Test your basic knowledge |

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. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urticaria
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
NAC or IV NaHCO3

2. Screened at 16-20 weeks GA for trisomy
Clindamycin AND gentamicin
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
NAC or IV NaHCO3

3. explorations
<20lb - <1YO - Reacts to pain - Responds to noise
9 mo - walks - throws - 1-3 words - 1-step commands
(ofloxacin OR levofloxacin) +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

4. Pregnancy class D smoking cessation drugs
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nicotine inhaler - nasal spray - gum

5. painless - deep - subQ swelling (periorbital - circumoral - facial)
5+ rads
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Angioedema
Lung; SCC head & neck; RCC; breast; MM; prostate

6. Fe deficient anemia tx
Most aggressive melanoma.
Aortic aneurysm
6 yo
Ferrous sulfate 325mg tid

7. recognizes strangers
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Clindamycin AND gentamicin
6 mo - pincer - crawls - cruises - mamma - dada - byebye
MTX

8. 2nd generation antihistamines
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Bupropion - varenicline - nicotine replacement
Pneumovax - influenza
Loratadine - fexofenadine - cetirizine

9. IV tx for PID
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ampicillin/sulbactam AND doxycycline
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium oxalate crystals

10. Recommended folic acid daily dose
Anemia
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Clindamycin AND gentamicin

11. Tx gonorrhea
Colchicine
Ceftriaxone 125mg IM
Hypomagnesemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

12. Fetal heart rate range
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anterior shoulder cannot readily pass below the pubic symphysis.
110-160bpm

13. Tx for anaphylaxis
Angioedema
Diphenhydramine - chlorpheniramine - hydroxyzine
1 mo - eyes follow object to midline - vocalizes
0.2-0.5mg aqueous EPI IM/SubQ

14. Tx bacterial vaginosis
Onset of labor until cervix dilation
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Metronidazole or clindamycin
Biopsy

15. The five A's of smoking cessation
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ask - Advise - Assess - Assist - Arrange
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Clindamycin AND gentamicin

16. Oral tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)

17. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Anterior shoulder cannot readily pass below the pubic symphysis.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

18. Bisphospohonates sfx
Onset of labor until cervix dilation
Esophagitis - gastritis - dysphagia
Tuberculosis; sarcoidosis; hodgkin disease
Tdap - influenza - pneumovax

19. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium pyrophosphate dehydrate crystals (pseudogout)
4mo - sits unsupported - hand transfer - babbles
Stridor - drooling - toxic appearance

20. Age by which child says 'mama' and 'dada'
Fluoroquinolones
6-9MO
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Stridor - drooling - toxic appearance

21. 1st generation antihistamines
Ear pain - itching - inflammation/swollen canal - exudates/discharge
(cefotetan OR cefoxitin) AND doxycycline
Diphenhydramine - chlorpheniramine - hydroxyzine
Fluoroquinolones

22. Screened at 11-13 weeks GA for trisomy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Nuchal translucency - serum hCG - PAPP-A
Hypomagnesemia
Metronidazole or clindamycin

23. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Aortic aneurysm
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fluoroquinolones
Bupropion - varenicline - nicotine replacement

24. IV tx for PID
Ampicillin/sulbactam AND doxycycline
After delivery until delivery of placenta and membranes <30 mins
Metronidazole or clindamycin
Clindamycin AND gentamicin

25. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
4 yo - copies triangle - catches ball - dresses self
Flexion - internal rotation - extension - external rotation
(ofloxacin OR levofloxacin) +/- metronidazole

26. Nonfunctioning nodules > 1cm require _____
Biopsy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Calcium oxalate crystals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

27. MCC blindness worldwide
0.2-0.5mg aqueous EPI IM/SubQ
Cataracts
9 mo - walks - throws - 1-3 words - 1-step commands
Prostatitis

28. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Most aggressive melanoma.
Monosodium urate crystals (gout)
Flexion - internal rotation - extension - external rotation

29. Superficial spreading melanoma
MCC melanoma. Radial growth.
Oxygen intervention 15h/d
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Colchicine

30. Low serum iron - low MCV - low ferritin - +stool guaiac
Anemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Most aggressive melanoma.
Fe deficient anemia

31. Sx of hypercalcemia
Diabetes - HTN - GN
Prostatitis
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Most aggressive melanoma.

32. Regards human face - eye contact
Thiazdes; lithium
1 mo - eyes follow object to midline - vocalizes
Aortic aneurysm
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

33. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ear pain - itching - inflammation/swollen canal - exudates/discharge

34. Electrolyte abnormality that increases the incidence of torsades de pointes
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Hypomagnesemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

35. MONA therapy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Most aggressive melanoma.

36. Nodular melanoma
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Calcium hydroxyapatite crystals
Most aggressive melanoma.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

37. Tx acute exacerbation COPD
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Tdap - influenza - pneumovax
4 yo - copies triangle - catches ball - dresses self
Short-acting + 40mg prednisone x 10-14days

38. Dx PID
Thiazides
Prostatitis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Colchicine

39. DDX for geriatric hearing impairment
1 mo - eyes follow object to midline - vocalizes
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(ofloxacin OR levofloxacin) +/- metronidazole
Fe deficient anemia

40. medications causing hypercalcemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Thiazdes; lithium
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

41. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Monosodium urate crystals (gout)
IV penicillin (or ampicillin)

42. Bacteria causing chronic sinusitis
1 mo - eyes follow object to midline - vocalizes
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
4 yo - copies triangle - catches ball - dresses self
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

43. shoulder dystocia
Cataracts
6 yo
Anterior shoulder cannot readily pass below the pubic symphysis.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

44. Fetal lie
Steroids + bronchodilators
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Tdap - influenza - pneumovax
Long axis of fetus to long axis of mother (longitudinal or transverse)

45. writes name - counts 10 objects
Anterior shoulder cannot readily pass below the pubic symphysis.
Cataracts
5 yo - draws person - ties shoes - skips
Diphenhydramine - chlorpheniramine - hydroxyzine

46. IADL
Ampicillin/sulbactam AND doxycycline
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

47. Tx of traveler's diarrhea
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Clindamycin AND gentamicin
6 mo - pincer - crawls - cruises - mamma - dada - byebye

48. IV tx for PID
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Loratadine - fexofenadine - cetirizine
Ofloxacin OR levofloxacin +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

49. tx shoulder dystocia

50. First stage of labor
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Onset of labor until cervix dilation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis