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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. Superficial spreading melanoma
MCC melanoma. Radial growth.
Metronidazole or clindamycin
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

2. Dx bacterial vaginosis
4 yo - copies triangle - catches ball - dresses self
Ampicillin/sulbactam AND doxycycline
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

3. needles - strong negative birefringent (yellow crystals parallel light)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Monosodium urate crystals (gout)

4. Recommendations for rear-facing car seat
5 yo - draws person - ties shoes - skips
Urinary calcium. Hyper PTH (high) >> FHH (normal)
<20lb - <1YO - Reacts to pain - Responds to noise
4 yo - copies triangle - catches ball - dresses self

5. variable deceleration
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Esophagitis - gastritis - dysphagia

6. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Flexion - internal rotation - extension - external rotation
Onset of labor until cervix dilation

7. Tx acute sinusitis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Calcium hydroxyapatite crystals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

8. Complications of GAS infxn
4 yo - copies triangle - catches ball - dresses self
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
4mo - sits unsupported - hand transfer - babbles
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

9. Tender - boggy prostate. Dx?
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Prostatitis
Fluoroquinolones
Metronidazole or clindamycin

10. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Thiazides

11. Immunizations at visit for 6MO
Anaphylaxis
Aortic aneurysm
DTaP - hepB - Hib - rotavirus - inactivated polio
(ofloxacin OR levofloxacin) +/- metronidazole

12. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxytocin (IV)
Bupropion - varenicline - nicotine replacement
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

13. Tx bacterial vaginosis
Metronidazole or clindamycin
Ceftriaxone 125mg IM
MTX
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

14. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diabetes - HTN - GN
Hypomagnesemia

15. regards hand
4mo - sits unsupported - hand transfer - babbles
Anterior shoulder cannot readily pass below the pubic symphysis.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Alpha-1 antitrypsin deficiency

16. Fe deficient anemia tx
Ferrous sulfate 325mg tid
Nicotine inhaler - nasal spray - gum
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Long axis of fetus to long axis of mother (longitudinal or transverse)

17. presbycusis
Ask - Advise - Assess - Assist - Arrange
Calcium oxalate crystals
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

18. Late deceleration
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Long axis of fetus to long axis of mother (longitudinal or transverse)
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

19. medications causing hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Cataracts
Thiazdes; lithium
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

20. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Oxytocin (IV)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

21. GBS tx
(ofloxacin OR levofloxacin) +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Onset of labor until cervix dilation
IV penicillin (or ampicillin)

22. Acral lentinous melanoma
Normal mental status; no other injuries; seen within 10 days of injury
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Long axis of fetus to long axis of mother (longitudinal or transverse)

23. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
5 yo - draws person - ties shoes - skips
Lung; SCC head & neck; RCC; breast; MM; prostate

24. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

25. Screened at 16-20 weeks GA for trisomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
After delivery until delivery of placenta and membranes <30 mins
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Thiazides

26. Fetal heart rate range
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
110-160bpm
3 yo - identify body part - copies square - hops - throws - past tense - story telling
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

27. Sx epiglottitis
Stridor - drooling - toxic appearance
Nuchal translucency - serum hCG - PAPP-A
Nicotine inhaler - nasal spray - gum
Aortic aneurysm

28. Tx acute gout
Long axis of fetus to long axis of mother (longitudinal or transverse)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Onset of labor until cervix dilation
Colchicine

29. Bacteria causing chronic sinusitis
Stridor - drooling - toxic appearance
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium hydroxyapatite crystals
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

30. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Fluoroquinolones
Colchicine
Aortic aneurysm

31. Pflx for traveler's diarrhea
Monosodium urate crystals (gout)
Pneumovax - influenza
4 yo - copies triangle - catches ball - dresses self
Fluoroquinolones

32. Malignancies with hypercalcemia
Stridor - drooling - toxic appearance
MTX
Lung; SCC head & neck; RCC; breast; MM; prostate
Tuberculosis; sarcoidosis; hodgkin disease

33. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
(ofloxacin OR levofloxacin) +/- metronidazole
NAC or IV NaHCO3

34. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ceftriaxone 125mg IM
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Metronidazole or clindamycin

35. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Ofloxacin OR levofloxacin +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
IV penicillin (or ampicillin)

36. Only therapy to decrease mortality in stage IV COPD
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Oxygen intervention 15h/d
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

37. Sx otitis externa
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

38. Tx acute exacerbation COPD
Nicotine inhaler - nasal spray - gum
Alpha-1 antitrypsin deficiency
Short-acting + 40mg prednisone x 10-14days
Age-related sensorineural hearing loss (high frequency and speech discrimination)

39. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

40. Low serum iron - low MCV - low ferritin - +stool guaiac
Calcium oxalate crystals
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Fe deficient anemia
Bathing - dressing - eating - transferring - continence - toileting

41. Augments contractions
Oxytocin (IV)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cataracts

42. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
DTaP - hepB - Hib - rotavirus - inactivated polio
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

43. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
= LMP + 7 days - 3 months
Bupropion - varenicline - nicotine replacement
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

44. Bisphospohonates sfx
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
9 mo - walks - throws - 1-3 words - 1-step commands
Esophagitis - gastritis - dysphagia
Alpha-1 antitrypsin deficiency

45. Optimal time for trisomy screen
<20lb - <1YO - Reacts to pain - Responds to noise
Anterior shoulder cannot readily pass below the pubic symphysis.
16-18 weeks GA
Flexion - internal rotation - extension - external rotation

46. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Thiazides
MTX
6-9MO

47. cystoplasmic inclusions - not birefringent
Patch - bupropion - varenicline
Urticaria
Calcium hydroxyapatite crystals
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

48. complications of otitis media
Thiazdes; lithium
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
(ofloxacin OR levofloxacin) +/- metronidazole

49. The five A's of smoking cessation
Colchicine
Patch - bupropion - varenicline
Ask - Advise - Assess - Assist - Arrange
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

50. IV tx for PID
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
MCC melanoma. Radial growth.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
(cefotetan OR cefoxitin) AND doxycycline