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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. DDX for geriatric hearing impairment
Calcium oxalate crystals
16-18 weeks GA
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

2. identifies left - right
6 yo
Pneumovax - influenza
Starts at contraction. caused by increased vagal tone from fetal head compression.
Biopsy

3. DOC for HTN in elderly
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thiazides
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Loratadine - fexofenadine - cetirizine

4. 2nd generation antihistamines
Fe deficient anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Loratadine - fexofenadine - cetirizine
After delivery until delivery of placenta and membranes <30 mins

5. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anaphylaxis
9 mo - walks - throws - 1-3 words - 1-step commands

6. Only therapy to decrease mortality in stage IV COPD
4 yo - copies triangle - catches ball - dresses self
Ask - Advise - Assess - Assist - Arrange
Oxygen intervention 15h/d
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

7. MCC blindness worldwide
4mo - sits unsupported - hand transfer - babbles
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Cataracts
Fe deficient anemia

8. Electrolyte abnormality that increases the incidence of torsades de pointes
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Hypomagnesemia
Measures strength of contractions
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

9. Immunizations for COPD patients
Pneumovax - influenza
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ferrous sulfate 325mg tid

10. causes of acute bronchitis
Ampicillin/sulbactam AND doxycycline
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Age-related sensorineural hearing loss (high frequency and speech discrimination)

11. Other causes of hypercalcemia
Short-acting + 40mg prednisone x 10-14days
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Loratadine - fexofenadine - cetirizine

12. CKD Stages
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Measures strength of contractions
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

13. Fetal lie
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

14. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Nuchal translucency - serum hCG - PAPP-A

15. variable deceleration
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

16. Mediators released in response to allergen
Loratadine - fexofenadine - cetirizine
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Most aggressive melanoma.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

17. IV tx for PID
Alpha-1 antitrypsin deficiency
1 mo - eyes follow object to midline - vocalizes
Loratadine - fexofenadine - cetirizine
Clindamycin AND gentamicin

18. Tx hyperkalemia in CKD
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Bathing - dressing - eating - transferring - continence - toileting
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
9 mo - walks - throws - 1-3 words - 1-step commands

19. Four cardinal fetal movements
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Flexion - internal rotation - extension - external rotation
Diphenhydramine - chlorpheniramine - hydroxyzine

20. regards hand
4mo - sits unsupported - hand transfer - babbles
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Clindamycin AND gentamicin

21. Tx bacterial vaginosis
After delivery until delivery of placenta and membranes <30 mins
Anaphylaxis
Nicotine inhaler - nasal spray - gum
Metronidazole or clindamycin

22. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Bathing - dressing - eating - transferring - continence - toileting
Ofloxacin OR levofloxacin +/- metronidazole
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

23. Nonfunctioning nodules > 1cm require _____
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Biopsy
NAC or IV NaHCO3

24. Dx bacterial rhinosinusitis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Biopsy
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)
Flexion - internal rotation - extension - external rotation

25. social smile - parent recognition
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Hypomagnesemia

26. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
NAC or IV NaHCO3
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

27. Nodular melanoma
Onset of labor until cervix dilation
Most aggressive melanoma.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Diphenhydramine - chlorpheniramine - hydroxyzine

28. recognizes strangers
Alpha-1 antitrypsin deficiency
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6 mo - pincer - crawls - cruises - mamma - dada - byebye

29. Low serum iron - low MCV - low ferritin - +stool guaiac
Urticaria
Fe deficient anemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

30. Tx RA (best long-term outcome)
After delivery until delivery of placenta and membranes <30 mins
Normal mental status; no other injuries; seen within 10 days of injury
MTX
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

31. dyspnea - visceral edema - hypotension
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anaphylaxis
5+ rads
Fluoroquinolones

32. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nicotine inhaler - nasal spray - gum
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

33. social interaction
4 yo - copies triangle - catches ball - dresses self
Anaphylaxis
Loratadine - fexofenadine - cetirizine
Age-related sensorineural hearing loss (high frequency and speech discrimination)

34. Age by which child says 'mama' and 'dada'
Biopsy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Esophagitis - gastritis - dysphagia
6-9MO

35. Tx gonorrhea
MTX
Ceftriaxone 125mg IM
Fe deficient anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

36. Granulomatous causes of hypercalcemia
(cefotetan OR cefoxitin) AND doxycycline
Normal mental status; no other injuries; seen within 10 days of injury
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Tuberculosis; sarcoidosis; hodgkin disease

37. Sx otitis externa
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Urinary calcium. Hyper PTH (high) >> FHH (normal)
9 mo - walks - throws - 1-3 words - 1-step commands
Ear pain - itching - inflammation/swollen canal - exudates/discharge

38. IV tx for PID
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(cefotetan OR cefoxitin) AND doxycycline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

39. stranger/separation anxiety
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Angioedema

40. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Long axis of fetus to long axis of mother (longitudinal or transverse)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

41. Complications of PID
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
3 yo - identify body part - copies square - hops - throws - past tense - story telling

42. bipyramidal - strongly positive birefringent
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Starts at contraction. caused by increased vagal tone from fetal head compression.
Calcium oxalate crystals

43. X-ray of ankle?
Short-acting + 40mg prednisone x 10-14days
Normal mental status; no other injuries; seen within 10 days of injury
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
9 mo - walks - throws - 1-3 words - 1-step commands

44. Optimal time for trisomy screen
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Flexion - internal rotation - extension - external rotation
0.2-0.5mg aqueous EPI IM/SubQ
16-18 weeks GA

45. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
= LMP + 7 days - 3 months
Ask - Advise - Assess - Assist - Arrange
5 yo - draws person - ties shoes - skips

46. tx shoulder dystocia

47. The five A's of smoking cessation
4 yo - copies triangle - catches ball - dresses self
Alpha-1 antitrypsin deficiency
Fluoroquinolones
Ask - Advise - Assess - Assist - Arrange

48. Estimated delivery date (Naegele's rule)
Anaphylaxis
Hypomagnesemia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
= LMP + 7 days - 3 months

49. X-ray on knee?
After delivery until delivery of placenta and membranes <30 mins
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stridor - drooling - toxic appearance

50. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
4mo - sits unsupported - hand transfer - babbles
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)