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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. Dx bacterial rhinosinusitis
Pneumovax - influenza
Esophagitis - gastritis - dysphagia
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)
Diabetes - HTN - GN

2. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
Diabetes - HTN - GN
Age-related sensorineural hearing loss (high frequency and speech discrimination)
6 yo

3. Smoking cessation agents
3 yo - identify body part - copies square - hops - throws - past tense - story telling
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bupropion - varenicline - nicotine replacement
Tuberculosis; sarcoidosis; hodgkin disease

4. bacteria causing pharyngitis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anterior shoulder cannot readily pass below the pubic symphysis.
Tdap - influenza - pneumovax
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

5. Tx RA (best long-term outcome)
16-18 weeks GA
(cefotetan OR cefoxitin) AND doxycycline
MTX
6-9MO

6. Tocodynamometer
(cefotetan OR cefoxitin) AND doxycycline
Conrtaction monitoring along with fetal heart rate assessment
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
5 yo - draws person - ties shoes - skips

7. Fe deficient anemia tx
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ferrous sulfate 325mg tid
Nuchal translucency - serum hCG - PAPP-A
Most aggressive melanoma.

8. Signs of rupture of membranes

9. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease

10. tx shoulder dystocia

11. IV tx for PID
Ask - Advise - Assess - Assist - Arrange
Clindamycin AND gentamicin
Tuberculosis; sarcoidosis; hodgkin disease
6-9MO

12. causes of acute bronchitis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Thiazdes; lithium
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

13. Age by which child says 'mama' and 'dada'
Onset of labor until cervix dilation
4 yo - copies triangle - catches ball - dresses self
6-9MO
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

14. Lentigo Maligna
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Measures strength of contractions
Angioedema

15. dyspnea - visceral edema - hypotension
IV penicillin (or ampicillin)
Anaphylaxis
Aortic aneurysm
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

16. parallel play
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
(ofloxacin OR levofloxacin) +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

17. Causes of CKD
Hypomagnesemia
Diabetes - HTN - GN
Ampicillin/sulbactam AND doxycycline
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)

18. Other causes of hypercalcemia
Fe deficient anemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Flexion - internal rotation - extension - external rotation
Alpha-1 antitrypsin deficiency

19. bipyramidal - strongly positive birefringent
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium oxalate crystals
Calcium pyrophosphate dehydrate crystals (pseudogout)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

20. Tx chlamydia
Measures strength of contractions
Ask - Advise - Assess - Assist - Arrange
Ceftriaxone 125mg IM
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

21. Pflx for traveler's diarrhea
Nicotine inhaler - nasal spray - gum
Fluoroquinolones
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
6-9MO

22. Immunizations for adult 65YO+
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Tdap - influenza - pneumovax
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Diabetes - HTN - GN

23. Tx gonorrhea
Conrtaction monitoring along with fetal heart rate assessment
Ceftriaxone 125mg IM
Short-acting + 40mg prednisone x 10-14days
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

24. IV tx for PID
Diabetes - HTN - GN
Ofloxacin OR levofloxacin +/- metronidazole
Angioedema
(ofloxacin OR levofloxacin) +/- metronidazole

25. presbycusis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Long axis of fetus to long axis of mother (longitudinal or transverse)

26. Regards human face - eye contact
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
1 mo - eyes follow object to midline - vocalizes
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bathing - dressing - eating - transferring - continence - toileting

27. Optimal time for trisomy screen
Aortic aneurysm
16-18 weeks GA
Diphenhydramine - chlorpheniramine - hydroxyzine
Loratadine - fexofenadine - cetirizine

28. Screened at 11-13 weeks GA for trisomy
Normal mental status; no other injuries; seen within 10 days of injury
IV penicillin (or ampicillin)
Nuchal translucency - serum hCG - PAPP-A
Thiazdes; lithium

29. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
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)
NAC or IV NaHCO3
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

30. Corrected serum calcium =

31. Tx bacterial vaginosis
Metronidazole or clindamycin
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
16-18 weeks GA
Alpha-1 antitrypsin deficiency

32. Sx peritonsillar abscess
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Hypomagnesemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

33. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Prostatitis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

34. Immunizations at visit for 6MO
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Colchicine
DTaP - hepB - Hib - rotavirus - inactivated polio
Anemia

35. Electrolyte abnormality that increases the incidence of torsades de pointes
Aortic aneurysm
(cefotetan OR cefoxitin) AND doxycycline
1 mo - eyes follow object to midline - vocalizes
Hypomagnesemia

36. DOC for HTN in elderly
Thiazides
9 mo - walks - throws - 1-3 words - 1-step commands
Ampicillin/sulbactam AND doxycycline
5 yo - draws person - ties shoes - skips

37. recognizes strangers
MCC melanoma. Radial growth.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
6 mo - pincer - crawls - cruises - mamma - dada - byebye

38. Tx for anaphylaxis
Clindamycin AND gentamicin
5 yo - draws person - ties shoes - skips
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
0.2-0.5mg aqueous EPI IM/SubQ

39. Nodular melanoma
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Oxytocin (IV)
Most aggressive melanoma.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

40. Dx PID
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Measures strength of contractions
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

41. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Diabetes - HTN - GN
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

42. The five A's of smoking cessation
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ask - Advise - Assess - Assist - Arrange
Anaphylaxis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

43. Tx acute gout
110-160bpm
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Colchicine

44. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Angioedema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
4 yo - copies triangle - catches ball - dresses self

45. Rod shaped - rhomboid - weakly positive birefringent
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium pyrophosphate dehydrate crystals (pseudogout)
Conrtaction monitoring along with fetal heart rate assessment

46. shoulder dystocia
Bupropion - varenicline - nicotine replacement
Ofloxacin OR levofloxacin +/- metronidazole
(ofloxacin OR levofloxacin) +/- metronidazole
Anterior shoulder cannot readily pass below the pubic symphysis.

47. Screened at 16-20 weeks GA for trisomy
Short-acting + 40mg prednisone x 10-14days
Angioedema
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

48. Fetal heart rate range
<20lb - <1YO - Reacts to pain - Responds to noise
110-160bpm
4mo - sits unsupported - hand transfer - babbles
Metronidazole or clindamycin

49. X-ray on knee?
<20lb - <1YO - Reacts to pain - Responds to noise
9 mo - walks - throws - 1-3 words - 1-step commands
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
After delivery until delivery of placenta and membranes <30 mins

50. IV tx for PID
Tuberculosis; sarcoidosis; hodgkin disease
(cefotetan OR cefoxitin) AND doxycycline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn