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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. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Most aggressive melanoma.
Measures strength of contractions
Biopsy

2. shoulder dystocia
6-9MO
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Anterior shoulder cannot readily pass below the pubic symphysis.

3. IADL
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ferrous sulfate 325mg tid
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Anemia

4. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
MCC melanoma. Radial growth.
Ferrous sulfate 325mg tid

5. MCC blindness worldwide
1 mo - eyes follow object to midline - vocalizes
Cataracts
Loratadine - fexofenadine - cetirizine
Calcium oxalate crystals

6. tx shoulder dystocia

7. Sx of hypercalcemia
Calcium hydroxyapatite crystals
Steroids + bronchodilators
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

8. identifies left - right
Conrtaction monitoring along with fetal heart rate assessment
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Short-acting + 40mg prednisone x 10-14days
6 yo

9. GBS tx
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
IV penicillin (or ampicillin)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

10. The five A's of smoking cessation
Calcium pyrophosphate dehydrate crystals (pseudogout)
Oxytocin (IV)
Ask - Advise - Assess - Assist - Arrange
4 yo - copies triangle - catches ball - dresses self

11. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Onset of labor until cervix dilation
Ofloxacin OR levofloxacin +/- metronidazole
Cataracts

12. Only therapy to decrease mortality in stage IV COPD
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ceftriaxone 125mg IM
Oxygen intervention 15h/d

13. parallel play
0.2-0.5mg aqueous EPI IM/SubQ
<20lb - <1YO - Reacts to pain - Responds to noise
Starts at contraction. caused by increased vagal tone from fetal head compression.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

14. Cockcroft-Gault equation
DTaP - hepB - Hib - rotavirus - inactivated polio
Aortic aneurysm
Diphenhydramine - chlorpheniramine - hydroxyzine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

15. Pflx for traveler's diarrhea
Fluoroquinolones
Tdap - influenza - pneumovax
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

16. Sx peritonsillar abscess
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
4mo - sits unsupported - hand transfer - babbles
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

17. Augments contractions
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Pneumovax - influenza
Oxytocin (IV)
Clindamycin AND gentamicin

18. Corrected serum calcium =

19. 2nd generation antihistamines
Ofloxacin OR levofloxacin +/- metronidazole
Loratadine - fexofenadine - cetirizine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Oxygen intervention 15h/d

20. Fetal heart rate range
Fe deficient anemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
110-160bpm
Nicotine inhaler - nasal spray - gum

21. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Conrtaction monitoring along with fetal heart rate assessment
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

22. Oral tx for PID
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
(ofloxacin OR levofloxacin) +/- metronidazole
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

23. needles - strong negative birefringent (yellow crystals parallel light)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Monosodium urate crystals (gout)

24. Tx for anaphylaxis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
0.2-0.5mg aqueous EPI IM/SubQ
Tdap - influenza - pneumovax
Oxytocin (IV)

25. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
Angioedema
Long axis of fetus to long axis of mother (longitudinal or transverse)
Normal mental status; no other injuries; seen within 10 days of injury

26. Sx epiglottitis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Stridor - drooling - toxic appearance
Ear pain - itching - inflammation/swollen canal - exudates/discharge

27. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Fe deficient anemia
Alpha-1 antitrypsin deficiency
Ferrous sulfate 325mg tid

28. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
16-18 weeks GA
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Anemia
Alpha-1 antitrypsin deficiency

29. Dx PID
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

30. Emphysema - <45YO - nonsmoker
(cefotetan OR cefoxitin) AND doxycycline
Bupropion - varenicline - nicotine replacement
Alpha-1 antitrypsin deficiency
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

31. Rod shaped - rhomboid - weakly positive birefringent
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Normal mental status; no other injuries; seen within 10 days of injury
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

32. Optimal time for trisomy screen
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
16-18 weeks GA
Patch - bupropion - varenicline
4mo - sits unsupported - hand transfer - babbles

33. bacteria causing pharyngitis
Fluoroquinolones
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Nuchal translucency - serum hCG - PAPP-A
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

34. Tx GAS ifxn
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Bupropion - varenicline - nicotine replacement
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

35. Bisphospohonates sfx
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Bupropion - varenicline - nicotine replacement
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Esophagitis - gastritis - dysphagia

36. Other causes of hypercalcemia
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)
Calcium hydroxyapatite crystals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

37. cystoplasmic inclusions - not birefringent
6-9MO
MTX
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium hydroxyapatite crystals

38. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
MTX
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Pneumovax - influenza

39. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

40. Tx acute gout
Oxytocin (IV)
Colchicine
Fe deficient anemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

41. Screened at 11-13 weeks GA for trisomy
Normal mental status; no other injuries; seen within 10 days of injury
Nuchal translucency - serum hCG - PAPP-A
110-160bpm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

42. Dx criteria for RA
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
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)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

43. regards hand
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Bupropion - varenicline - nicotine replacement
4mo - sits unsupported - hand transfer - babbles
9 mo - walks - throws - 1-3 words - 1-step commands

44. Complications of PID
Diabetes - HTN - GN
Normal mental status; no other injuries; seen within 10 days of injury
MTX
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

45. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Diabetes - HTN - GN

46. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
= LMP + 7 days - 3 months
4mo - sits unsupported - hand transfer - babbles
Long axis of fetus to long axis of mother (longitudinal or transverse)

47. Estimated delivery date (Naegele's rule)
Long axis of fetus to long axis of mother (longitudinal or transverse)
= LMP + 7 days - 3 months
Ofloxacin OR levofloxacin +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise

48. Electrolyte abnormality that increases the incidence of torsades de pointes
16-18 weeks GA
Hypomagnesemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Normal mental status; no other injuries; seen within 10 days of injury

49. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Ask - Advise - Assess - Assist - Arrange
NAC or IV NaHCO3
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Colchicine

50. Unstable angina vs MI Dx tests
6 yo
9 mo - walks - throws - 1-3 words - 1-step commands
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Fluoroquinolones