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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. Immunizations for COPD patients
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Pneumovax - influenza
6 yo

2. Age by which child says 'mama' and 'dada'
MTX
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6-9MO
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

3. Augments contractions
Ask - Advise - Assess - Assist - Arrange
4 yo - copies triangle - catches ball - dresses self
Measures strength of contractions
Oxytocin (IV)

4. Oral tx for PID
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
(ofloxacin OR levofloxacin) +/- metronidazole

5. IUPC (intrauterine pressure catheter)
DTaP - hepB - Hib - rotavirus - inactivated polio
Measures strength of contractions
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

6. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
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
Normal mental status; no other injuries; seen within 10 days of injury

7. Tx GAS ifxn
Starts at contraction. caused by increased vagal tone from fetal head compression.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Conrtaction monitoring along with fetal heart rate assessment
Anemia

8. Screening for 65-76YO male smoker
Measures strength of contractions
Urticaria
MTX
Aortic aneurysm

9. Tx of traveler's diarrhea
MCC melanoma. Radial growth.
Bupropion - varenicline - nicotine replacement
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
6 yo

10. Bisphospohonates sfx
Calcium hydroxyapatite crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Esophagitis - gastritis - dysphagia
5 yo - draws person - ties shoes - skips

11. Nodular melanoma
6 yo
Clindamycin AND gentamicin
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Most aggressive melanoma.

12. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ampicillin/sulbactam AND doxycycline
Normal mental status; no other injuries; seen within 10 days of injury

13. Sx of hypercalcemia
Tdap - influenza - pneumovax
Most aggressive melanoma.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

14. IV tx for PID
Clindamycin AND gentamicin
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Fe deficient anemia
Esophagitis - gastritis - dysphagia

15. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

16. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Cataracts

17. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Short-acting + 40mg prednisone x 10-14days

18. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Monosodium urate crystals (gout)
Conrtaction monitoring along with fetal heart rate assessment

19. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ampicillin/sulbactam AND doxycycline
Oxytocin (IV)

20. Tx gonorrhea
Ceftriaxone 125mg IM
MTX
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
After delivery until delivery of placenta and membranes <30 mins

21. Dx bacterial rhinosinusitis
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)
Stridor - drooling - toxic appearance
NAC or IV NaHCO3
Nuchal translucency - serum hCG - PAPP-A

22. social smile - parent recognition
Esophagitis - gastritis - dysphagia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ampicillin/sulbactam AND doxycycline

23. Pregnancy class D smoking cessation drugs
0.2-0.5mg aqueous EPI IM/SubQ
Nicotine inhaler - nasal spray - gum
Calcium pyrophosphate dehydrate crystals (pseudogout)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

24. Sx peritonsillar abscess
Ampicillin/sulbactam AND doxycycline
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Prostatitis
Diphenhydramine - chlorpheniramine - hydroxyzine

25. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1 mo - eyes follow object to midline - vocalizes
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

26. Estimated delivery date (Naegele's rule)
Stridor - drooling - toxic appearance
= LMP + 7 days - 3 months
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

27. Recommendations for rear-facing car seat
Anterior shoulder cannot readily pass below the pubic symphysis.
16-18 weeks GA
<20lb - <1YO - Reacts to pain - Responds to noise
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

28. Tender - boggy prostate. Dx?
Prostatitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Measures strength of contractions
Hypomagnesemia

29. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6-9MO

30. X-ray on knee?
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fe deficient anemia
Angioedema
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

31. Pregnancy class C smoking cessation drugs
5 yo - draws person - ties shoes - skips
Patch - bupropion - varenicline
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
0.2-0.5mg aqueous EPI IM/SubQ

32. dyspnea - visceral edema - hypotension
NAC or IV NaHCO3
Anaphylaxis
Bathing - dressing - eating - transferring - continence - toileting
9 mo - walks - throws - 1-3 words - 1-step commands

33. Nonfunctioning nodules > 1cm require _____
Biopsy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anemia
Tdap - influenza - pneumovax

34. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Tdap - influenza - pneumovax
Tuberculosis; sarcoidosis; hodgkin disease
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

35. Only therapy to decrease mortality in stage IV COPD
4mo - sits unsupported - hand transfer - babbles
Tuberculosis; sarcoidosis; hodgkin disease
Oxygen intervention 15h/d
Ask - Advise - Assess - Assist - Arrange

36. Other causes of hypercalcemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Prostatitis

37. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MTX
Most aggressive melanoma.

38. variable deceleration
Short-acting + 40mg prednisone x 10-14days
DTaP - hepB - Hib - rotavirus - inactivated polio
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

39. Tx acute sinusitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
After delivery until delivery of placenta and membranes <30 mins
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

40. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

41. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
MCC melanoma. Radial growth.
9 mo - walks - throws - 1-3 words - 1-step commands

42. Early deceleration
= LMP + 7 days - 3 months
Starts at contraction. caused by increased vagal tone from fetal head compression.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

43. Low serum iron - low MCV - low ferritin - +stool guaiac
Patch - bupropion - varenicline
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Fe deficient anemia
110-160bpm

44. Electrolyte abnormality that increases the incidence of torsades de pointes
1 mo - eyes follow object to midline - vocalizes
Lung; SCC head & neck; RCC; breast; MM; prostate
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Hypomagnesemia

45. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Nuchal translucency - serum hCG - PAPP-A
(ofloxacin OR levofloxacin) +/- metronidazole
Colchicine

46. DOC for HTN in elderly
Thiazides
DTaP - hepB - Hib - rotavirus - inactivated polio
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

47. causes of acute bronchitis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
4 yo - copies triangle - catches ball - dresses self
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

48. Tocodynamometer
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Nuchal translucency - serum hCG - PAPP-A
Conrtaction monitoring along with fetal heart rate assessment

49. Second stage of labor
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
4 yo - copies triangle - catches ball - dresses self
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Loratadine - fexofenadine - cetirizine

50. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Oxytocin (IV)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide