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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. IADL
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Anaphylaxis
MCC melanoma. Radial growth.

2. Optimal time for trisomy screen
Ampicillin/sulbactam AND doxycycline
16-18 weeks GA
Tuberculosis; sarcoidosis; hodgkin disease
0.2-0.5mg aqueous EPI IM/SubQ

3. writes name - counts 10 objects
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
5 yo - draws person - ties shoes - skips
Conrtaction monitoring along with fetal heart rate assessment
Stridor - drooling - toxic appearance

4. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Conrtaction monitoring along with fetal heart rate assessment
Hypomagnesemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

5. Pflx for traveler's diarrhea
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Diabetes - HTN - GN
Fluoroquinolones

6. Corrected serum calcium =

7. social interaction
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
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
Bathing - dressing - eating - transferring - continence - toileting

8. group play - gender - knows name
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Esophagitis - gastritis - dysphagia
Anemia

9. How much radiation is associated with fetal harm?
5+ rads
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Oxytocin (IV)
Metronidazole or clindamycin

10. Tx of traveler's diarrhea
110-160bpm
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

11. Tx hyperkalemia in CKD
6-9MO
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ask - Advise - Assess - Assist - Arrange
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

12. Dx PID
Oxygen intervention 15h/d
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Calcium pyrophosphate dehydrate crystals (pseudogout)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

13. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
110-160bpm
DTaP - hepB - Hib - rotavirus - inactivated polio
6 mo - pincer - crawls - cruises - mamma - dada - byebye

14. presbycusis
Metronidazole or clindamycin
Aortic aneurysm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

15. Tender - boggy prostate. Dx?
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Normal mental status; no other injuries; seen within 10 days of injury
Prostatitis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

16. IV tx for PID
Clindamycin AND gentamicin
Anterior shoulder cannot readily pass below the pubic symphysis.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

17. X-ray on knee?
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
4 yo - copies triangle - catches ball - dresses self
Calcium pyrophosphate dehydrate crystals (pseudogout)

18. Fe deficient anemia tx
Monosodium urate crystals (gout)
Ferrous sulfate 325mg tid
Thiazides
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

19. Tx acute exacerbation COPD
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Short-acting + 40mg prednisone x 10-14days
Ampicillin/sulbactam AND doxycycline
Normal mental status; no other injuries; seen within 10 days of injury

20. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
<20lb - <1YO - Reacts to pain - Responds to noise
6 mo - pincer - crawls - cruises - mamma - dada - byebye

21. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

22. Rod shaped - rhomboid - weakly positive birefringent
Fe deficient anemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
NAC or IV NaHCO3
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

23. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
6 yo
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

24. 1st generation antihistamines
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Diphenhydramine - chlorpheniramine - hydroxyzine
Stridor - drooling - toxic appearance
Patch - bupropion - varenicline

25. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Conrtaction monitoring along with fetal heart rate assessment
Measures strength of contractions

26. Superficial spreading melanoma
MCC melanoma. Radial growth.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Angioedema
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

27. Only therapy to decrease mortality in stage IV COPD
Patch - bupropion - varenicline
Cataracts
Oxygen intervention 15h/d
Flexion - internal rotation - extension - external rotation

28. Recommended folic acid daily dose
IV penicillin (or ampicillin)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Biopsy
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

29. MCC blindness worldwide
Cataracts
Diphenhydramine - chlorpheniramine - hydroxyzine
Ceftriaxone 125mg IM
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

30. Pregnancy class C smoking cessation drugs
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
16-18 weeks GA
Ferrous sulfate 325mg tid
Patch - bupropion - varenicline

31. Lentigo Maligna
Urticaria
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Pneumovax - influenza

32. Pregnancy class D smoking cessation drugs
= LMP + 7 days - 3 months
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Nicotine inhaler - nasal spray - gum

33. Signs of rupture of membranes

34. Tx gonorrhea
Ceftriaxone 125mg IM
Flexion - internal rotation - extension - external rotation
Urticaria
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

35. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Flexion - internal rotation - extension - external rotation
Ferrous sulfate 325mg tid

36. IUPC (intrauterine pressure catheter)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Measures strength of contractions
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Flexion - internal rotation - extension - external rotation

37. Cockcroft-Gault equation
1 mo - eyes follow object to midline - vocalizes
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
6 yo
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

38. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Bathing - dressing - eating - transferring - continence - toileting
(ofloxacin OR levofloxacin) +/- metronidazole
NAC or IV NaHCO3
Most aggressive melanoma.

39. tx shoulder dystocia

40. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Metronidazole or clindamycin
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

41. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Loratadine - fexofenadine - cetirizine
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

42. Malignancies with hypercalcemia
Metronidazole or clindamycin
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)
Lung; SCC head & neck; RCC; breast; MM; prostate
Patch - bupropion - varenicline

43. painless - deep - subQ swelling (periorbital - circumoral - facial)
Bathing - dressing - eating - transferring - continence - toileting
IV penicillin (or ampicillin)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Angioedema

44. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cataracts
MCC melanoma in Africans/Asians. Under nails - soles - palms.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

45. First stage of labor
Onset of labor until cervix dilation
Starts at contraction. caused by increased vagal tone from fetal head compression.
NAC or IV NaHCO3
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

46. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
5 yo - draws person - ties shoes - skips
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Short-acting + 40mg prednisone x 10-14days

47. Tx acute gout
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Colchicine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

48. The five A's of smoking cessation
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Alpha-1 antitrypsin deficiency
Ask - Advise - Assess - Assist - Arrange
Bathing - dressing - eating - transferring - continence - toileting

49. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Lung; SCC head & neck; RCC; breast; MM; prostate
Ask - Advise - Assess - Assist - Arrange

50. medications causing hypercalcemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ceftriaxone 125mg IM
Ofloxacin OR levofloxacin +/- metronidazole
Thiazdes; lithium