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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. Recommended folic acid daily dose
Thiazides
NAC or IV NaHCO3
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)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

2. MCC blindness worldwide
Alpha-1 antitrypsin deficiency
Cataracts
Measures strength of contractions
Hypomagnesemia

3. complications of otitis media
Anemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Aortic aneurysm

4. ADL
Bathing - dressing - eating - transferring - continence - toileting
Stridor - drooling - toxic appearance
Calcium pyrophosphate dehydrate crystals (pseudogout)
6 yo

5. Augments contractions
Onset of labor until cervix dilation
Oxytocin (IV)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

6. Smoking cessation agents
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
= LMP + 7 days - 3 months
Bupropion - varenicline - nicotine replacement

7. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium oxalate crystals

8. MONA therapy
Oxygen intervention 15h/d
MTX
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

9. Four cardinal fetal movements
110-160bpm
5 yo - draws person - ties shoes - skips
Cataracts
Flexion - internal rotation - extension - external rotation

10. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Short-acting + 40mg prednisone x 10-14days
Tuberculosis; sarcoidosis; hodgkin disease
9 mo - walks - throws - 1-3 words - 1-step commands

11. Lentigo Maligna
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Lung; SCC head & neck; RCC; breast; MM; prostate

12. Sx peritonsillar abscess
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)
MCC melanoma. Radial growth.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

13. Tx hyperkalemia in CKD
MCC melanoma. Radial growth.
Thiazdes; lithium
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Thiazides

14. tx shoulder dystocia

15. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Colchicine
4mo - sits unsupported - hand transfer - babbles
Calcium hydroxyapatite crystals

16. Other causes of hypercalcemia
Calcium oxalate crystals
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Hypomagnesemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

17. Sx otitis externa
MTX
<20lb - <1YO - Reacts to pain - Responds to noise
Steroids + bronchodilators
Ear pain - itching - inflammation/swollen canal - exudates/discharge

18. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fluoroquinolones
MCC melanoma in Africans/Asians. Under nails - soles - palms.

19. CKD Stages
Bupropion - varenicline - nicotine replacement
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Urinary calcium. Hyper PTH (high) >> FHH (normal)
4mo - sits unsupported - hand transfer - babbles

20. writes name - counts 10 objects
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
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ear pain - itching - inflammation/swollen canal - exudates/discharge

21. bacteria causing pharyngitis
Cataracts
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Lung; SCC head & neck; RCC; breast; MM; prostate
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

22. regards hand
4mo - sits unsupported - hand transfer - babbles
Oxygen intervention 15h/d
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Prostatitis

23. Bisphospohonates sfx
(cefotetan OR cefoxitin) AND doxycycline
Esophagitis - gastritis - dysphagia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
16-18 weeks GA

24. Tx RA (best long-term outcome)
1 mo - eyes follow object to midline - vocalizes
MTX
(cefotetan OR cefoxitin) AND doxycycline
Calcium oxalate crystals

25. Rod shaped - rhomboid - weakly positive birefringent
Ask - Advise - Assess - Assist - Arrange
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Anemia
Calcium pyrophosphate dehydrate crystals (pseudogout)

26. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium hydroxyapatite crystals
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Anemia

27. Nonfunctioning nodules > 1cm require _____
Measures strength of contractions
Biopsy
DTaP - hepB - Hib - rotavirus - inactivated polio
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

28. Fetal heart rate range
9 mo - walks - throws - 1-3 words - 1-step commands
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ceftriaxone 125mg IM
110-160bpm

29. Nodular melanoma
(cefotetan OR cefoxitin) AND doxycycline
Most aggressive melanoma.
5+ rads
Ceftriaxone 125mg IM

30. shoulder dystocia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Biopsy
9 mo - walks - throws - 1-3 words - 1-step commands
Anterior shoulder cannot readily pass below the pubic symphysis.

31. Regards human face - eye contact
Aortic aneurysm
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
1 mo - eyes follow object to midline - vocalizes
Ear pain - itching - inflammation/swollen canal - exudates/discharge

32. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
MCC melanoma in Africans/Asians. Under nails - soles - palms.
After delivery until delivery of placenta and membranes <30 mins

33. dyspnea - visceral edema - hypotension
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Most aggressive melanoma.
Monosodium urate crystals (gout)
Anaphylaxis

34. X-ray of ankle?
Fe deficient anemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Normal mental status; no other injuries; seen within 10 days of injury

35. Acral lentinous melanoma
5+ rads
Steroids + bronchodilators
MCC melanoma in Africans/Asians. Under nails - soles - palms.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

36. Dx PID
Pneumovax - influenza
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
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

37. Pregnancy class C smoking cessation drugs
5 yo - draws person - ties shoes - skips
Ampicillin/sulbactam AND doxycycline
Patch - bupropion - varenicline
Oxytocin (IV)

38. Sx epiglottitis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Urinary calcium. Hyper PTH (high) >> FHH (normal)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Stridor - drooling - toxic appearance

39. Tender - boggy prostate. Dx?
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Prostatitis
After delivery until delivery of placenta and membranes <30 mins
Bathing - dressing - eating - transferring - continence - toileting

40. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
5+ rads
MCC melanoma in Africans/Asians. Under nails - soles - palms.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

41. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Long axis of fetus to long axis of mother (longitudinal or transverse)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

42. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Lung; SCC head & neck; RCC; breast; MM; prostate

43. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ampicillin/sulbactam AND doxycycline
(cefotetan OR cefoxitin) AND doxycycline

44. IUPC (intrauterine pressure catheter)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anemia
Measures strength of contractions

45. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
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)
Diphenhydramine - chlorpheniramine - hydroxyzine
Biopsy

46. Low serum iron - low MCV - low ferritin - +stool guaiac
Diabetes - HTN - GN
Fe deficient anemia
110-160bpm
Urinary calcium. Hyper PTH (high) >> FHH (normal)

47. Causes of CKD
Diabetes - HTN - GN
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Aortic aneurysm
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

48. Superficial spreading melanoma
Stridor - drooling - toxic appearance
MCC melanoma. Radial growth.
Fe deficient anemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

49. social interaction
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
4 yo - copies triangle - catches ball - dresses self
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Most aggressive melanoma.

50. social smile - parent recognition
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
<20lb - <1YO - Reacts to pain - Responds to noise
2 mo - eyes follow object past midline - rolls over - laughs - squeals
After delivery until delivery of placenta and membranes <30 mins