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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 epiglottitis
Stridor - drooling - toxic appearance
Ofloxacin OR levofloxacin +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

2. complications of otitis media
6-9MO
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Most aggressive melanoma.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

3. Mediators released in response to allergen
Anemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Fluoroquinolones
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

4. Tx acute gout
MCC melanoma. Radial growth.
After delivery until delivery of placenta and membranes <30 mins
Colchicine
Ask - Advise - Assess - Assist - Arrange

5. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
4 yo - copies triangle - catches ball - dresses self
Oxygen intervention 15h/d
Nuchal translucency - serum hCG - PAPP-A

6. social interaction
4 yo - copies triangle - catches ball - dresses self
Anemia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Steroids + bronchodilators

7. presbycusis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Age-related sensorineural hearing loss (high frequency and speech discrimination)
= LMP + 7 days - 3 months
Ask - Advise - Assess - Assist - Arrange

8. Improve short-term outcomes in acute exacerbations of COPD - asthma
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Steroids + bronchodilators
Bupropion - varenicline - nicotine replacement
2 mo - eyes follow object past midline - rolls over - laughs - squeals

9. Complications of PID
Metronidazole or clindamycin
Calcium oxalate crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

10. tx shoulder dystocia

11. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Loratadine - fexofenadine - cetirizine
Colchicine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

12. IV tx for PID
Anemia
Ofloxacin OR levofloxacin +/- metronidazole
Loratadine - fexofenadine - cetirizine
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

13. Malignancies with hypercalcemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Lung; SCC head & neck; RCC; breast; MM; prostate

14. Late deceleration
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Steroids + bronchodilators

15. Low serum iron - low MCV - low ferritin - +stool guaiac
= LMP + 7 days - 3 months
Fe deficient anemia
MTX
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

16. Tx acute exacerbation COPD
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Starts at contraction. caused by increased vagal tone from fetal head compression.
Short-acting + 40mg prednisone x 10-14days
0.2-0.5mg aqueous EPI IM/SubQ

17. Only therapy to decrease mortality in stage IV COPD
Nicotine inhaler - nasal spray - gum
Oxygen intervention 15h/d
Biopsy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

18. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
NAC or IV NaHCO3
Biopsy
Oxytocin (IV)

19. Pregnancy class C smoking cessation drugs
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Alpha-1 antitrypsin deficiency
Patch - bupropion - varenicline
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

20. Oral tx for PID
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
(ofloxacin OR levofloxacin) +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

21. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
5 yo - draws person - ties shoes - skips
Nicotine inhaler - nasal spray - gum
MCC melanoma in Africans/Asians. Under nails - soles - palms.

22. Rod shaped - rhomboid - weakly positive birefringent
Tuberculosis; sarcoidosis; hodgkin disease
Calcium pyrophosphate dehydrate crystals (pseudogout)
Aortic aneurysm
IV penicillin (or ampicillin)

23. Immunizations for COPD patients
Diphenhydramine - chlorpheniramine - hydroxyzine
Esophagitis - gastritis - dysphagia
Pneumovax - influenza
Ferrous sulfate 325mg tid

24. Dx bacterial rhinosinusitis
DTaP - hepB - Hib - rotavirus - inactivated polio
6-9MO
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
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)

25. parallel play
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
<20lb - <1YO - Reacts to pain - Responds to noise
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

26. Third stage of labor
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
4mo - sits unsupported - hand transfer - babbles
After delivery until delivery of placenta and membranes <30 mins
Clindamycin AND gentamicin

27. Tx for thyroid storm
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
6-9MO
Anemia

28. needles - strong negative birefringent (yellow crystals parallel light)
<20lb - <1YO - Reacts to pain - Responds to noise
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)
Monosodium urate crystals (gout)

29. variable deceleration
Diphenhydramine - chlorpheniramine - hydroxyzine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ofloxacin OR levofloxacin +/- metronidazole
Steroids + bronchodilators

30. Lentigo Maligna
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Calcium hydroxyapatite crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

31. Acral lentinous melanoma
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

32. painless - deep - subQ swelling (periorbital - circumoral - facial)
Clindamycin AND gentamicin
Angioedema
Bupropion - varenicline - nicotine replacement
Oxytocin (IV)

33. How much radiation is associated with fetal harm?
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)
Monosodium urate crystals (gout)
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads

34. DDX for geriatric hearing impairment
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

35. explorations
MCC melanoma. Radial growth.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
9 mo - walks - throws - 1-3 words - 1-step commands
(ofloxacin OR levofloxacin) +/- metronidazole

36. Early deceleration
Nuchal translucency - serum hCG - PAPP-A
(ofloxacin OR levofloxacin) +/- metronidazole
Cataracts
Starts at contraction. caused by increased vagal tone from fetal head compression.

37. dyspnea - visceral edema - hypotension
5+ rads
Anaphylaxis
Normal mental status; no other injuries; seen within 10 days of injury
Conrtaction monitoring along with fetal heart rate assessment

38. GBS tx
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Loratadine - fexofenadine - cetirizine
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
IV penicillin (or ampicillin)

39. Superficial spreading melanoma
MCC melanoma. Radial growth.
110-160bpm
Anterior shoulder cannot readily pass below the pubic symphysis.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

40. Dx bacterial vaginosis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Starts at contraction. caused by increased vagal tone from fetal head compression.
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)

41. causes of acute bronchitis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ferrous sulfate 325mg tid

42. Pregnancy class D smoking cessation drugs
4 yo - copies triangle - catches ball - dresses self
Lung; SCC head & neck; RCC; breast; MM; prostate
Measures strength of contractions
Nicotine inhaler - nasal spray - gum

43. Second stage of labor
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Anterior shoulder cannot readily pass below the pubic symphysis.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

44. Fe deficient anemia tx
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Biopsy
Ferrous sulfate 325mg tid
6 yo

45. regards hand
4mo - sits unsupported - hand transfer - babbles
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
MCC melanoma in Africans/Asians. Under nails - soles - palms.

46. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Long axis of fetus to long axis of mother (longitudinal or transverse)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

47. Dx PID
Nuchal translucency - serum hCG - PAPP-A
5 yo - draws person - ties shoes - skips
Ceftriaxone 125mg IM
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

48. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Oxygen intervention 15h/d
Anemia

49. Screened at 11-13 weeks GA for trisomy
Conrtaction monitoring along with fetal heart rate assessment
Calcium pyrophosphate dehydrate crystals (pseudogout)
Anterior shoulder cannot readily pass below the pubic symphysis.
Nuchal translucency - serum hCG - PAPP-A

50. stranger/separation anxiety
Diphenhydramine - chlorpheniramine - hydroxyzine
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
9 mo - walks - throws - 1-3 words - 1-step commands
Urticaria