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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. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium hydroxyapatite crystals
Angioedema
Metronidazole or clindamycin

2. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Esophagitis - gastritis - dysphagia
5+ rads
Oxytocin (IV)

3. IV tx for PID
= LMP + 7 days - 3 months
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
4mo - sits unsupported - hand transfer - babbles
Ampicillin/sulbactam AND doxycycline

4. Tx otitis media
Biopsy
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange

5. Tx acute sinusitis
Nuchal translucency - serum hCG - PAPP-A
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)
Diabetes - HTN - GN

6. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Urticaria
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

7. IUPC (intrauterine pressure catheter)
Tdap - influenza - pneumovax
Measures strength of contractions
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

8. Age by which child says 'mama' and 'dada'
(cefotetan OR cefoxitin) AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6-9MO
Anaphylaxis

9. Four cardinal fetal movements
Thiazides
Flexion - internal rotation - extension - external rotation
5+ rads
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

10. Fe deficient anemia tx
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Fe deficient anemia
Ferrous sulfate 325mg tid

11. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anemia
Thiazdes; lithium
Ampicillin/sulbactam AND doxycycline

12. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
4 yo - copies triangle - catches ball - dresses self
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Cataracts

13. Cockcroft-Gault equation
Aortic aneurysm
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
(ofloxacin OR levofloxacin) +/- metronidazole

14. How much radiation is associated with fetal harm?
Pneumovax - influenza
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
5+ rads
Metronidazole or clindamycin

15. Immunizations for adult 65YO+
Ampicillin/sulbactam AND doxycycline
Most aggressive melanoma.
Tdap - influenza - pneumovax
Anemia

16. IV tx for PID
Angioedema
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
(cefotetan OR cefoxitin) AND doxycycline
Biopsy

17. DOC for HTN in elderly
Cataracts
Biopsy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Thiazides

18. Sx of hypercalcemia
6-9MO
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Urticaria
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

19. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
<20lb - <1YO - Reacts to pain - Responds to noise
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anterior shoulder cannot readily pass below the pubic symphysis.

20. Oral tx for PID
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Steroids + bronchodilators
Bupropion - varenicline - nicotine replacement
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

21. Tx gonorrhea
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ceftriaxone 125mg IM
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

22. Screened at 16-20 weeks GA for trisomy
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Flexion - internal rotation - extension - external rotation
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

23. Tx acute exacerbation COPD
Patch - bupropion - varenicline
Onset of labor until cervix dilation
Short-acting + 40mg prednisone x 10-14days
Nicotine inhaler - nasal spray - gum

24. IV tx for PID
Loratadine - fexofenadine - cetirizine
Clindamycin AND gentamicin
Angioedema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

25. Causes of CKD
Steroids + bronchodilators
Patch - bupropion - varenicline
Diabetes - HTN - GN
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

26. needles - strong negative birefringent (yellow crystals parallel light)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Monosodium urate crystals (gout)
IV penicillin (or ampicillin)

27. Oral tx for PID
Anemia
(ofloxacin OR levofloxacin) +/- metronidazole
16-18 weeks GA
Measures strength of contractions

28. ADL
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Bathing - dressing - eating - transferring - continence - toileting
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
5 yo - draws person - ties shoes - skips

29. recognizes strangers
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
IV penicillin (or ampicillin)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

30. Rod shaped - rhomboid - weakly positive birefringent
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium pyrophosphate dehydrate crystals (pseudogout)
Oxygen intervention 15h/d
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

31. Dx criteria for RA
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Calcium oxalate crystals
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Prostatitis

32. social interaction
4 yo - copies triangle - catches ball - dresses self
Conrtaction monitoring along with fetal heart rate assessment
Biopsy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

33. Pflx for traveler's diarrhea
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Fluoroquinolones
Ferrous sulfate 325mg tid
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

34. Bisphospohonates sfx
Ofloxacin OR levofloxacin +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
IV penicillin (or ampicillin)
Esophagitis - gastritis - dysphagia

35. bacteria causing pharyngitis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
<20lb - <1YO - Reacts to pain - Responds to noise

36. X-ray of ankle?
Short-acting + 40mg prednisone x 10-14days
Cataracts
Normal mental status; no other injuries; seen within 10 days of injury
Nicotine inhaler - nasal spray - gum

37. Immunizations at visit for 6MO
Steroids + bronchodilators
DTaP - hepB - Hib - rotavirus - inactivated polio
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Measures strength of contractions

38. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Oxytocin (IV)
Colchicine
(ofloxacin OR levofloxacin) +/- metronidazole

39. Tx bacterial vaginosis
Stridor - drooling - toxic appearance
Metronidazole or clindamycin
Nuchal translucency - serum hCG - PAPP-A
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

40. Corrected serum calcium =

41. DDX for geriatric hearing impairment
Steroids + bronchodilators
Oxygen intervention 15h/d
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Anemia

42. Tx hyperkalemia in CKD
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Cataracts
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

43. Optimal time for trisomy screen
16-18 weeks GA
Anterior shoulder cannot readily pass below the pubic symphysis.
MTX
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

44. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
4mo - sits unsupported - hand transfer - babbles
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thiazides

45. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Flexion - internal rotation - extension - external rotation
0.2-0.5mg aqueous EPI IM/SubQ
Fe deficient anemia

46. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Biopsy
Tdap - influenza - pneumovax
<20lb - <1YO - Reacts to pain - Responds to noise

47. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anterior shoulder cannot readily pass below the pubic symphysis.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

48. Granulomatous causes of hypercalcemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

49. First stage of labor
Angioedema
Onset of labor until cervix dilation
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

50. Sx epiglottitis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 mo - eyes follow object to midline - vocalizes
(cefotetan OR cefoxitin) AND doxycycline
Stridor - drooling - toxic appearance