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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. Malignancies with hypercalcemia
Prostatitis
Ask - Advise - Assess - Assist - Arrange
Lung; SCC head & neck; RCC; breast; MM; prostate
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

2. Immunizations for COPD patients
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Diabetes - HTN - GN
Pneumovax - influenza

3. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Diphenhydramine - chlorpheniramine - hydroxyzine
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

4. Recommendations for rear-facing car seat
= LMP + 7 days - 3 months
Diabetes - HTN - GN
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
<20lb - <1YO - Reacts to pain - Responds to noise

5. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ampicillin/sulbactam AND doxycycline
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

6. ADL
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Bathing - dressing - eating - transferring - continence - toileting
Alpha-1 antitrypsin deficiency

7. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Oxygen intervention 15h/d
Thiazdes; lithium
NAC or IV NaHCO3

8. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Diabetes - HTN - GN
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

9. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Angioedema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Tuberculosis; sarcoidosis; hodgkin disease

10. GBS tx
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
IV penicillin (or ampicillin)
Normal mental status; no other injuries; seen within 10 days of injury
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

11. Fe deficient anemia tx
MTX
Bupropion - varenicline - nicotine replacement
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ferrous sulfate 325mg tid

12. Tx bacterial vaginosis
Metronidazole or clindamycin
Stridor - drooling - toxic appearance
After delivery until delivery of placenta and membranes <30 mins
6-9MO

13. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
DTaP - hepB - Hib - rotavirus - inactivated polio

14. identifies left - right
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
DTaP - hepB - Hib - rotavirus - inactivated polio
6 yo
Tdap - influenza - pneumovax

15. bipyramidal - strongly positive birefringent
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Oxytocin (IV)
Clindamycin AND gentamicin
Calcium oxalate crystals

16. Immunizations at visit for 6MO
Monosodium urate crystals (gout)
Normal mental status; no other injuries; seen within 10 days of injury
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
DTaP - hepB - Hib - rotavirus - inactivated polio

17. Screened at 16-20 weeks GA for trisomy
(ofloxacin OR levofloxacin) +/- metronidazole
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

18. Tx RA (best long-term outcome)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MTX
Urticaria

19. Tx of traveler's diarrhea
Steroids + bronchodilators
IV penicillin (or ampicillin)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

20. parallel play
Conrtaction monitoring along with fetal heart rate assessment
Diphenhydramine - chlorpheniramine - hydroxyzine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
6 yo

21. Tx acute sinusitis
Pneumovax - influenza
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
6-9MO

22. writes name - counts 10 objects
6 mo - pincer - crawls - cruises - mamma - dada - byebye
16-18 weeks GA
5 yo - draws person - ties shoes - skips
Normal mental status; no other injuries; seen within 10 days of injury

23. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Prostatitis
Conrtaction monitoring along with fetal heart rate assessment
2 mo - eyes follow object past midline - rolls over - laughs - squeals

24. Acral lentinous melanoma
Fluoroquinolones
MCC melanoma in Africans/Asians. Under nails - soles - palms.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

25. How much radiation is associated with fetal harm?
Biopsy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MTX
5+ rads

26. Regards human face - eye contact
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 mo - eyes follow object to midline - vocalizes
After delivery until delivery of placenta and membranes <30 mins
MCC melanoma. Radial growth.

27. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Anaphylaxis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Steroids + bronchodilators

28. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Anterior shoulder cannot readily pass below the pubic symphysis.
5 yo - draws person - ties shoes - skips
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

29. Corrected serum calcium =

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30. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Calcium oxalate crystals

31. dyspnea - visceral edema - hypotension
Anaphylaxis
Oxytocin (IV)
Patch - bupropion - varenicline
Lung; SCC head & neck; RCC; breast; MM; prostate

32. Age by which child says 'mama' and 'dada'
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Age-related sensorineural hearing loss (high frequency and speech discrimination)
6-9MO

33. Second stage of labor
After delivery until delivery of placenta and membranes <30 mins
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Short-acting + 40mg prednisone x 10-14days
Thiazdes; lithium

34. Granulomatous causes of hypercalcemia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
110-160bpm
Calcium pyrophosphate dehydrate crystals (pseudogout)
Tuberculosis; sarcoidosis; hodgkin disease

35. Dx bacterial vaginosis
MTX
Calcium hydroxyapatite crystals
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
2 mo - eyes follow object past midline - rolls over - laughs - squeals

36. Dx bacterial rhinosinusitis
Esophagitis - gastritis - dysphagia
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)
Onset of labor until cervix dilation
After delivery until delivery of placenta and membranes <30 mins

37. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
0.2-0.5mg aqueous EPI IM/SubQ
Urinary calcium. Hyper PTH (high) >> FHH (normal)

38. Complications of PID
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium hydroxyapatite crystals

39. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
MCC melanoma. Radial growth.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
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)

40. Tender - boggy prostate. Dx?
Nicotine inhaler - nasal spray - gum
1 mo - eyes follow object to midline - vocalizes
Oxygen intervention 15h/d
Prostatitis

41. Only therapy to decrease mortality in stage IV COPD
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
9 mo - walks - throws - 1-3 words - 1-step commands
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Oxygen intervention 15h/d

42. Unstable angina vs MI Dx tests
16-18 weeks GA
9 mo - walks - throws - 1-3 words - 1-step commands
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

43. causes of acute bronchitis
MTX
Calcium hydroxyapatite crystals
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

44. Tx gonorrhea
Ceftriaxone 125mg IM
Bupropion - varenicline - nicotine replacement
Cataracts
Diphenhydramine - chlorpheniramine - hydroxyzine

45. cystoplasmic inclusions - not birefringent
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Thiazdes; lithium
Calcium hydroxyapatite crystals
Anterior shoulder cannot readily pass below the pubic symphysis.

46. Cockcroft-Gault equation
Calcium pyrophosphate dehydrate crystals (pseudogout)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

47. Sx otitis externa
(cefotetan OR cefoxitin) AND doxycycline
Anaphylaxis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Diabetes - HTN - GN

48. Oral tx for PID
Starts at contraction. caused by increased vagal tone from fetal head compression.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
5+ rads
Bupropion - varenicline - nicotine replacement

49. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
2 mo - eyes follow object past midline - rolls over - laughs - squeals

50. DOC for HTN in elderly
Thiazides
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
16-18 weeks GA
Esophagitis - gastritis - dysphagia