha-1 antitrypsin deficiency
Bupropion - varenicline - nicotine replacement
5 yo - draws person - ties shoes - skips
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

12. 2nd generation antihistamines
Patch - bupropion - varenicline
110-160bpm
Loratadine - fexofenadine - cetirizine
Cataracts

13. Tx for thyroid storm
<20lb - <1YO - Reacts to pain - Responds to noise
= LMP + 7 days - 3 months
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

14. Sx epiglottitis
Stridor - drooling - toxic appearance
Cataracts
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Nicotine inhaler - nasal spray - gum

15. cystoplasmic inclusions - not birefringent
After delivery until delivery of placenta and membranes <30 mins
Calcium pyrophosphate dehydrate crystals (pseudogout)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Calcium hydroxyapatite crystals

16. IUPC (intrauterine pressure catheter)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Measures strength of contractions
Stridor - drooling - toxic appearance
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

17. X-ray of ankle?
Diabetes - HTN - GN
IV penicillin (or ampicillin)
Stridor - drooling - toxic appearance
Normal mental status; no other injuries; seen within 10 days of injury

18. Augments contractions
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Oxytocin (IV)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

19. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Esophagitis - gastritis - dysphagia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Loratadine - fexofenadine - cetirizine

20. Tocodynamometer
Calcium pyrophosphate dehydrate crystals (pseudogout)
Bupropion - varenicline - nicotine replacement
Conrtaction monitoring along with fetal heart rate assessment
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

21. Tx of traveler's diarrhea
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)
DTaP - hepB - Hib - rotavirus - inactivated polio
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

22. Other causes of hypercalcemia
110-160bpm
6 yo
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

23. Sx otitis media
Esophagitis - gastritis - dysphagia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Steroids + bronchodilators
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

24. Electrolyte abnormality that increases the incidence of torsades de pointes
MTX
Hypomagnesemia
110-160bpm
9 mo - walks - throws - 1-3 words - 1-step commands

25. Rod shaped - rhomboid - weakly positive birefringent
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
16-18 weeks GA
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium pyrophosphate dehydrate crystals (pseudogout)

26. Tx hyperkalemia in CKD
IV penicillin (or ampicillin)
1 mo - eyes follow object to midline - vocalizes
DTaP - hepB - Hib - rotavirus - inactivated polio
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

27. group play - gender - knows name
Colchicine
Short-acting + 40mg prednisone x 10-14days
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

28. The five A's of smoking cessation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
(cefotetan OR cefoxitin) AND doxycycline
Diphenhydramine - chlorpheniramine - hydroxyzine
Ask - Advise - Assess - Assist - Arrange

29. dyspnea - visceral edema - hypotension
5+ rads
Anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

30. Bisphospohonates sfx
MCC melanoma. Radial growth.
Aortic aneurysm
Esophagitis - gastritis - dysphagia
Urticaria

31. Tx chlamydia
Thiazides
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
5+ rads

32. Pregnancy class D smoking cessation drugs
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid
Ear pain - itching - inflammation/swollen canal - exudates/discharge

33. Tx GAS ifxn
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Patch - bupropion - varenicline
Clindamycin AND gentamicin

34. Tender - boggy prostate. Dx?
6 yo
Prostatitis
DTaP - hepB - Hib - rotavirus - inactivated polio
Urinary calcium. Hyper PTH (high) >> FHH (normal)

35. Oral tx for PID
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ofloxacin OR levofloxacin +/- metronidazole
Calcium hydroxyapatite crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

36. social interaction
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid
4 yo - copies triangle - catches ball - dresses self
Bupropion - varenicline - nicotine replacement

37. Dx PID
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6 yo
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium oxalate crystals

38. Acral lentinous melanoma
1 mo - eyes follow object to midline - vocalizes
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Measures strength of contractions

39. Regards human face - eye contact
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 mo - eyes follow object to midline - vocalizes
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

40. identifies left - right
Pneumovax - influenza
NAC or IV NaHCO3
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
6 yo

41. Four cardinal fetal movements
1 mo - eyes follow object to midline - vocalizes
Flexion - internal rotation - extension - external rotation
Anaphylaxis
Monosodium urate crystals (gout)

42. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

43. DDX for geriatric hearing impairment
Ask - Advise - Assess - Assist - Arrange
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lung; SCC head & neck; RCC; breast; MM; prostate
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

44. Large - irregularly shaped - prutitic - erythematous wheals
Anemia
Urticaria
Esophagitis - gastritis - dysphagia
Calcium oxalate crystals

45. Superficial spreading melanoma
Ofloxacin OR levofloxacin +/- metronidazole
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
MCC melanoma. Radial growth.

46. Late deceleration
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium hydroxyapatite crystals
Bupropion - varenicline - nicotine replacement
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

47. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Cataracts
Calcium hydroxyapatite crystals

48. regards hand
4mo - sits unsupported - hand transfer - babbles
Pneumovax - influenza
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance

49. Signs of rupture of membranes

50. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
5 yo - draws person - ties shoes - skips
NAC or IV NaHCO3
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide