Test your basic knowledge |

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. IUPC (intrauterine pressure catheter)
Measures strength of contractions
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)
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)

2. First stage of labor
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ceftriaxone 125mg IM
Onset of labor until cervix dilation
Angioedema

3. Malignancies with hypercalcemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Lung; SCC head & neck; RCC; breast; MM; prostate
6 mo - pincer - crawls - cruises - mamma - dada - byebye

4. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Oxygen intervention 15h/d
Ear pain - itching - inflammation/swollen canal - exudates/discharge

5. DDX for geriatric hearing impairment
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Fe deficient anemia

6. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
5 yo - draws person - ties shoes - skips
Hypomagnesemia
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

7. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Tuberculosis; sarcoidosis; hodgkin disease

8. Sx of hypercalcemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Tuberculosis; sarcoidosis; hodgkin disease
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

9. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
6-9MO
4 yo - copies triangle - catches ball - dresses self
Ofloxacin OR levofloxacin +/- metronidazole

10. Causes of CKD
Urticaria
Diabetes - HTN - GN
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Normal mental status; no other injuries; seen within 10 days of injury

11. bipyramidal - strongly positive birefringent
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Long axis of fetus to long axis of mother (longitudinal or transverse)
Calcium oxalate crystals

12. Augments contractions
Hypomagnesemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Oxytocin (IV)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

13. Tx chlamydia
Long axis of fetus to long axis of mother (longitudinal or transverse)
Angioedema
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

14. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
DTaP - hepB - Hib - rotavirus - inactivated polio
Aortic aneurysm
Bathing - dressing - eating - transferring - continence - toileting

15. Corrected serum calcium =

16. Complications of PID
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(cefotetan OR cefoxitin) AND doxycycline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

17. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Short-acting + 40mg prednisone x 10-14days

18. social interaction
Oxytocin (IV)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
4 yo - copies triangle - catches ball - dresses self
Flexion - internal rotation - extension - external rotation

19. Other causes of hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Long axis of fetus to long axis of mother (longitudinal or transverse)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Flexion - internal rotation - extension - external rotation

20. X-ray of ankle?
NAC or IV NaHCO3
Long axis of fetus to long axis of mother (longitudinal or transverse)
Normal mental status; no other injuries; seen within 10 days of injury
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

21. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Flexion - internal rotation - extension - external rotation
Cataracts

22. Optimal time for trisomy screen
16-18 weeks GA
Anaphylaxis
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

23. Tx acute sinusitis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
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)
NAC or IV NaHCO3

24. Rod shaped - rhomboid - weakly positive birefringent
Ampicillin/sulbactam AND doxycycline
Calcium pyrophosphate dehydrate crystals (pseudogout)
16-18 weeks GA
Fluoroquinolones

25. Sx otitis externa
Esophagitis - gastritis - dysphagia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Nuchal translucency - serum hCG - PAPP-A
Fluoroquinolones

26. IV tx for PID
Lung; SCC head & neck; RCC; breast; MM; prostate
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
(cefotetan OR cefoxitin) AND doxycycline
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

27. Low serum iron - low MCV - low ferritin - +stool guaiac
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fe deficient anemia

28. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Monosodium urate crystals (gout)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

29. Screening for 65-76YO male smoker
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Fe deficient anemia
Aortic aneurysm
4 yo - copies triangle - catches ball - dresses self

30. Tx RA (best long-term outcome)
MTX
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

31. Estimated delivery date (Naegele's rule)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
= LMP + 7 days - 3 months
Nicotine inhaler - nasal spray - gum
6-9MO

32. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Esophagitis - gastritis - dysphagia
DTaP - hepB - Hib - rotavirus - inactivated polio
6 mo - pincer - crawls - cruises - mamma - dada - byebye

33. regards hand
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
4mo - sits unsupported - hand transfer - babbles
DTaP - hepB - Hib - rotavirus - inactivated polio
Calcium pyrophosphate dehydrate crystals (pseudogout)

34. Large - irregularly shaped - prutitic - erythematous wheals
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Oxygen intervention 15h/d
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urticaria

35. group play - gender - knows name
110-160bpm
Diphenhydramine - chlorpheniramine - hydroxyzine
Ofloxacin OR levofloxacin +/- metronidazole
3 yo - identify body part - copies square - hops - throws - past tense - story telling

36. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
1 mo - eyes follow object to midline - vocalizes
0.2-0.5mg aqueous EPI IM/SubQ
16-18 weeks GA
Anemia

37. Sx otitis media
Pneumovax - influenza
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

38. The five A's of smoking cessation
4mo - sits unsupported - hand transfer - babbles
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ask - Advise - Assess - Assist - Arrange
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

39. Dx bacterial rhinosinusitis
Thiazides
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
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)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

40. Screened at 11-13 weeks GA for trisomy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Loratadine - fexofenadine - cetirizine
Nuchal translucency - serum hCG - PAPP-A
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

41. Nonfunctioning nodules > 1cm require _____
Biopsy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
4 yo - copies triangle - catches ball - dresses self
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

42. Cockcroft-Gault equation
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Thiazides
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

43. Sx peritonsillar abscess
Metronidazole or clindamycin
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
IV penicillin (or ampicillin)

44. Tx hyperkalemia in CKD
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Cataracts

45. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Diabetes - HTN - GN
Onset of labor until cervix dilation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

46. X-ray on knee?
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

47. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Ferrous sulfate 325mg tid
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

48. Age by which child says 'mama' and 'dada'
0.2-0.5mg aqueous EPI IM/SubQ
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium pyrophosphate dehydrate crystals (pseudogout)
6-9MO

49. Sx epiglottitis
Monosodium urate crystals (gout)
Stridor - drooling - toxic appearance
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

50. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Lung; SCC head & neck; RCC; breast; MM; prostate
2 mo - eyes follow object past midline - rolls over - laughs - squeals