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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. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
MTX
MCC melanoma in Africans/Asians. Under nails - soles - palms.

2. tx shoulder dystocia

3. Electrolyte abnormality that increases the incidence of torsades de pointes
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Hypomagnesemia
0.2-0.5mg aqueous EPI IM/SubQ
Calcium pyrophosphate dehydrate crystals (pseudogout)

4. First stage of labor
4 yo - copies triangle - catches ball - dresses self
= LMP + 7 days - 3 months
Onset of labor until cervix dilation
Urinary calcium. Hyper PTH (high) >> FHH (normal)

5. shoulder dystocia
MTX
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
9 mo - walks - throws - 1-3 words - 1-step commands
Anterior shoulder cannot readily pass below the pubic symphysis.

6. Large - irregularly shaped - prutitic - erythematous wheals
Lung; SCC head & neck; RCC; breast; MM; prostate
Conrtaction monitoring along with fetal heart rate assessment
Urticaria
Esophagitis - gastritis - dysphagia

7. social smile - parent recognition
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Aortic aneurysm
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

8. Sx epiglottitis
Bathing - dressing - eating - transferring - continence - toileting
Stridor - drooling - toxic appearance
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Oxytocin (IV)

9. Sx otitis media
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
4mo - sits unsupported - hand transfer - babbles

10. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Angioedema
Most aggressive melanoma.
Ampicillin/sulbactam AND doxycycline

11. bacteria causing pharyngitis
6-9MO
Calcium oxalate crystals
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Colchicine

12. bipyramidal - strongly positive birefringent
Ask - Advise - Assess - Assist - Arrange
Short-acting + 40mg prednisone x 10-14days
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Calcium oxalate crystals

13. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

14. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Cataracts
= LMP + 7 days - 3 months
NAC or IV NaHCO3

15. Low serum iron - low MCV - low ferritin - +stool guaiac
Tuberculosis; sarcoidosis; hodgkin disease
Fe deficient anemia
Thiazdes; lithium
6 mo - pincer - crawls - cruises - mamma - dada - byebye

16. writes name - counts 10 objects
6-9MO
Ampicillin/sulbactam AND doxycycline
5 yo - draws person - ties shoes - skips
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

17. dyspnea - visceral edema - hypotension
= LMP + 7 days - 3 months
Thiazdes; lithium
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anaphylaxis

18. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
DTaP - hepB - Hib - rotavirus - inactivated polio
0.2-0.5mg aqueous EPI IM/SubQ

19. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
6 yo
After delivery until delivery of placenta and membranes <30 mins
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

20. DOC for HTN in elderly
Thiazides
Bupropion - varenicline - nicotine replacement
Tdap - influenza - pneumovax
Normal mental status; no other injuries; seen within 10 days of injury

21. Complications of PID
(cefotetan OR cefoxitin) AND doxycycline
DTaP - hepB - Hib - rotavirus - inactivated polio
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Metronidazole or clindamycin

22. X-ray of ankle?
Age-related sensorineural hearing loss (high frequency and speech discrimination)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Normal mental status; no other injuries; seen within 10 days of injury
Thiazides

23. GBS tx
Tuberculosis; sarcoidosis; hodgkin disease
IV penicillin (or ampicillin)
Ask - Advise - Assess - Assist - Arrange
3 yo - identify body part - copies square - hops - throws - past tense - story telling

24. Optimal time for trisomy screen
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
6-9MO
16-18 weeks GA

25. Tx acute gout
Colchicine
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
4mo - sits unsupported - hand transfer - babbles
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

26. Early deceleration
Ofloxacin OR levofloxacin +/- metronidazole
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ask - Advise - Assess - Assist - Arrange
Monosodium urate crystals (gout)

27. IV tx for PID
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium hydroxyapatite crystals
IV penicillin (or ampicillin)
(cefotetan OR cefoxitin) AND doxycycline

28. Regards human face - eye contact
Diphenhydramine - chlorpheniramine - hydroxyzine
1 mo - eyes follow object to midline - vocalizes
Pneumovax - influenza
Calcium oxalate crystals

29. Unstable angina vs MI Dx tests
Ceftriaxone 125mg IM
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
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)

30. Second stage of labor
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

31. Only therapy to decrease mortality in stage IV COPD
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Oxygen intervention 15h/d
5 yo - draws person - ties shoes - skips
Colchicine

32. Cockcroft-Gault equation
Hypomagnesemia
5+ rads
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

33. CKD Stages
(cefotetan OR cefoxitin) AND doxycycline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
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)
Anterior shoulder cannot readily pass below the pubic symphysis.

34. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
MTX
Calcium pyrophosphate dehydrate crystals (pseudogout)
Diphenhydramine - chlorpheniramine - hydroxyzine

35. Emphysema - <45YO - nonsmoker
4 yo - copies triangle - catches ball - dresses self
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Alpha-1 antitrypsin deficiency
Ear pain - itching - inflammation/swollen canal - exudates/discharge

36. Late deceleration
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Esophagitis - gastritis - dysphagia
Tdap - influenza - pneumovax

37. IUPC (intrauterine pressure catheter)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Measures strength of contractions
Nicotine inhaler - nasal spray - gum
NAC or IV NaHCO3

38. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
16-18 weeks GA
IV penicillin (or ampicillin)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

39. Tx acute exacerbation COPD
4mo - sits unsupported - hand transfer - babbles
Ear pain - itching - inflammation/swollen canal - exudates/discharge
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Short-acting + 40mg prednisone x 10-14days

40. causes of acute bronchitis
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
NAC or IV NaHCO3

41. Superficial spreading melanoma
MCC melanoma. Radial growth.
Nicotine inhaler - nasal spray - gum
Alpha-1 antitrypsin deficiency
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

42. Fetal lie
Fe deficient anemia
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
6 yo

43. Nonfunctioning nodules > 1cm require _____
Metronidazole or clindamycin
Biopsy
DTaP - hepB - Hib - rotavirus - inactivated polio
Diphenhydramine - chlorpheniramine - hydroxyzine

44. Dx bacterial rhinosinusitis
Onset of labor until cervix dilation
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)
Clindamycin AND gentamicin
Normal mental status; no other injuries; seen within 10 days of injury

45. IADL
Flexion - internal rotation - extension - external rotation
Clindamycin AND gentamicin
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
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)

46. MCC blindness worldwide
Cataracts
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Esophagitis - gastritis - dysphagia

47. Screening for 65-76YO male smoker
Aortic aneurysm
(cefotetan OR cefoxitin) AND doxycycline
Thiazides
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

48. Dx criteria for RA
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)
Urticaria
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

49. Oral tx for PID
Anterior shoulder cannot readily pass below the pubic symphysis.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Pneumovax - influenza
1 mo - eyes follow object to midline - vocalizes

50. Tx bacterial vaginosis
Flexion - internal rotation - extension - external rotation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Metronidazole or clindamycin
Ofloxacin OR levofloxacin +/- metronidazole