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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
Measures strength of contractions
Angioedema
3 yo - identify body part - copies square - hops - throws - past tense - story telling
2 mo - eyes follow object past midline - rolls over - laughs - squeals

2. MCC blindness worldwide
Lung; SCC head & neck; RCC; breast; MM; prostate
9 mo - walks - throws - 1-3 words - 1-step commands
Cataracts
Diabetes - HTN - GN

3. Screened at 16-20 weeks GA for trisomy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Prostatitis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

4. Acral lentinous melanoma
MCC melanoma. Radial growth.
MCC melanoma in Africans/Asians. Under nails - soles - palms.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

5. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Pneumovax - influenza
Nicotine inhaler - nasal spray - gum
Bathing - dressing - eating - transferring - continence - toileting

6. Superficial spreading melanoma
= LMP + 7 days - 3 months
MCC melanoma. Radial growth.
Alpha-1 antitrypsin deficiency
Anaphylaxis

7. Corrected serum calcium =

8. Electrolyte abnormality that increases the incidence of torsades de pointes
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Hypomagnesemia
Long axis of fetus to long axis of mother (longitudinal or transverse)

9. X-ray on knee?
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
DTaP - hepB - Hib - rotavirus - inactivated polio
Pneumovax - influenza
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

10. Age by which child says 'mama' and 'dada'
1 mo - eyes follow object to midline - vocalizes
6-9MO
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
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)

11. Augments contractions
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium hydroxyapatite crystals
Oxytocin (IV)
Nicotine inhaler - nasal spray - gum

12. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
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)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

13. bacteria causing pharyngitis
After delivery until delivery of placenta and membranes <30 mins
Conrtaction monitoring along with fetal heart rate assessment
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

14. MONA therapy
16-18 weeks GA
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)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

15. Recommendations for rear-facing car seat
Prostatitis
<20lb - <1YO - Reacts to pain - Responds to noise
(ofloxacin OR levofloxacin) +/- metronidazole
Thiazides

16. Pregnancy class C smoking cessation drugs
Anemia
Patch - bupropion - varenicline
Clindamycin AND gentamicin
DTaP - hepB - Hib - rotavirus - inactivated polio

17. needles - strong negative birefringent (yellow crystals parallel light)
Bupropion - varenicline - nicotine replacement
Monosodium urate crystals (gout)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
= LMP + 7 days - 3 months

18. Recommended folic acid daily dose
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Bathing - dressing - eating - transferring - continence - toileting
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
4mo - sits unsupported - hand transfer - babbles

19. Pregnancy class D smoking cessation drugs
Colchicine
Nicotine inhaler - nasal spray - gum
Urticaria
Conrtaction monitoring along with fetal heart rate assessment

20. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Patch - bupropion - varenicline
Calcium hydroxyapatite crystals
Ear pain - itching - inflammation/swollen canal - exudates/discharge

21. Third stage of labor
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
After delivery until delivery of placenta and membranes <30 mins
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Cataracts

22. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Patch - bupropion - varenicline
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

23. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MTX
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

24. Immunizations for adult 65YO+
Anterior shoulder cannot readily pass below the pubic symphysis.
Ear pain - itching - inflammation/swollen canal - exudates/discharge
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)
Tdap - influenza - pneumovax

25. Unstable angina vs MI Dx tests
Conrtaction monitoring along with fetal heart rate assessment
2 mo - eyes follow object past midline - rolls over - laughs - squeals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
16-18 weeks GA

26. Oral tx for PID
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Biopsy
(ofloxacin OR levofloxacin) +/- metronidazole
Patch - bupropion - varenicline

27. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Prostatitis
Diphenhydramine - chlorpheniramine - hydroxyzine
Ceftriaxone 125mg IM

28. The five A's of smoking cessation
Hypomagnesemia
Aortic aneurysm
Ask - Advise - Assess - Assist - Arrange
Bupropion - varenicline - nicotine replacement

29. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
6-9MO
Fe deficient anemia
Anemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

30. variable deceleration
16-18 weeks GA
Ofloxacin OR levofloxacin +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tuberculosis; sarcoidosis; hodgkin disease

31. Oral tx for PID
5 yo - draws person - ties shoes - skips
Diabetes - HTN - GN
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)

32. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
4 yo - copies triangle - catches ball - dresses self
Onset of labor until cervix dilation
MCC melanoma in Africans/Asians. Under nails - soles - palms.

33. ADL
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
5 yo - draws person - ties shoes - skips
Bathing - dressing - eating - transferring - continence - toileting

34. Bisphospohonates sfx
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Esophagitis - gastritis - dysphagia
Anemia

35. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Starts at contraction. caused by increased vagal tone from fetal head compression.
Thiazides
Normal mental status; no other injuries; seen within 10 days of injury

36. DDX for geriatric hearing impairment
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ask - Advise - Assess - Assist - Arrange
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

37. Improve short-term outcomes in acute exacerbations of COPD - asthma
Prostatitis
Steroids + bronchodilators
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Long axis of fetus to long axis of mother (longitudinal or transverse)

38. Smoking cessation agents
Anterior shoulder cannot readily pass below the pubic symphysis.
Bupropion - varenicline - nicotine replacement
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. Dx criteria for RA
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(cefotetan OR cefoxitin) AND doxycycline

40. Tx acute gout
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Colchicine
Fluoroquinolones
Stridor - drooling - toxic appearance

41. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Calcium oxalate crystals
Oxygen intervention 15h/d

42. Malignancies with hypercalcemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lung; SCC head & neck; RCC; breast; MM; prostate
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
6-9MO

43. First stage of labor
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Onset of labor until cervix dilation
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anemia

44. Dx PID
Calcium hydroxyapatite crystals
(cefotetan OR cefoxitin) AND doxycycline
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Starts at contraction. caused by increased vagal tone from fetal head compression.

45. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Metronidazole or clindamycin
Pneumovax - influenza

46. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Nuchal translucency - serum hCG - PAPP-A
NAC or IV NaHCO3
Angioedema
Short-acting + 40mg prednisone x 10-14days

47. Tx GAS ifxn
Biopsy
Pneumovax - influenza
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

48. dyspnea - visceral edema - hypotension
Anaphylaxis
DTaP - hepB - Hib - rotavirus - inactivated polio
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
MTX

49. cystoplasmic inclusions - not birefringent
Urinary calcium. Hyper PTH (high) >> FHH (normal)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Calcium hydroxyapatite crystals
Ofloxacin OR levofloxacin +/- metronidazole

50. Other causes of hypercalcemia
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Oxygen intervention 15h/d
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency