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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. needles - strong negative birefringent (yellow crystals parallel light)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Monosodium urate crystals (gout)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Starts at contraction. caused by increased vagal tone from fetal head compression.

2. Large - irregularly shaped - prutitic - erythematous wheals
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Urticaria
5+ rads
Anterior shoulder cannot readily pass below the pubic symphysis.

3. Tx for anaphylaxis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
0.2-0.5mg aqueous EPI IM/SubQ
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

4. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
After delivery until delivery of placenta and membranes <30 mins
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
NAC or IV NaHCO3

5. group play - gender - knows name
Diphenhydramine - chlorpheniramine - hydroxyzine
Ferrous sulfate 325mg tid
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

6. Third stage of labor
Starts at contraction. caused by increased vagal tone from fetal head compression.
Lung; SCC head & neck; RCC; breast; MM; prostate
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
After delivery until delivery of placenta and membranes <30 mins

7. Immunizations for COPD patients
Thiazdes; lithium
Monosodium urate crystals (gout)
Pneumovax - influenza
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

8. Causes of CKD
Diabetes - HTN - GN
16-18 weeks GA
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Stridor - drooling - toxic appearance

9. social interaction
Ask - Advise - Assess - Assist - Arrange
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anemia
4 yo - copies triangle - catches ball - dresses self

10. CKD Stages
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Most aggressive melanoma.

11. parallel play
0.2-0.5mg aqueous EPI IM/SubQ
Fluoroquinolones
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium oxalate crystals

12. Fetal lie
Onset of labor until cervix dilation
4 yo - copies triangle - catches ball - dresses self
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Long axis of fetus to long axis of mother (longitudinal or transverse)

13. DOC for HTN in elderly
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Patch - bupropion - varenicline
Ofloxacin OR levofloxacin +/- metronidazole
Thiazides

14. Early deceleration
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.
16-18 weeks GA
Normal mental status; no other injuries; seen within 10 days of injury

15. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
5 yo - draws person - ties shoes - skips
Thiazides
9 mo - walks - throws - 1-3 words - 1-step commands

16. Tx chlamydia
Prostatitis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Bupropion - varenicline - nicotine replacement
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

17. Corrected serum calcium =

18. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Steroids + bronchodilators
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Thiazides

19. Dx PID
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Oxygen intervention 15h/d

20. 1st generation antihistamines
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Diphenhydramine - chlorpheniramine - hydroxyzine
Anemia

21. tx shoulder dystocia

22. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
Ferrous sulfate 325mg tid
Ask - Advise - Assess - Assist - Arrange
Biopsy

23. writes name - counts 10 objects
6-9MO
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Cataracts
5 yo - draws person - ties shoes - skips

24. Tocodynamometer
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ask - Advise - Assess - Assist - Arrange
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Conrtaction monitoring along with fetal heart rate assessment

25. Tx gonorrhea
9 mo - walks - throws - 1-3 words - 1-step commands
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ceftriaxone 125mg IM
MCC melanoma. Radial growth.

26. painless - deep - subQ swelling (periorbital - circumoral - facial)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Angioedema
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

27. bipyramidal - strongly positive birefringent
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Calcium oxalate crystals
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

28. Fetal heart rate range
Stridor - drooling - toxic appearance
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
110-160bpm
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

29. Four cardinal fetal movements
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Flexion - internal rotation - extension - external rotation

30. Malignancies with hypercalcemia
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)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Lung; SCC head & neck; RCC; breast; MM; prostate
Ferrous sulfate 325mg tid

31. explorations
DTaP - hepB - Hib - rotavirus - inactivated polio
9 mo - walks - throws - 1-3 words - 1-step commands
Measures strength of contractions
Tuberculosis; sarcoidosis; hodgkin disease

32. ADL
Bathing - dressing - eating - transferring - continence - toileting
Prostatitis
Esophagitis - gastritis - dysphagia
9 mo - walks - throws - 1-3 words - 1-step commands

33. 2nd generation antihistamines
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Loratadine - fexofenadine - cetirizine
Oxytocin (IV)
Ofloxacin OR levofloxacin +/- metronidazole

34. Optimal time for trisomy screen
16-18 weeks GA
Hypomagnesemia
6 yo
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

35. Only therapy to decrease mortality in stage IV COPD
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Starts at contraction. caused by increased vagal tone from fetal head compression.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Oxygen intervention 15h/d

36. Oral tx for PID
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Anemia
(ofloxacin OR levofloxacin) +/- metronidazole
Oxygen intervention 15h/d

37. Sx otitis media
Esophagitis - gastritis - dysphagia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

38. Emphysema - <45YO - nonsmoker
Metronidazole or clindamycin
Measures strength of contractions
Calcium hydroxyapatite crystals
Alpha-1 antitrypsin deficiency

39. Tx otitis media
6 yo
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
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)
Biopsy

40. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Onset of labor until cervix dilation
4 yo - copies triangle - catches ball - dresses self
Alpha-1 antitrypsin deficiency

41. Complications of PID
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ask - Advise - Assess - Assist - Arrange
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

42. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ceftriaxone 125mg IM

43. X-ray on knee?
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Loratadine - fexofenadine - cetirizine

44. Tx acute exacerbation COPD
Tdap - influenza - pneumovax
9 mo - walks - throws - 1-3 words - 1-step commands
Short-acting + 40mg prednisone x 10-14days
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

45. Dx criteria for RA
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

46. Second stage of labor
Aortic aneurysm
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thiazides

47. MCC blindness worldwide
Cataracts
Biopsy
Onset of labor until cervix dilation
Thiazides

48. cystoplasmic inclusions - not birefringent
DTaP - hepB - Hib - rotavirus - inactivated polio
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Calcium hydroxyapatite crystals

49. medications causing hypercalcemia
<20lb - <1YO - Reacts to pain - Responds to noise
Clindamycin AND gentamicin
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Thiazdes; lithium

50. Other causes of hypercalcemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
NAC or IV NaHCO3