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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. DOC for HTN in elderly
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Thiazides
Cataracts
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

2. Tx of traveler's diarrhea
Anaphylaxis
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
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)
(ofloxacin OR levofloxacin) +/- metronidazole

3. IV tx for PID
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Clindamycin AND gentamicin
Measures strength of contractions

4. Estimated delivery date (Naegele's rule)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
= LMP + 7 days - 3 months
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Urticaria

5. Tx bacterial vaginosis
Metronidazole or clindamycin
Age-related sensorineural hearing loss (high frequency and speech discrimination)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

6. Tx for anaphylaxis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
MCC melanoma. Radial growth.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
0.2-0.5mg aqueous EPI IM/SubQ

7. Regards human face - eye contact
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
1 mo - eyes follow object to midline - vocalizes
Clindamycin AND gentamicin

8. Electrolyte abnormality that increases the incidence of torsades de pointes
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
9 mo - walks - throws - 1-3 words - 1-step commands
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Hypomagnesemia

9. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bathing - dressing - eating - transferring - continence - toileting
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

10. painless - deep - subQ swelling (periorbital - circumoral - facial)
Nicotine inhaler - nasal spray - gum
Diabetes - HTN - GN
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Angioedema

11. Sx peritonsillar abscess
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Pneumovax - influenza

12. shoulder dystocia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Bupropion - varenicline - nicotine replacement
Anterior shoulder cannot readily pass below the pubic symphysis.
Anaphylaxis

13. Granulomatous causes of hypercalcemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Tuberculosis; sarcoidosis; hodgkin disease
Diphenhydramine - chlorpheniramine - hydroxyzine
Fe deficient anemia

14. Sx of hypercalcemia
Ask - Advise - Assess - Assist - Arrange
Starts at contraction. caused by increased vagal tone from fetal head compression.
Angioedema
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

15. presbycusis
Calcium hydroxyapatite crystals
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
5 yo - draws person - ties shoes - skips

16. Tx acute exacerbation COPD
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Diphenhydramine - chlorpheniramine - hydroxyzine
Short-acting + 40mg prednisone x 10-14days
Ofloxacin OR levofloxacin +/- metronidazole

17. Third stage of labor
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Stridor - drooling - toxic appearance
Calcium pyrophosphate dehydrate crystals (pseudogout)
After delivery until delivery of placenta and membranes <30 mins

18. Only therapy to decrease mortality in stage IV COPD
0.2-0.5mg aqueous EPI IM/SubQ
Oxygen intervention 15h/d
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
5 yo - draws person - ties shoes - skips

19. identifies left - right
Cataracts
Biopsy
Nicotine inhaler - nasal spray - gum
6 yo

20. Screening for 65-76YO male smoker
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Aortic aneurysm
MTX
0.2-0.5mg aqueous EPI IM/SubQ

21. Nonfunctioning nodules > 1cm require _____
= LMP + 7 days - 3 months
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Anaphylaxis
Biopsy

22. 2nd generation antihistamines
Ceftriaxone 125mg IM
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Loratadine - fexofenadine - cetirizine
4mo - sits unsupported - hand transfer - babbles

23. Fe deficient anemia tx
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Nicotine inhaler - nasal spray - gum
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ferrous sulfate 325mg tid

24. Cockcroft-Gault equation
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Short-acting + 40mg prednisone x 10-14days
Bathing - dressing - eating - transferring - continence - toileting
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

25. Screened at 11-13 weeks GA for trisomy
6 yo
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)
Nuchal translucency - serum hCG - PAPP-A
Anterior shoulder cannot readily pass below the pubic symphysis.

26. 1st generation antihistamines
Diabetes - HTN - GN
Lung; SCC head & neck; RCC; breast; MM; prostate
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Diphenhydramine - chlorpheniramine - hydroxyzine

27. Nodular melanoma
Most aggressive melanoma.
Anaphylaxis
Ferrous sulfate 325mg tid
16-18 weeks GA

28. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Metronidazole or clindamycin
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. Superficial spreading melanoma
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
MCC melanoma. Radial growth.
Angioedema
Ask - Advise - Assess - Assist - Arrange

30. Signs of rupture of membranes

31. X-ray on knee?
Hypomagnesemia
Aortic aneurysm
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stridor - drooling - toxic appearance

32. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
9 mo - walks - throws - 1-3 words - 1-step commands
Aortic aneurysm
Urticaria

33. Optimal time for trisomy screen
MCC melanoma in Africans/Asians. Under nails - soles - palms.
6 yo
16-18 weeks GA
Nuchal translucency - serum hCG - PAPP-A

34. Low serum iron - low MCV - low ferritin - +stool guaiac
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Thiazdes; lithium
Fe deficient anemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

35. parallel play
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
4 yo - copies triangle - catches ball - dresses self
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Aortic aneurysm

36. variable deceleration
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Biopsy
Anemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

37. IADL
5 yo - draws person - ties shoes - skips
Tdap - influenza - pneumovax
Long axis of fetus to long axis of mother (longitudinal or transverse)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

38. Corrected serum calcium =

39. Acral lentinous melanoma
= LMP + 7 days - 3 months
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Patch - bupropion - varenicline

40. Rod shaped - rhomboid - weakly positive birefringent
Esophagitis - gastritis - dysphagia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Oxytocin (IV)
Calcium pyrophosphate dehydrate crystals (pseudogout)

41. Tx chlamydia
Ofloxacin OR levofloxacin +/- metronidazole
Bathing - dressing - eating - transferring - continence - toileting
MCC melanoma. Radial growth.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

42. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Patch - bupropion - varenicline
NAC or IV NaHCO3
Anterior shoulder cannot readily pass below the pubic symphysis.

43. writes name - counts 10 objects
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
5 yo - draws person - ties shoes - skips
(ofloxacin OR levofloxacin) +/- metronidazole

44. medications causing hypercalcemia
Thiazdes; lithium
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
0.2-0.5mg aqueous EPI IM/SubQ
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

45. Dx bacterial rhinosinusitis
Prostatitis
16-18 weeks GA
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)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

46. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Hypomagnesemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
5 yo - draws person - ties shoes - skips

47. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

48. Causes of CKD
Tdap - influenza - pneumovax
Measures strength of contractions
Diabetes - HTN - GN
(cefotetan OR cefoxitin) AND doxycycline

49. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
6-9MO
Colchicine
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)

50. Four cardinal fetal movements
Calcium pyrophosphate dehydrate crystals (pseudogout)
Flexion - internal rotation - extension - external rotation
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urinary calcium. Hyper PTH (high) >> FHH (normal)