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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. 2nd generation antihistamines
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Loratadine - fexofenadine - cetirizine
Anaphylaxis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

2. Oral tx for PID
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

3. bacteria causing pharyngitis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
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)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

4. Fetal heart rate range
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Alpha-1 antitrypsin deficiency
(cefotetan OR cefoxitin) AND doxycycline
110-160bpm

5. Late deceleration
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

6. recognizes strangers
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Steroids + bronchodilators
6 mo - pincer - crawls - cruises - mamma - dada - byebye

7. X-ray of ankle?
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Normal mental status; no other injuries; seen within 10 days of injury
Ofloxacin OR levofloxacin +/- metronidazole

8. Tx for anaphylaxis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
0.2-0.5mg aqueous EPI IM/SubQ
Colchicine

9. Immunizations for COPD patients
Pneumovax - influenza
Prostatitis
IV penicillin (or ampicillin)
MCC melanoma. Radial growth.

10. Sx epiglottitis
Calcium hydroxyapatite crystals
Stridor - drooling - toxic appearance
Clindamycin AND gentamicin
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

11. Screening for 65-76YO male smoker
Aortic aneurysm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MTX
Urinary calcium. Hyper PTH (high) >> FHH (normal)

12. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Fe deficient anemia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
6 yo

13. Mediators released in response to allergen
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ferrous sulfate 325mg tid
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

14. Tx of traveler's diarrhea
<20lb - <1YO - Reacts to pain - Responds to noise
Esophagitis - gastritis - dysphagia
MTX
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

15. stranger/separation anxiety
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

16. CKD Stages
Fluoroquinolones
MTX
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

17. writes name - counts 10 objects
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
16-18 weeks GA
5 yo - draws person - ties shoes - skips
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

18. Electrolyte abnormality that increases the incidence of torsades de pointes
Clindamycin AND gentamicin
Ceftriaxone 125mg IM
Hypomagnesemia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

19. Fe deficient anemia tx
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ferrous sulfate 325mg tid
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
After delivery until delivery of placenta and membranes <30 mins

20. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxytocin (IV)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

21. How much radiation is associated with fetal harm?
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators
Calcium oxalate crystals
5+ rads

22. Recommendations for rear-facing car seat
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
<20lb - <1YO - Reacts to pain - Responds to noise
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Most aggressive melanoma.

23. X-ray on knee?
<20lb - <1YO - Reacts to pain - Responds to noise
2 mo - eyes follow object past midline - rolls over - laughs - squeals
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Patch - bupropion - varenicline

24. Corrected serum calcium =

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25. Tx hyperkalemia in CKD
Diabetes - HTN - GN
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)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

26. Signs of rupture of membranes

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27. needles - strong negative birefringent (yellow crystals parallel light)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Monosodium urate crystals (gout)
Ofloxacin OR levofloxacin +/- metronidazole
5+ rads

28. Fetal lie
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1 mo - eyes follow object to midline - vocalizes
Ceftriaxone 125mg IM
Long axis of fetus to long axis of mother (longitudinal or transverse)

29. Screened at 16-20 weeks GA for trisomy
110-160bpm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Pneumovax - influenza

30. IV tx for PID
Bathing - dressing - eating - transferring - continence - toileting
Ofloxacin OR levofloxacin +/- metronidazole
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

31. parallel play
Most aggressive melanoma.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Normal mental status; no other injuries; seen within 10 days of injury
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

32. Pregnancy class D smoking cessation drugs
NAC or IV NaHCO3
5 yo - draws person - ties shoes - skips
Nicotine inhaler - nasal spray - gum
6 mo - pincer - crawls - cruises - mamma - dada - byebye

33. Tender - boggy prostate. Dx?
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
4 yo - copies triangle - catches ball - dresses self
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Prostatitis

34. Augments contractions
Calcium hydroxyapatite crystals
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Oxytocin (IV)
DTaP - hepB - Hib - rotavirus - inactivated polio

35. Malignancies with hypercalcemia
4mo - sits unsupported - hand transfer - babbles
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Lung; SCC head & neck; RCC; breast; MM; prostate
Loratadine - fexofenadine - cetirizine

36. complications of otitis media
Alpha-1 antitrypsin deficiency
Oxygen intervention 15h/d
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
<20lb - <1YO - Reacts to pain - Responds to noise

37. shoulder dystocia
Calcium oxalate crystals
Anterior shoulder cannot readily pass below the pubic symphysis.
Patch - bupropion - varenicline
Thiazides

38. Immunizations at visit for 6MO
Long axis of fetus to long axis of mother (longitudinal or transverse)
DTaP - hepB - Hib - rotavirus - inactivated polio
Ask - Advise - Assess - Assist - Arrange
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. Screened at 11-13 weeks GA for trisomy
Flexion - internal rotation - extension - external rotation
Nuchal translucency - serum hCG - PAPP-A
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
(ofloxacin OR levofloxacin) +/- metronidazole

40. social interaction
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
4 yo - copies triangle - catches ball - dresses self
NAC or IV NaHCO3
Calcium pyrophosphate dehydrate crystals (pseudogout)

41. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Anterior shoulder cannot readily pass below the pubic symphysis.
After delivery until delivery of placenta and membranes <30 mins
Fe deficient anemia

42. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Calcium oxalate crystals
Anaphylaxis
Prostatitis

43. DDX for geriatric hearing impairment
Biopsy
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
4 yo - copies triangle - catches ball - dresses self

44. Other causes of hypercalcemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

45. dyspnea - visceral edema - hypotension
Anterior shoulder cannot readily pass below the pubic symphysis.
Anaphylaxis
Loratadine - fexofenadine - cetirizine
Bupropion - varenicline - nicotine replacement

46. Large - irregularly shaped - prutitic - erythematous wheals
NAC or IV NaHCO3
Urticaria
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Diabetes - HTN - GN

47. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Urticaria
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

48. Improve short-term outcomes in acute exacerbations of COPD - asthma
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Metronidazole or clindamycin
Steroids + bronchodilators
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

49. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Steroids + bronchodilators
Patch - bupropion - varenicline
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

50. Cockcroft-Gault equation
Ofloxacin OR levofloxacin +/- metronidazole
Metronidazole or clindamycin
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors