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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. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
NAC or IV NaHCO3

2. dyspnea - visceral edema - hypotension
Anaphylaxis
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Tdap - influenza - pneumovax
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

3. cystoplasmic inclusions - not birefringent
NAC or IV NaHCO3
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium hydroxyapatite crystals
6-9MO

4. Optimal time for trisomy screen
Tuberculosis; sarcoidosis; hodgkin disease
16-18 weeks GA
Thiazides
Anemia

5. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ferrous sulfate 325mg tid
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Normal mental status; no other injuries; seen within 10 days of injury

6. Tx chlamydia
Ofloxacin OR levofloxacin +/- metronidazole
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

7. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
6-9MO
(ofloxacin OR levofloxacin) +/- metronidazole
Most aggressive melanoma.

8. painless - deep - subQ swelling (periorbital - circumoral - facial)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Oxytocin (IV)
Angioedema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

9. Only therapy to decrease mortality in stage IV COPD
Clindamycin AND gentamicin
5+ rads
Oxygen intervention 15h/d
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

10. Dx criteria for RA
MTX
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
4mo - sits unsupported - hand transfer - babbles

11. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Tdap - influenza - pneumovax
1 mo - eyes follow object to midline - vocalizes
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

12. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Lung; SCC head & neck; RCC; breast; MM; prostate
Thiazides
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

13. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Fluoroquinolones
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at contraction. caused by increased vagal tone from fetal head compression.

14. IADL
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
= LMP + 7 days - 3 months
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

15. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Long axis of fetus to long axis of mother (longitudinal or transverse)
Alpha-1 antitrypsin deficiency
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

16. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Aortic aneurysm
Nicotine inhaler - nasal spray - gum

17. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Diabetes - HTN - GN
Most aggressive melanoma.
Esophagitis - gastritis - dysphagia

18. regards hand
0.2-0.5mg aqueous EPI IM/SubQ
4mo - sits unsupported - hand transfer - babbles
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

19. Tx acute sinusitis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Oxygen intervention 15h/d
Tdap - influenza - pneumovax

20. 2nd generation antihistamines
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Loratadine - fexofenadine - cetirizine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

21. IV tx for PID
Nuchal translucency - serum hCG - PAPP-A
(cefotetan OR cefoxitin) AND doxycycline
IV penicillin (or ampicillin)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

22. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Fluoroquinolones
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

23. Acral lentinous melanoma
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Colchicine
Normal mental status; no other injuries; seen within 10 days of injury

24. Pflx for traveler's diarrhea
0.2-0.5mg aqueous EPI IM/SubQ
Ceftriaxone 125mg IM
Fluoroquinolones
Bathing - dressing - eating - transferring - continence - toileting

25. writes name - counts 10 objects
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
5 yo - draws person - ties shoes - skips
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Diabetes - HTN - GN

26. Nodular melanoma
= LMP + 7 days - 3 months
Ask - Advise - Assess - Assist - Arrange
Most aggressive melanoma.
Anemia

27. Recommended folic acid daily dose
5 yo - draws person - ties shoes - skips
Anterior shoulder cannot readily pass below the pubic symphysis.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

28. First stage of labor
Onset of labor until cervix dilation
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
6 yo

29. Cockcroft-Gault equation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 mo - eyes follow object to midline - vocalizes
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

30. presbycusis
6 yo
Bathing - dressing - eating - transferring - continence - toileting
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Loratadine - fexofenadine - cetirizine

31. social smile - parent recognition
Urinary calcium. Hyper PTH (high) >> FHH (normal)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Urticaria
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

32. Tx gonorrhea
9 mo - walks - throws - 1-3 words - 1-step commands
<20lb - <1YO - Reacts to pain - Responds to noise
Ceftriaxone 125mg IM
Ask - Advise - Assess - Assist - Arrange

33. Sx epiglottitis
Stridor - drooling - toxic appearance
Long axis of fetus to long axis of mother (longitudinal or transverse)
9 mo - walks - throws - 1-3 words - 1-step commands
Short-acting + 40mg prednisone x 10-14days

34. Nonfunctioning nodules > 1cm require _____
Biopsy
6-9MO
Conrtaction monitoring along with fetal heart rate assessment
Prostatitis

35. Sx peritonsillar abscess
Anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Esophagitis - gastritis - dysphagia

36. bacteria causing pharyngitis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Thiazides
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Alpha-1 antitrypsin deficiency

37. Rod shaped - rhomboid - weakly positive birefringent
Diabetes - HTN - GN
Calcium pyrophosphate dehydrate crystals (pseudogout)
Calcium oxalate crystals
Steroids + bronchodilators

38. Tx RA (best long-term outcome)
Anemia
MTX
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

39. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Esophagitis - gastritis - dysphagia
After delivery until delivery of placenta and membranes <30 mins

40. Tx GAS ifxn
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

41. Estimated delivery date (Naegele's rule)
110-160bpm
= LMP + 7 days - 3 months
Anterior shoulder cannot readily pass below the pubic symphysis.
6-9MO

42. Tx otitis media
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anterior shoulder cannot readily pass below the pubic symphysis.
MCC melanoma. Radial growth.

43. Tx bacterial vaginosis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Conrtaction monitoring along with fetal heart rate assessment
Metronidazole or clindamycin

44. Screened at 16-20 weeks GA for trisomy
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

45. Superficial spreading melanoma
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MCC melanoma. Radial growth.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

46. Sx otitis media
16-18 weeks GA
Prostatitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

47. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
0.2-0.5mg aqueous EPI IM/SubQ
5+ rads
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Diabetes - HTN - GN

48. Age by which child says 'mama' and 'dada'
Anaphylaxis
Hypomagnesemia
(cefotetan OR cefoxitin) AND doxycycline
6-9MO

49. Malignancies with hypercalcemia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Lung; SCC head & neck; RCC; breast; MM; prostate
Nicotine inhaler - nasal spray - gum
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

50. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Biopsy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Thiazides