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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. GBS tx
Thiazides
Hypomagnesemia
IV penicillin (or ampicillin)
Aortic aneurysm

2. ADL
Bathing - dressing - eating - transferring - continence - toileting
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
16-18 weeks GA
110-160bpm

3. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Fe deficient anemia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

4. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Long axis of fetus to long axis of mother (longitudinal or transverse)

5. 2nd generation antihistamines
Clindamycin AND gentamicin
5 yo - draws person - ties shoes - skips
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)
Loratadine - fexofenadine - cetirizine

6. Emphysema - <45YO - nonsmoker
Nuchal translucency - serum hCG - PAPP-A
Bupropion - varenicline - nicotine replacement
Loratadine - fexofenadine - cetirizine
Alpha-1 antitrypsin deficiency

7. Tx hyperkalemia in CKD
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Fluoroquinolones
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

8. Fetal lie
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Long axis of fetus to long axis of mother (longitudinal or transverse)
110-160bpm
Ampicillin/sulbactam AND doxycycline

9. Dx bacterial vaginosis
Ofloxacin OR levofloxacin +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Colchicine
Ask - Advise - Assess - Assist - Arrange

10. bacteria causing pharyngitis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

11. explorations
Nuchal translucency - serum hCG - PAPP-A
Measures strength of contractions
Aortic aneurysm
9 mo - walks - throws - 1-3 words - 1-step commands

12. social interaction
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Esophagitis - gastritis - dysphagia
4 yo - copies triangle - catches ball - dresses self
Ceftriaxone 125mg IM

13. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Diphenhydramine - chlorpheniramine - hydroxyzine
NAC or IV NaHCO3
Clindamycin AND gentamicin

14. Tx of traveler's diarrhea
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
3 yo - identify body part - copies square - hops - throws - past tense - story telling

15. Pflx for traveler's diarrhea
Short-acting + 40mg prednisone x 10-14days
Pneumovax - influenza
Fluoroquinolones
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

16. Third stage of labor
MCC melanoma in Africans/Asians. Under nails - soles - palms.
MCC melanoma. Radial growth.
Fluoroquinolones
After delivery until delivery of placenta and membranes <30 mins

17. Sx otitis media
Oxygen intervention 15h/d
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Calcium hydroxyapatite crystals
Normal mental status; no other injuries; seen within 10 days of injury

18. DDX for geriatric hearing impairment
Tdap - influenza - pneumovax
9 mo - walks - throws - 1-3 words - 1-step commands
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Monosodium urate crystals (gout)

19. recognizes strangers
Ferrous sulfate 325mg tid
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Flexion - internal rotation - extension - external rotation
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

20. Immunizations for COPD patients
Long axis of fetus to long axis of mother (longitudinal or transverse)
4 yo - copies triangle - catches ball - dresses self
Calcium oxalate crystals
Pneumovax - influenza

21. social smile - parent recognition
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
6-9MO

22. Sx epiglottitis
5 yo - draws person - ties shoes - skips
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

23. shoulder dystocia
Ceftriaxone 125mg IM
After delivery until delivery of placenta and membranes <30 mins
DTaP - hepB - Hib - rotavirus - inactivated polio
Anterior shoulder cannot readily pass below the pubic symphysis.

24. Cockcroft-Gault equation
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium pyrophosphate dehydrate crystals (pseudogout)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

25. Bisphospohonates sfx
Short-acting + 40mg prednisone x 10-14days
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Esophagitis - gastritis - dysphagia
Thiazides

26. Second stage of labor
Oxytocin (IV)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Lung; SCC head & neck; RCC; breast; MM; prostate
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

27. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ear pain - itching - inflammation/swollen canal - exudates/discharge
MCC melanoma. Radial growth.
Prostatitis

28. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium oxalate crystals
Alpha-1 antitrypsin deficiency
(ofloxacin OR levofloxacin) +/- metronidazole

29. Optimal time for trisomy screen
16-18 weeks GA
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Anaphylaxis
NAC or IV NaHCO3

30. Screening for 65-76YO male smoker
(ofloxacin OR levofloxacin) +/- metronidazole
Starts at contraction. caused by increased vagal tone from fetal head compression.
Nicotine inhaler - nasal spray - gum
Aortic aneurysm

31. IV tx for PID
5+ rads
Cataracts
Clindamycin AND gentamicin
5 yo - draws person - ties shoes - skips

32. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bupropion - varenicline - nicotine replacement
Urinary calcium. Hyper PTH (high) >> FHH (normal)

33. First stage of labor
Alpha-1 antitrypsin deficiency
Onset of labor until cervix dilation
Tdap - influenza - pneumovax
Bathing - dressing - eating - transferring - continence - toileting

34. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Nicotine inhaler - nasal spray - gum
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Stridor - drooling - toxic appearance

35. Recommended folic acid daily dose
DTaP - hepB - Hib - rotavirus - inactivated polio
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Onset of labor until cervix dilation
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

36. Tx GAS ifxn
1 mo - eyes follow object to midline - vocalizes
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

37. Tx for thyroid storm
Ofloxacin OR levofloxacin +/- metronidazole
Calcium hydroxyapatite crystals
9 mo - walks - throws - 1-3 words - 1-step commands
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

38. MCC blindness worldwide
Cataracts
After delivery until delivery of placenta and membranes <30 mins
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Starts at contraction. caused by increased vagal tone from fetal head compression.

39. CKD Stages
Short-acting + 40mg prednisone x 10-14days
9 mo - walks - throws - 1-3 words - 1-step commands
Nuchal translucency - serum hCG - PAPP-A
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

40. Tx bacterial vaginosis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Metronidazole or clindamycin
Loratadine - fexofenadine - cetirizine
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

41. Fe deficient anemia tx
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ferrous sulfate 325mg tid
Cataracts

42. IADL
Calcium hydroxyapatite crystals
Hypomagnesemia
Bupropion - varenicline - nicotine replacement
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

43. Early deceleration
Esophagitis - gastritis - dysphagia
4mo - sits unsupported - hand transfer - babbles
Starts at contraction. caused by increased vagal tone from fetal head compression.
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)

44. Tocodynamometer
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Fe deficient anemia
Prostatitis
Conrtaction monitoring along with fetal heart rate assessment

45. Improve short-term outcomes in acute exacerbations of COPD - asthma
Alpha-1 antitrypsin deficiency
= LMP + 7 days - 3 months
Steroids + bronchodilators
MCC melanoma. Radial growth.

46. Complications of PID
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Metronidazole or clindamycin
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Long axis of fetus to long axis of mother (longitudinal or transverse)

47. medications causing hypercalcemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nicotine inhaler - nasal spray - gum
After delivery until delivery of placenta and membranes <30 mins
Thiazdes; lithium

48. Oral tx for PID
6 yo
Urinary calcium. Hyper PTH (high) >> FHH (normal)
(ofloxacin OR levofloxacin) +/- metronidazole
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

49. Large - irregularly shaped - prutitic - erythematous wheals
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
6 yo
Urticaria

50. Tx acute sinusitis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Stridor - drooling - toxic appearance