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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. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

2. medications causing hypercalcemia
Thiazdes; lithium
Clindamycin AND gentamicin
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

3. DOC for HTN in elderly
Bupropion - varenicline - nicotine replacement
DTaP - hepB - Hib - rotavirus - inactivated polio
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Thiazides

4. The five A's of smoking cessation
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ask - Advise - Assess - Assist - Arrange
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)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

5. Unstable angina vs MI Dx tests
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

6. X-ray of ankle?
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Normal mental status; no other injuries; seen within 10 days of injury
Hypomagnesemia
Anaphylaxis

7. Tx gonorrhea
Onset of labor until cervix dilation
Ceftriaxone 125mg IM
Oxytocin (IV)
1 mo - eyes follow object to midline - vocalizes

8. Recommended folic acid daily dose
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Cataracts
Bathing - dressing - eating - transferring - continence - toileting
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

9. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
After delivery until delivery of placenta and membranes <30 mins
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
NAC or IV NaHCO3
Cataracts

10. Fetal heart rate range
110-160bpm
Ceftriaxone 125mg IM
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
MCC melanoma. Radial growth.

11. Tx RA (best long-term outcome)
Calcium oxalate crystals
MTX
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Conrtaction monitoring along with fetal heart rate assessment

12. writes name - counts 10 objects
Thiazdes; lithium
Fluoroquinolones
Age-related sensorineural hearing loss (high frequency and speech discrimination)
5 yo - draws person - ties shoes - skips

13. bipyramidal - strongly positive birefringent
MCC melanoma in Africans/Asians. Under nails - soles - palms.
= LMP + 7 days - 3 months
Calcium oxalate crystals
(cefotetan OR cefoxitin) AND doxycycline

14. Tender - boggy prostate. Dx?
Thiazides
Prostatitis
Patch - bupropion - varenicline
Flexion - internal rotation - extension - external rotation

15. Rod shaped - rhomboid - weakly positive birefringent
Tdap - influenza - pneumovax
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Calcium pyrophosphate dehydrate crystals (pseudogout)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

16. Tx otitis media
Aortic aneurysm
Long axis of fetus to long axis of mother (longitudinal or transverse)
4mo - sits unsupported - hand transfer - babbles
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

17. Complications of PID
Tdap - influenza - pneumovax
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
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)
Oxygen intervention 15h/d

18. Only therapy to decrease mortality in stage IV COPD
Biopsy
Oxygen intervention 15h/d
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

19. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
IV penicillin (or ampicillin)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

20. Pflx for traveler's diarrhea
Fluoroquinolones
IV penicillin (or ampicillin)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Nicotine inhaler - nasal spray - gum

21. Sx epiglottitis
Diabetes - HTN - GN
Biopsy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stridor - drooling - toxic appearance

22. Second stage of labor
Biopsy
Calcium hydroxyapatite crystals
Oxytocin (IV)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

23. Corrected serum calcium =

24. Tx bacterial vaginosis
Clindamycin AND gentamicin
Metronidazole or clindamycin
Ask - Advise - Assess - Assist - Arrange
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

25. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ask - Advise - Assess - Assist - Arrange
Fluoroquinolones
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

26. Age by which child says 'mama' and 'dada'
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Tdap - influenza - pneumovax
Alpha-1 antitrypsin deficiency
6-9MO

27. explorations
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Oxygen intervention 15h/d
MTX
9 mo - walks - throws - 1-3 words - 1-step commands

28. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Steroids + bronchodilators
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Fe deficient anemia

29. shoulder dystocia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
(cefotetan OR cefoxitin) AND doxycycline
Anterior shoulder cannot readily pass below the pubic symphysis.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

30. Tx hyperkalemia in CKD
Ask - Advise - Assess - Assist - Arrange
Calcium oxalate crystals
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

31. Oral tx for PID
Angioedema
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium pyrophosphate dehydrate crystals (pseudogout)
Bupropion - varenicline - nicotine replacement

32. Sx otitis externa
NAC or IV NaHCO3
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ampicillin/sulbactam AND doxycycline

33. Emphysema - <45YO - nonsmoker
110-160bpm
Bupropion - varenicline - nicotine replacement
Alpha-1 antitrypsin deficiency
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

34. Sx peritonsillar abscess
Pneumovax - influenza
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Fluoroquinolones

35. Dx bacterial vaginosis
Alpha-1 antitrypsin deficiency
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

36. Estimated delivery date (Naegele's rule)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
= LMP + 7 days - 3 months
Diabetes - HTN - GN
Calcium pyrophosphate dehydrate crystals (pseudogout)

37. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
Oxygen intervention 15h/d
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

38. Tx for anaphylaxis
Starts at contraction. caused by increased vagal tone from fetal head compression.
0.2-0.5mg aqueous EPI IM/SubQ
MCC melanoma in Africans/Asians. Under nails - soles - palms.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

39. Tx acute gout
Colchicine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
4mo - sits unsupported - hand transfer - babbles
Pneumovax - influenza

40. identifies left - right
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)
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)
6 yo

41. Fe deficient anemia tx
Ferrous sulfate 325mg tid
110-160bpm
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

42. tx shoulder dystocia

43. Tx for thyroid storm
MTX
Stridor - drooling - toxic appearance
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

44. DDX for geriatric hearing impairment
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ampicillin/sulbactam AND doxycycline
Loratadine - fexofenadine - cetirizine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

45. social smile - parent recognition
<20lb - <1YO - Reacts to pain - Responds to noise
Fluoroquinolones
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
2 mo - eyes follow object past midline - rolls over - laughs - squeals

46. Smoking cessation agents
Tuberculosis; sarcoidosis; hodgkin disease
Cataracts
Clindamycin AND gentamicin
Bupropion - varenicline - nicotine replacement

47. Nodular melanoma
Oxygen intervention 15h/d
Most aggressive melanoma.
Stridor - drooling - toxic appearance
(ofloxacin OR levofloxacin) +/- metronidazole

48. Screened at 16-20 weeks GA for trisomy
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Anterior shoulder cannot readily pass below the pubic symphysis.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

49. Superficial spreading melanoma
MCC melanoma. Radial growth.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
6 mo - pincer - crawls - cruises - mamma - dada - byebye
0.2-0.5mg aqueous EPI IM/SubQ

50. IV tx for PID
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Clindamycin AND gentamicin
After delivery until delivery of placenta and membranes <30 mins
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry