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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. Nodular melanoma
Oxytocin (IV)
Anterior shoulder cannot readily pass below the pubic symphysis.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Most aggressive melanoma.

2. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Tuberculosis; sarcoidosis; hodgkin disease
Measures strength of contractions
DTaP - hepB - Hib - rotavirus - inactivated polio

3. How much radiation is associated with fetal harm?
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
5+ rads
Angioedema

4. Rod shaped - rhomboid - weakly positive birefringent
Onset of labor until cervix dilation
Calcium pyrophosphate dehydrate crystals (pseudogout)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

5. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ferrous sulfate 325mg tid

6. Sx epiglottitis
Stridor - drooling - toxic appearance
9 mo - walks - throws - 1-3 words - 1-step commands
Clindamycin AND gentamicin
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

7. Bisphospohonates sfx
NAC or IV NaHCO3
Esophagitis - gastritis - dysphagia
9 mo - walks - throws - 1-3 words - 1-step commands
Urticaria

8. X-ray of ankle?
DTaP - hepB - Hib - rotavirus - inactivated polio
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Normal mental status; no other injuries; seen within 10 days of injury
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

9. Screened at 11-13 weeks GA for trisomy
Urticaria
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Nuchal translucency - serum hCG - PAPP-A
Calcium hydroxyapatite crystals

10. First stage of labor
Calcium pyrophosphate dehydrate crystals (pseudogout)
Onset of labor until cervix dilation
110-160bpm
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

11. Augments contractions
Oxytocin (IV)
Hypomagnesemia
Flexion - internal rotation - extension - external rotation
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

12. Early deceleration
Nicotine inhaler - nasal spray - gum
Starts at contraction. caused by increased vagal tone from fetal head compression.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
2 mo - eyes follow object past midline - rolls over - laughs - squeals

13. ADL
Tdap - influenza - pneumovax
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Fluoroquinolones
Bathing - dressing - eating - transferring - continence - toileting

14. IV tx for PID
6 yo
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ampicillin/sulbactam AND doxycycline
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

15. regards hand
4 yo - copies triangle - catches ball - dresses self
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Nicotine inhaler - nasal spray - gum
4mo - sits unsupported - hand transfer - babbles

16. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
NAC or IV NaHCO3
5 yo - draws person - ties shoes - skips
Normal mental status; no other injuries; seen within 10 days of injury

17. Tender - boggy prostate. Dx?
Prostatitis
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance
Fluoroquinolones

18. dyspnea - visceral edema - hypotension
Anaphylaxis
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)
Nicotine inhaler - nasal spray - gum
Anemia

19. Granulomatous causes of hypercalcemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
4 yo - copies triangle - catches ball - dresses self
Tuberculosis; sarcoidosis; hodgkin disease

20. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Ask - Advise - Assess - Assist - Arrange
Ear pain - itching - inflammation/swollen canal - exudates/discharge
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

21. Tx otitis media
NAC or IV NaHCO3
Colchicine
Biopsy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

22. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
<20lb - <1YO - Reacts to pain - Responds to noise
NAC or IV NaHCO3
= LMP + 7 days - 3 months
Measures strength of contractions

23. Cockcroft-Gault equation
6 yo
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Most aggressive melanoma.

24. Third stage of labor
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
6-9MO
After delivery until delivery of placenta and membranes <30 mins
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

25. 1st generation antihistamines
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ofloxacin OR levofloxacin +/- metronidazole
Diphenhydramine - chlorpheniramine - hydroxyzine
Oxytocin (IV)

26. MCC blindness worldwide
Cataracts
Lung; SCC head & neck; RCC; breast; MM; prostate
Oxytocin (IV)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

27. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Oxygen intervention 15h/d
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
NAC or IV NaHCO3

28. Tx for thyroid storm
Lung; SCC head & neck; RCC; breast; MM; prostate
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Anemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

29. Corrected serum calcium =

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30. Tx acute gout
Thiazides
Colchicine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anemia

31. Tx RA (best long-term outcome)
Calcium oxalate crystals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Aortic aneurysm
MTX

32. IUPC (intrauterine pressure catheter)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Measures strength of contractions
16-18 weeks GA

33. IADL
5 yo - draws person - ties shoes - skips
MTX
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
5+ rads

34. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Aortic aneurysm
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ferrous sulfate 325mg tid

35. bipyramidal - strongly positive birefringent
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Calcium oxalate crystals
Diphenhydramine - chlorpheniramine - hydroxyzine

36. Tx GAS ifxn
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Normal mental status; no other injuries; seen within 10 days of injury

37. bacteria causing pharyngitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
(ofloxacin OR levofloxacin) +/- metronidazole

38. Recommended folic acid daily dose
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
4 yo - copies triangle - catches ball - dresses self
Onset of labor until cervix dilation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

39. Electrolyte abnormality that increases the incidence of torsades de pointes
4mo - sits unsupported - hand transfer - babbles
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Conrtaction monitoring along with fetal heart rate assessment
Hypomagnesemia

40. Sx of hypercalcemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

41. Oral tx for PID
Calcium oxalate crystals
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
DTaP - hepB - Hib - rotavirus - inactivated polio
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

42. medications causing hypercalcemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Measures strength of contractions
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Thiazdes; lithium

43. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Most aggressive melanoma.
Bupropion - varenicline - nicotine replacement
Calcium oxalate crystals

44. Complications of GAS infxn
9 mo - walks - throws - 1-3 words - 1-step commands
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

45. painless - deep - subQ swelling (periorbital - circumoral - facial)
4 yo - copies triangle - catches ball - dresses self
Angioedema
(ofloxacin OR levofloxacin) +/- metronidazole
Cataracts

46. social interaction
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Tdap - influenza - pneumovax
4 yo - copies triangle - catches ball - dresses self
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

47. Tx hyperkalemia in CKD
Nuchal translucency - serum hCG - PAPP-A
Anemia
Anterior shoulder cannot readily pass below the pubic symphysis.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

48. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Short-acting + 40mg prednisone x 10-14days
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

49. Superficial spreading melanoma
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)
MCC melanoma. Radial growth.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Prostatitis

50. tx shoulder dystocia

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