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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. bipyramidal - strongly positive birefringent
Flexion - internal rotation - extension - external rotation
Ask - Advise - Assess - Assist - Arrange
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Calcium oxalate crystals

2. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
After delivery until delivery of placenta and membranes <30 mins
Normal mental status; no other injuries; seen within 10 days of injury
Diabetes - HTN - GN

3. 1st generation antihistamines
Starts at contraction. caused by increased vagal tone from fetal head compression.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Diphenhydramine - chlorpheniramine - hydroxyzine
Loratadine - fexofenadine - cetirizine

4. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
5+ rads

5. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Onset of labor until cervix dilation
Urinary calcium. Hyper PTH (high) >> FHH (normal)

6. recognizes strangers
Flexion - internal rotation - extension - external rotation
Ampicillin/sulbactam AND doxycycline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

7. Tx acute sinusitis
5+ rads
Patch - bupropion - varenicline
Steroids + bronchodilators
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

8. Large - irregularly shaped - prutitic - erythematous wheals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Hypomagnesemia
4mo - sits unsupported - hand transfer - babbles
Urticaria

9. IV tx for PID
6 yo
Loratadine - fexofenadine - cetirizine
(cefotetan OR cefoxitin) AND doxycycline
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

10. Fe deficient anemia tx
(cefotetan OR cefoxitin) AND doxycycline
Ferrous sulfate 325mg tid
Oxygen intervention 15h/d
Calcium oxalate crystals

11. DDX for geriatric hearing impairment
Tuberculosis; sarcoidosis; hodgkin disease
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Lung; SCC head & neck; RCC; breast; MM; prostate

12. Four cardinal fetal movements
Colchicine
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals
Flexion - internal rotation - extension - external rotation

13. Tx bacterial vaginosis
Urticaria
Short-acting + 40mg prednisone x 10-14days
Alpha-1 antitrypsin deficiency
Metronidazole or clindamycin

14. Pflx for traveler's diarrhea
Fluoroquinolones
Ask - Advise - Assess - Assist - Arrange
Stridor - drooling - toxic appearance
Ferrous sulfate 325mg tid

15. Second stage of labor
Urticaria
= LMP + 7 days - 3 months
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ferrous sulfate 325mg tid

16. Improve short-term outcomes in acute exacerbations of COPD - asthma
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Bupropion - varenicline - nicotine replacement
Tuberculosis; sarcoidosis; hodgkin disease
Steroids + bronchodilators

17. Tx for thyroid storm
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Bathing - dressing - eating - transferring - continence - toileting
Bupropion - varenicline - nicotine replacement

18. Lentigo Maligna
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diphenhydramine - chlorpheniramine - hydroxyzine
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

19. Screened at 16-20 weeks GA for trisomy
4 yo - copies triangle - catches ball - dresses self
Anaphylaxis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
9 mo - walks - throws - 1-3 words - 1-step commands

20. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
4mo - sits unsupported - hand transfer - babbles
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anemia

21. Dx bacterial rhinosinusitis
Biopsy
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)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

22. Electrolyte abnormality that increases the incidence of torsades de pointes
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Calcium oxalate crystals
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Hypomagnesemia

23. Pregnancy class D smoking cessation drugs
Monosodium urate crystals (gout)
Loratadine - fexofenadine - cetirizine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nicotine inhaler - nasal spray - gum

24. 2nd generation antihistamines
MCC melanoma. Radial growth.
Steroids + bronchodilators
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Loratadine - fexofenadine - cetirizine

25. MCC blindness worldwide
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cataracts
Stridor - drooling - toxic appearance

26. IV tx for PID
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Ofloxacin OR levofloxacin +/- metronidazole
Short-acting + 40mg prednisone x 10-14days
2 mo - eyes follow object past midline - rolls over - laughs - squeals

27. Oral tx for PID
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Oxytocin (IV)
(ofloxacin OR levofloxacin) +/- metronidazole
5+ rads

28. Unstable angina vs MI Dx tests
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
= LMP + 7 days - 3 months
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Steroids + bronchodilators

29. Screening for 65-76YO male smoker
Calcium oxalate crystals
Aortic aneurysm
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

30. IV tx for PID
Anemia
<20lb - <1YO - Reacts to pain - Responds to noise
Clindamycin AND gentamicin
= LMP + 7 days - 3 months

31. tx shoulder dystocia

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32. Low serum iron - low MCV - low ferritin - +stool guaiac
Diphenhydramine - chlorpheniramine - hydroxyzine
Fe deficient anemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

33. Tx chlamydia
Oxytocin (IV)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Starts at contraction. caused by increased vagal tone from fetal head compression.
NAC or IV NaHCO3

34. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Onset of labor until cervix dilation
Calcium oxalate crystals
4 yo - copies triangle - catches ball - dresses self

35. Tx acute gout
Measures strength of contractions
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Colchicine
Diabetes - HTN - GN

36. dyspnea - visceral edema - hypotension
Hypomagnesemia
9 mo - walks - throws - 1-3 words - 1-step commands
Ofloxacin OR levofloxacin +/- metronidazole
Anaphylaxis

37. complications of otitis media
Most aggressive melanoma.
Flexion - internal rotation - extension - external rotation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

38. Screened at 11-13 weeks GA for trisomy
Hypomagnesemia
Nuchal translucency - serum hCG - PAPP-A
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
MCC melanoma in Africans/Asians. Under nails - soles - palms.

39. Age by which child says 'mama' and 'dada'
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
110-160bpm
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6-9MO

40. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Onset of labor until cervix dilation
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

41. Tender - boggy prostate. Dx?
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Oxytocin (IV)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Prostatitis

42. Tx acute exacerbation COPD
Bathing - dressing - eating - transferring - continence - toileting
0.2-0.5mg aqueous EPI IM/SubQ
Short-acting + 40mg prednisone x 10-14days
1 mo - eyes follow object to midline - vocalizes

43. IV tx for PID
Clindamycin AND gentamicin
Ampicillin/sulbactam AND doxycycline
NAC or IV NaHCO3
Age-related sensorineural hearing loss (high frequency and speech discrimination)

44. Oral tx for PID
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)
Ask - Advise - Assess - Assist - Arrange
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

45. causes of acute bronchitis
Hypomagnesemia
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

46. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Colchicine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
110-160bpm

47. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fluoroquinolones

48. Augments contractions
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Oxytocin (IV)
Tuberculosis; sarcoidosis; hodgkin disease
Long axis of fetus to long axis of mother (longitudinal or transverse)

49. Optimal time for trisomy screen
16-18 weeks GA
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

50. Late deceleration
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)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ampicillin/sulbactam AND doxycycline