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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. Sx otitis media
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Bathing - dressing - eating - transferring - continence - toileting
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

2. Tx bacterial vaginosis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Alpha-1 antitrypsin deficiency
Colchicine
Metronidazole or clindamycin

3. GBS tx
(cefotetan OR cefoxitin) AND doxycycline
IV penicillin (or ampicillin)
NAC or IV NaHCO3
Urticaria

4. Pregnancy class D smoking cessation drugs
Loratadine - fexofenadine - cetirizine
IV penicillin (or ampicillin)
Flexion - internal rotation - extension - external rotation
Nicotine inhaler - nasal spray - gum

5. Screened at 11-13 weeks GA for trisomy
Angioedema
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nuchal translucency - serum hCG - PAPP-A
= LMP + 7 days - 3 months

6. Smoking cessation agents
Pneumovax - influenza
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Bupropion - varenicline - nicotine replacement
Tuberculosis; sarcoidosis; hodgkin disease

7. Mediators released in response to allergen
Calcium pyrophosphate dehydrate crystals (pseudogout)
Monosodium urate crystals (gout)
Most aggressive melanoma.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

8. Acral lentinous melanoma
Fe deficient anemia
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
4 yo - copies triangle - catches ball - dresses self
MCC melanoma in Africans/Asians. Under nails - soles - palms.

9. Oral tx for PID
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Short-acting + 40mg prednisone x 10-14days
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

10. Bacteria causing chronic sinusitis
Alpha-1 antitrypsin deficiency
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Conrtaction monitoring along with fetal heart rate assessment
2 mo - eyes follow object past midline - rolls over - laughs - squeals

11. Rod shaped - rhomboid - weakly positive birefringent
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Calcium pyrophosphate dehydrate crystals (pseudogout)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

12. Nonfunctioning nodules > 1cm require _____
Aortic aneurysm
Calcium pyrophosphate dehydrate crystals (pseudogout)
Biopsy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

13. Fetal lie
Starts at contraction. caused by increased vagal tone from fetal head compression.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Long axis of fetus to long axis of mother (longitudinal or transverse)

14. painless - deep - subQ swelling (periorbital - circumoral - facial)
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)
0.2-0.5mg aqueous EPI IM/SubQ
Angioedema

15. Screened at 16-20 weeks GA for trisomy
Bathing - dressing - eating - transferring - continence - toileting
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Urticaria

16. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
5+ rads
Tdap - influenza - pneumovax

17. Third stage of labor
IV penicillin (or ampicillin)
9 mo - walks - throws - 1-3 words - 1-step commands
After delivery until delivery of placenta and membranes <30 mins
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

18. Pflx for traveler's diarrhea
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Thiazdes; lithium
Fluoroquinolones
Most aggressive melanoma.

19. Tx acute gout
Measures strength of contractions
4mo - sits unsupported - hand transfer - babbles
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Colchicine

20. Bisphospohonates sfx
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Esophagitis - gastritis - dysphagia
Pneumovax - influenza

21. identifies left - right
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Fe deficient anemia
Short-acting + 40mg prednisone x 10-14days
6 yo

22. Corrected serum calcium =

23. Lentigo Maligna
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Patch - bupropion - varenicline

24. Large - irregularly shaped - prutitic - erythematous wheals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Hypomagnesemia
Urticaria
Ferrous sulfate 325mg tid

25. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tdap - influenza - pneumovax
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

26. X-ray on knee?
Anterior shoulder cannot readily pass below the pubic symphysis.
Diphenhydramine - chlorpheniramine - hydroxyzine
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

27. Emphysema - <45YO - nonsmoker
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Alpha-1 antitrypsin deficiency
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

28. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Oxygen intervention 15h/d

29. writes name - counts 10 objects
MCC melanoma. Radial growth.
Bathing - dressing - eating - transferring - continence - toileting
5 yo - draws person - ties shoes - skips
Conrtaction monitoring along with fetal heart rate assessment

30. Complications of GAS infxn
Thiazdes; lithium
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anaphylaxis
Alpha-1 antitrypsin deficiency

31. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ear pain - itching - inflammation/swollen canal - exudates/discharge

32. complications of otitis media
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MTX
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ear pain - itching - inflammation/swollen canal - exudates/discharge

33. How much radiation is associated with fetal harm?
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
5+ rads
Starts at contraction. caused by increased vagal tone from fetal head compression.
Long axis of fetus to long axis of mother (longitudinal or transverse)

34. Dx criteria for RA
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
4mo - sits unsupported - hand transfer - babbles
Bupropion - varenicline - nicotine replacement
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

35. Unstable angina vs MI Dx tests
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

36. Recommended folic acid daily dose
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

37. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
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
5+ rads

38. Cockcroft-Gault equation
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
= LMP + 7 days - 3 months
Calcium hydroxyapatite crystals
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

39. Late deceleration
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Measures strength of contractions
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Urinary calcium. Hyper PTH (high) >> FHH (normal)

40. IADL
Bupropion - varenicline - nicotine replacement
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

41. CKD Stages
Clindamycin AND gentamicin
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Bathing - dressing - eating - transferring - continence - toileting

42. Only therapy to decrease mortality in stage IV COPD
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
4mo - sits unsupported - hand transfer - babbles
Oxygen intervention 15h/d
Urinary calcium. Hyper PTH (high) >> FHH (normal)

43. Estimated delivery date (Naegele's rule)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
= LMP + 7 days - 3 months
Urticaria
Measures strength of contractions

44. causes of acute bronchitis
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Most aggressive melanoma.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
0.2-0.5mg aqueous EPI IM/SubQ

45. social smile - parent recognition
Fluoroquinolones
Tdap - influenza - pneumovax
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bathing - dressing - eating - transferring - continence - toileting

46. Tocodynamometer
Anterior shoulder cannot readily pass below the pubic symphysis.
Conrtaction monitoring along with fetal heart rate assessment
4mo - sits unsupported - hand transfer - babbles
Diabetes - HTN - GN

47. Immunizations at visit for 6MO
Aortic aneurysm
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Alpha-1 antitrypsin deficiency
DTaP - hepB - Hib - rotavirus - inactivated polio

48. Oral tx for PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
(ofloxacin OR levofloxacin) +/- metronidazole
IV penicillin (or ampicillin)
Oxytocin (IV)

49. Tx GAS ifxn
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
1 mo - eyes follow object to midline - vocalizes
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

50. Causes of CKD
Diabetes - HTN - GN
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ofloxacin OR levofloxacin +/- metronidazole
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins