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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. Fe deficient anemia tx
Flexion - internal rotation - extension - external rotation
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
NAC or IV NaHCO3
Ferrous sulfate 325mg tid

2. Nodular melanoma
Most aggressive melanoma.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Lung; SCC head & neck; RCC; breast; MM; prostate
Thiazides

3. Nonfunctioning nodules > 1cm require _____
Biopsy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

4. Sx epiglottitis
Stridor - drooling - toxic appearance
6-9MO
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium pyrophosphate dehydrate crystals (pseudogout)

5. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Esophagitis - gastritis - dysphagia
Anaphylaxis

6. social smile - parent recognition
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Onset of labor until cervix dilation
Ofloxacin OR levofloxacin +/- metronidazole
2 mo - eyes follow object past midline - rolls over - laughs - squeals

7. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
DTaP - hepB - Hib - rotavirus - inactivated polio
Long axis of fetus to long axis of mother (longitudinal or transverse)
Clindamycin AND gentamicin

8. Immunizations at visit for 6MO
6 yo
DTaP - hepB - Hib - rotavirus - inactivated polio
2 mo - eyes follow object past midline - rolls over - laughs - squeals
= LMP + 7 days - 3 months

9. Screened at 16-20 weeks GA for trisomy
Fe deficient anemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Normal mental status; no other injuries; seen within 10 days of injury
Stridor - drooling - toxic appearance

10. Tx acute sinusitis
Aortic aneurysm
6 yo
Anemia
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

11. Causes of CKD
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
4mo - sits unsupported - hand transfer - babbles
Diabetes - HTN - GN

12. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Esophagitis - gastritis - dysphagia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

13. Tx acute exacerbation COPD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Loratadine - fexofenadine - cetirizine
Short-acting + 40mg prednisone x 10-14days
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

14. group play - gender - knows name
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anemia
Esophagitis - gastritis - dysphagia

15. Tx RA (best long-term outcome)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MTX
Anaphylaxis
Short-acting + 40mg prednisone x 10-14days

16. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Fe deficient anemia
IV penicillin (or ampicillin)
9 mo - walks - throws - 1-3 words - 1-step commands

17. Age by which child says 'mama' and 'dada'
Alpha-1 antitrypsin deficiency
DTaP - hepB - Hib - rotavirus - inactivated polio
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
6-9MO

18. Tx of traveler's diarrhea
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

19. X-ray on knee?
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

20. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
(cefotetan OR cefoxitin) AND doxycycline
Conrtaction monitoring along with fetal heart rate assessment
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

21. Dx criteria for RA
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

22. Augments contractions
Tdap - influenza - pneumovax
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Oxytocin (IV)
Lung; SCC head & neck; RCC; breast; MM; prostate

23. Tx gonorrhea
Aortic aneurysm
DTaP - hepB - Hib - rotavirus - inactivated polio
Thiazides
Ceftriaxone 125mg IM

24. Acral lentinous melanoma
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Bathing - dressing - eating - transferring - continence - toileting
MCC melanoma in Africans/Asians. Under nails - soles - palms.
6 mo - pincer - crawls - cruises - mamma - dada - byebye

25. 2nd generation antihistamines
5+ rads
Ceftriaxone 125mg IM
Loratadine - fexofenadine - cetirizine
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

26. ADL
Bathing - dressing - eating - transferring - continence - toileting
Thiazides
Ofloxacin OR levofloxacin +/- metronidazole
Ferrous sulfate 325mg tid

27. Emphysema - <45YO - nonsmoker
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Alpha-1 antitrypsin deficiency
Conrtaction monitoring along with fetal heart rate assessment
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

28. DDX for geriatric hearing impairment
DTaP - hepB - Hib - rotavirus - inactivated polio
Most aggressive melanoma.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Nicotine inhaler - nasal spray - gum

29. Dx bacterial vaginosis
Oxytocin (IV)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Clindamycin AND gentamicin
= LMP + 7 days - 3 months

30. Tx GAS ifxn
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Flexion - internal rotation - extension - external rotation
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

31. regards hand
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
4mo - sits unsupported - hand transfer - babbles
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Esophagitis - gastritis - dysphagia

32. Immunizations for COPD patients
MCC melanoma. Radial growth.
Pneumovax - influenza
Flexion - internal rotation - extension - external rotation
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

33. presbycusis
Metronidazole or clindamycin
Fluoroquinolones
(cefotetan OR cefoxitin) AND doxycycline
Age-related sensorineural hearing loss (high frequency and speech discrimination)

34. Improve short-term outcomes in acute exacerbations of COPD - asthma
After delivery until delivery of placenta and membranes <30 mins
4 yo - copies triangle - catches ball - dresses self
Steroids + bronchodilators
MCC melanoma. Radial growth.

35. causes of acute bronchitis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ofloxacin OR levofloxacin +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

36. Immunizations for adult 65YO+
Bupropion - varenicline - nicotine replacement
Diabetes - HTN - GN
Most aggressive melanoma.
Tdap - influenza - pneumovax

37. identifies left - right
Nuchal translucency - serum hCG - PAPP-A
Prostatitis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
6 yo

38. Lentigo Maligna
Diphenhydramine - chlorpheniramine - hydroxyzine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nuchal translucency - serum hCG - PAPP-A
Onset of labor until cervix dilation

39. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
After delivery until delivery of placenta and membranes <30 mins
Prostatitis
Stridor - drooling - toxic appearance

40. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Ofloxacin OR levofloxacin +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

41. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

42. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Patch - bupropion - varenicline
Nicotine inhaler - nasal spray - gum

43. Early deceleration
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

44. 1st generation antihistamines
(cefotetan OR cefoxitin) AND doxycycline
Bupropion - varenicline - nicotine replacement
4mo - sits unsupported - hand transfer - babbles
Diphenhydramine - chlorpheniramine - hydroxyzine

45. MONA therapy
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Steroids + bronchodilators
Monosodium urate crystals (gout)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

46. Pregnancy class C smoking cessation drugs
5+ rads
After delivery until delivery of placenta and membranes <30 mins
Angioedema
Patch - bupropion - varenicline

47. CKD Stages
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
4mo - sits unsupported - hand transfer - babbles
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

48. Four cardinal fetal movements
NAC or IV NaHCO3
5+ rads
Oxygen intervention 15h/d
Flexion - internal rotation - extension - external rotation

49. Recommended folic acid daily dose
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Normal mental status; no other injuries; seen within 10 days of injury

50. Superficial spreading melanoma
(cefotetan OR cefoxitin) AND doxycycline
MCC melanoma. Radial growth.
NAC or IV NaHCO3
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis