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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. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anemia
Measures strength of contractions
16-18 weeks GA

2. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
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)

3. Sx epiglottitis
Urticaria
Stridor - drooling - toxic appearance
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ofloxacin OR levofloxacin +/- metronidazole

4. Third stage of labor
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
After delivery until delivery of placenta and membranes <30 mins
Starts at contraction. caused by increased vagal tone from fetal head compression.
9 mo - walks - throws - 1-3 words - 1-step commands

5. social interaction
4 yo - copies triangle - catches ball - dresses self
Ask - Advise - Assess - Assist - Arrange
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

6. Nodular melanoma
Most aggressive melanoma.
<20lb - <1YO - Reacts to pain - Responds to noise
Conrtaction monitoring along with fetal heart rate assessment
Urinary calcium. Hyper PTH (high) >> FHH (normal)

7. Early deceleration
6-9MO
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Urticaria

8. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
Anterior shoulder cannot readily pass below the pubic symphysis.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

9. Rod shaped - rhomboid - weakly positive birefringent
Nicotine inhaler - nasal spray - gum
4mo - sits unsupported - hand transfer - babbles
Calcium pyrophosphate dehydrate crystals (pseudogout)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

10. Acral lentinous melanoma
Urticaria
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

11. Screened at 11-13 weeks GA for trisomy
Patch - bupropion - varenicline
Nuchal translucency - serum hCG - PAPP-A
Monosodium urate crystals (gout)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

12. ADL
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Bathing - dressing - eating - transferring - continence - toileting
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
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)

13. Tx for thyroid storm
16-18 weeks GA
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Patch - bupropion - varenicline

14. Tx GAS ifxn
Thiazdes; lithium
Fluoroquinolones
Calcium hydroxyapatite crystals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

15. Estimated delivery date (Naegele's rule)
Calcium hydroxyapatite crystals
Anemia
= LMP + 7 days - 3 months
Calcium oxalate crystals

16. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Patch - bupropion - varenicline
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Clindamycin AND gentamicin

17. Fetal lie
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Patch - bupropion - varenicline
Calcium hydroxyapatite crystals

18. medications causing hypercalcemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Colchicine
Diabetes - HTN - GN
Thiazdes; lithium

19. First stage of labor
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium oxalate crystals
Alpha-1 antitrypsin deficiency
Onset of labor until cervix dilation

20. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Cataracts
16-18 weeks GA
Most aggressive melanoma.

21. Tx chlamydia
Thiazides
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
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)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

22. Bacteria causing chronic sinusitis
Steroids + bronchodilators
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Aortic aneurysm
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

23. Dx bacterial rhinosinusitis
Alpha-1 antitrypsin deficiency
1 mo - eyes follow object to midline - vocalizes
Aortic aneurysm
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)

24. Corrected serum calcium =

25. writes name - counts 10 objects
Ampicillin/sulbactam AND doxycycline
Hypomagnesemia
5 yo - draws person - ties shoes - skips
Pneumovax - influenza

26. Fe deficient anemia tx
Ferrous sulfate 325mg tid
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

27. bacteria causing pharyngitis
MCC melanoma. Radial growth.
Anaphylaxis
16-18 weeks GA
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

28. Regards human face - eye contact
Monosodium urate crystals (gout)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
1 mo - eyes follow object to midline - vocalizes

29. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
16-18 weeks GA
9 mo - walks - throws - 1-3 words - 1-step commands
3 yo - identify body part - copies square - hops - throws - past tense - story telling

30. Complications of PID
Calcium oxalate crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
(cefotetan OR cefoxitin) AND doxycycline
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

31. Bisphospohonates sfx
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ferrous sulfate 325mg tid
Esophagitis - gastritis - dysphagia
Starts at contraction. caused by increased vagal tone from fetal head compression.

32. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

33. Recommendations for rear-facing car seat
Short-acting + 40mg prednisone x 10-14days
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
2 mo - eyes follow object past midline - rolls over - laughs - squeals
<20lb - <1YO - Reacts to pain - Responds to noise

34. Sx of hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

35. Pregnancy class C smoking cessation drugs
Starts at contraction. caused by increased vagal tone from fetal head compression.
MCC melanoma. Radial growth.
Thiazdes; lithium
Patch - bupropion - varenicline

36. 1st generation antihistamines
Diabetes - HTN - GN
16-18 weeks GA
Diphenhydramine - chlorpheniramine - hydroxyzine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

37. Dx bacterial vaginosis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Metronidazole or clindamycin
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Diabetes - HTN - GN

38. social smile - parent recognition
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Prostatitis

39. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
4 yo - copies triangle - catches ball - dresses self
Tdap - influenza - pneumovax

40. Tocodynamometer
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Biopsy
Conrtaction monitoring along with fetal heart rate assessment

41. DOC for HTN in elderly
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)
Thiazides
Ofloxacin OR levofloxacin +/- metronidazole
(ofloxacin OR levofloxacin) +/- metronidazole

42. Mediators released in response to allergen
Diphenhydramine - chlorpheniramine - hydroxyzine
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
5+ rads
Urinary calcium. Hyper PTH (high) >> FHH (normal)

43. shoulder dystocia
6 yo
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Patch - bupropion - varenicline
Anterior shoulder cannot readily pass below the pubic symphysis.

44. Tx acute sinusitis
6 yo
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Oxytocin (IV)
Ceftriaxone 125mg IM

45. group play - gender - knows name
Ask - Advise - Assess - Assist - Arrange
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Tuberculosis; sarcoidosis; hodgkin disease
Short-acting + 40mg prednisone x 10-14days

46. Fetal heart rate range
110-160bpm
= LMP + 7 days - 3 months
Nuchal translucency - serum hCG - PAPP-A
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

47. Large - irregularly shaped - prutitic - erythematous wheals
Nuchal translucency - serum hCG - PAPP-A
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Patch - bupropion - varenicline
Urticaria

48. Pflx for traveler's diarrhea
Fluoroquinolones
Ampicillin/sulbactam AND doxycycline
Nicotine inhaler - nasal spray - gum
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

49. IV tx for PID
Thiazdes; lithium
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Clindamycin AND gentamicin
MCC melanoma. Radial growth.

50. stranger/separation anxiety
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anaphylaxis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name