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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. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ampicillin/sulbactam AND doxycycline

2. IADL
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Tuberculosis; sarcoidosis; hodgkin disease
Cataracts
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

3. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Oxytocin (IV)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Anemia

4. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
DTaP - hepB - Hib - rotavirus - inactivated polio
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
After delivery until delivery of placenta and membranes <30 mins

5. Sx peritonsillar abscess
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Metronidazole or clindamycin
Esophagitis - gastritis - dysphagia

6. cystoplasmic inclusions - not birefringent
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium hydroxyapatite crystals
MCC melanoma in Africans/Asians. Under nails - soles - palms.

7. medications causing hypercalcemia
<20lb - <1YO - Reacts to pain - Responds to noise
After delivery until delivery of placenta and membranes <30 mins
0.2-0.5mg aqueous EPI IM/SubQ
Thiazdes; lithium

8. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Biopsy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

9. explorations
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
9 mo - walks - throws - 1-3 words - 1-step commands
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Oxytocin (IV)

10. Sx epiglottitis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Stridor - drooling - toxic appearance
Most aggressive melanoma.
2 mo - eyes follow object past midline - rolls over - laughs - squeals

11. IUPC (intrauterine pressure catheter)
After delivery until delivery of placenta and membranes <30 mins
6 yo
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Measures strength of contractions

12. Screened at 11-13 weeks GA for trisomy
Most aggressive melanoma.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Nuchal translucency - serum hCG - PAPP-A
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

13. Sx otitis externa
NAC or IV NaHCO3
Ear pain - itching - inflammation/swollen canal - exudates/discharge
IV penicillin (or ampicillin)
Tuberculosis; sarcoidosis; hodgkin disease

14. Immunizations for COPD patients
Pneumovax - influenza
Alpha-1 antitrypsin deficiency
110-160bpm
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

15. ADL
Bathing - dressing - eating - transferring - continence - toileting
Ampicillin/sulbactam AND doxycycline
Thiazides
Monosodium urate crystals (gout)

16. Emphysema - <45YO - nonsmoker
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Alpha-1 antitrypsin deficiency
Starts at contraction. caused by increased vagal tone from fetal head compression.
Flexion - internal rotation - extension - external rotation

17. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Colchicine
Patch - bupropion - varenicline

18. First stage of labor
Angioedema
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)
5 yo - draws person - ties shoes - skips

19. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Oxytocin (IV)
Flexion - internal rotation - extension - external rotation
Anemia
Alpha-1 antitrypsin deficiency

20. tx shoulder dystocia

21. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
NAC or IV NaHCO3
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ceftriaxone 125mg IM

22. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Flexion - internal rotation - extension - external rotation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Metronidazole or clindamycin

23. Early deceleration
Aortic aneurysm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Starts at contraction. caused by increased vagal tone from fetal head compression.
= LMP + 7 days - 3 months

24. Bacteria causing chronic sinusitis
Loratadine - fexofenadine - cetirizine
5 yo - draws person - ties shoes - skips
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

25. Only therapy to decrease mortality in stage IV COPD
110-160bpm
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Oxygen intervention 15h/d

26. shoulder dystocia
Bathing - dressing - eating - transferring - continence - toileting
Anterior shoulder cannot readily pass below the pubic symphysis.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

27. identifies left - right
6 yo
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Short-acting + 40mg prednisone x 10-14days
= LMP + 7 days - 3 months

28. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anterior shoulder cannot readily pass below the pubic symphysis.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Tdap - influenza - pneumovax

29. Corrected serum calcium =

30. Late deceleration
Ask - Advise - Assess - Assist - Arrange
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Angioedema
0.2-0.5mg aqueous EPI IM/SubQ

31. Age by which child says 'mama' and 'dada'
Starts at contraction. caused by increased vagal tone from fetal head compression.
Prostatitis
6-9MO
IV penicillin (or ampicillin)

32. needles - strong negative birefringent (yellow crystals parallel light)
Conrtaction monitoring along with fetal heart rate assessment
Urinary calcium. Hyper PTH (high) >> FHH (normal)
110-160bpm
Monosodium urate crystals (gout)

33. IV tx for PID
NAC or IV NaHCO3
Ceftriaxone 125mg IM
(cefotetan OR cefoxitin) AND doxycycline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

34. Causes of CKD
Fe deficient anemia
Diabetes - HTN - GN
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Calcium hydroxyapatite crystals

35. IV tx for PID
Cataracts
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
After delivery until delivery of placenta and membranes <30 mins
Ofloxacin OR levofloxacin +/- metronidazole

36. GBS tx
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
IV penicillin (or ampicillin)
Fe deficient anemia
16-18 weeks GA

37. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
Anaphylaxis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Bathing - dressing - eating - transferring - continence - toileting

38. Optimal time for trisomy screen
Colchicine
Ask - Advise - Assess - Assist - Arrange
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
16-18 weeks GA

39. Tx for thyroid storm
Diabetes - HTN - GN
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Alpha-1 antitrypsin deficiency
6 mo - pincer - crawls - cruises - mamma - dada - byebye

40. complications of otitis media
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

41. Tx otitis media
Oxygen intervention 15h/d
5+ rads
Calcium hydroxyapatite crystals
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

42. Fetal heart rate range
Short-acting + 40mg prednisone x 10-14days
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
110-160bpm

43. Tx RA (best long-term outcome)
MTX
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Bupropion - varenicline - nicotine replacement

44. Tender - boggy prostate. Dx?
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Prostatitis
Tdap - influenza - pneumovax
Stridor - drooling - toxic appearance

45. Screening for 65-76YO male smoker
Aortic aneurysm
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Conrtaction monitoring along with fetal heart rate assessment

46. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
4mo - sits unsupported - hand transfer - babbles
Conrtaction monitoring along with fetal heart rate assessment
Nicotine inhaler - nasal spray - gum

47. Second stage of labor
MCC melanoma. Radial growth.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Nicotine inhaler - nasal spray - gum
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

48. Tx acute sinusitis
9 mo - walks - throws - 1-3 words - 1-step commands
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Monosodium urate crystals (gout)
DTaP - hepB - Hib - rotavirus - inactivated polio

49. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Nicotine inhaler - nasal spray - gum
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
(ofloxacin OR levofloxacin) +/- metronidazole

50. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
= LMP + 7 days - 3 months
3 yo - identify body part - copies square - hops - throws - past tense - story telling