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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. Bacteria causing chronic sinusitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Patch - bupropion - varenicline
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

2. Tx acute sinusitis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Bupropion - varenicline - nicotine replacement
Onset of labor until cervix dilation
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

3. cystoplasmic inclusions - not birefringent
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Calcium hydroxyapatite crystals
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

4. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Aortic aneurysm
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

5. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
4 yo - copies triangle - catches ball - dresses self
16-18 weeks GA
Age-related sensorineural hearing loss (high frequency and speech discrimination)

6. Early deceleration
6 yo
Colchicine
Starts at contraction. caused by increased vagal tone from fetal head compression.
After delivery until delivery of placenta and membranes <30 mins

7. X-ray on knee?
Bupropion - varenicline - nicotine replacement
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
4 yo - copies triangle - catches ball - dresses self
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

8. Unstable angina vs MI Dx tests
1 mo - eyes follow object to midline - vocalizes
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Pneumovax - influenza
Calcium hydroxyapatite crystals

9. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
4mo - sits unsupported - hand transfer - babbles
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

10. identifies left - right
Ofloxacin OR levofloxacin +/- metronidazole
1 mo - eyes follow object to midline - vocalizes
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
6 yo

11. bacteria causing pharyngitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Nicotine inhaler - nasal spray - gum
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

12. Corrected serum calcium =

13. Granulomatous causes of hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Tuberculosis; sarcoidosis; hodgkin disease
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Urinary calcium. Hyper PTH (high) >> FHH (normal)

14. writes name - counts 10 objects
2 mo - eyes follow object past midline - rolls over - laughs - squeals
5 yo - draws person - ties shoes - skips
110-160bpm
Lung; SCC head & neck; RCC; breast; MM; prostate

15. MONA therapy
<20lb - <1YO - Reacts to pain - Responds to noise
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
NAC or IV NaHCO3
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

16. Tx gonorrhea
Alpha-1 antitrypsin deficiency
Ceftriaxone 125mg IM
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

17. Tx of traveler's diarrhea
Patch - bupropion - varenicline
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Normal mental status; no other injuries; seen within 10 days of injury
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

18. Oral tx for PID
Tuberculosis; sarcoidosis; hodgkin disease
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)
Nicotine inhaler - nasal spray - gum

19. Tx hyperkalemia in CKD
Lung; SCC head & neck; RCC; breast; MM; prostate
5+ rads
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

20. shoulder dystocia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ceftriaxone 125mg IM
Normal mental status; no other injuries; seen within 10 days of injury
Anterior shoulder cannot readily pass below the pubic symphysis.

21. Fetal lie
Prostatitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Long axis of fetus to long axis of mother (longitudinal or transverse)
Colchicine

22. Tender - boggy prostate. Dx?
6-9MO
Prostatitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
IV penicillin (or ampicillin)

23. Age by which child says 'mama' and 'dada'
6-9MO
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Aortic aneurysm

24. Dx criteria for RA
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

25. Second stage of labor
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Clindamycin AND gentamicin
Prostatitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

26. Fe deficient anemia tx
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Ferrous sulfate 325mg tid
<20lb - <1YO - Reacts to pain - Responds to noise
Nuchal translucency - serum hCG - PAPP-A

27. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Oxytocin (IV)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Calcium hydroxyapatite crystals

28. Sx epiglottitis
Stridor - drooling - toxic appearance
Onset of labor until cervix dilation
1 mo - eyes follow object to midline - vocalizes
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

29. Complications of PID
= LMP + 7 days - 3 months
Thiazdes; lithium
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
0.2-0.5mg aqueous EPI IM/SubQ

30. Pregnancy class D smoking cessation drugs
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Nicotine inhaler - nasal spray - gum
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

31. IV tx for PID
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ofloxacin OR levofloxacin +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)

32. X-ray of ankle?
Calcium hydroxyapatite crystals
Anterior shoulder cannot readily pass below the pubic symphysis.
Normal mental status; no other injuries; seen within 10 days of injury
Biopsy

33. bipyramidal - strongly positive birefringent
Angioedema
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium oxalate crystals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

34. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Diphenhydramine - chlorpheniramine - hydroxyzine
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ceftriaxone 125mg IM

35. Screening for 65-76YO male smoker
Pneumovax - influenza
Aortic aneurysm
9 mo - walks - throws - 1-3 words - 1-step commands
Ofloxacin OR levofloxacin +/- metronidazole

36. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
MTX
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Oxygen intervention 15h/d

37. Tx chlamydia
Loratadine - fexofenadine - cetirizine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

38. Late deceleration
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
110-160bpm
<20lb - <1YO - Reacts to pain - Responds to noise
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

39. Pflx for traveler's diarrhea
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Fluoroquinolones
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Short-acting + 40mg prednisone x 10-14days

40. Electrolyte abnormality that increases the incidence of torsades de pointes
Calcium hydroxyapatite crystals
Hypomagnesemia
Calcium oxalate crystals
6 yo

41. Large - irregularly shaped - prutitic - erythematous wheals
(cefotetan OR cefoxitin) AND doxycycline
6-9MO
Loratadine - fexofenadine - cetirizine
Urticaria

42. dyspnea - visceral edema - hypotension
Oxytocin (IV)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anaphylaxis
5+ rads

43. regards hand
5+ rads
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Aortic aneurysm
4mo - sits unsupported - hand transfer - babbles

44. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Pneumovax - influenza
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Tdap - influenza - pneumovax

45. First stage of labor
Onset of labor until cervix dilation
Urticaria
Tdap - influenza - pneumovax
IV penicillin (or ampicillin)

46. Pregnancy class C smoking cessation drugs
(cefotetan OR cefoxitin) AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Patch - bupropion - varenicline

47. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
NAC or IV NaHCO3
Thiazdes; lithium

48. IUPC (intrauterine pressure catheter)
MCC melanoma. Radial growth.
Monosodium urate crystals (gout)
Measures strength of contractions
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

49. Nodular melanoma
Flexion - internal rotation - extension - external rotation
Measures strength of contractions
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Most aggressive melanoma.

50. Acral lentinous melanoma
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Biopsy
Ask - Advise - Assess - Assist - Arrange