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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. Tx RA (best long-term outcome)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
MCC melanoma. Radial growth.
MTX
NAC or IV NaHCO3

2. Tx hyperkalemia in CKD
Anaphylaxis
Calcium hydroxyapatite crystals
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

3. Pflx for traveler's diarrhea
Fluoroquinolones
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

4. Tx for thyroid storm
Tuberculosis; sarcoidosis; hodgkin disease
Calcium hydroxyapatite crystals
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Tdap - influenza - pneumovax

5. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Patch - bupropion - varenicline
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

6. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at contraction. caused by increased vagal tone from fetal head compression.
DTaP - hepB - Hib - rotavirus - inactivated polio
Patch - bupropion - varenicline

7. Sx of hypercalcemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Calcium oxalate crystals
Steroids + bronchodilators
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

8. Acral lentinous melanoma
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Fe deficient anemia
MCC melanoma in Africans/Asians. Under nails - soles - palms.

9. IUPC (intrauterine pressure catheter)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Measures strength of contractions
Oxytocin (IV)
Esophagitis - gastritis - dysphagia

10. Four cardinal fetal movements
IV penicillin (or ampicillin)
Alpha-1 antitrypsin deficiency
Flexion - internal rotation - extension - external rotation
Tuberculosis; sarcoidosis; hodgkin disease

11. 2nd generation antihistamines
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Loratadine - fexofenadine - cetirizine
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Pneumovax - influenza

12. Dx criteria for RA
Most aggressive melanoma.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Oxytocin (IV)

13. ADL
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)
Bupropion - varenicline - nicotine replacement
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Bathing - dressing - eating - transferring - continence - toileting

14. MONA therapy
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ask - Advise - Assess - Assist - Arrange
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

15. Age by which child says 'mama' and 'dada'
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6-9MO

16. GBS tx
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
Calcium pyrophosphate dehydrate crystals (pseudogout)
IV penicillin (or ampicillin)

17. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Short-acting + 40mg prednisone x 10-14days
IV penicillin (or ampicillin)
Clindamycin AND gentamicin

18. tx shoulder dystocia

19. cystoplasmic inclusions - not birefringent
Cataracts
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium hydroxyapatite crystals
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

20. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Urticaria

21. X-ray of ankle?
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Prostatitis
MCC melanoma. Radial growth.
Normal mental status; no other injuries; seen within 10 days of injury

22. MCC blindness worldwide
4 yo - copies triangle - catches ball - dresses self
6-9MO
Cataracts
Calcium pyrophosphate dehydrate crystals (pseudogout)

23. X-ray on knee?
MCC melanoma. Radial growth.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
4mo - sits unsupported - hand transfer - babbles
MCC melanoma in Africans/Asians. Under nails - soles - palms.

24. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Starts at contraction. caused by increased vagal tone from fetal head compression.
16-18 weeks GA
Metronidazole or clindamycin

25. group play - gender - knows name
Oxytocin (IV)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
4mo - sits unsupported - hand transfer - babbles
Calcium hydroxyapatite crystals

26. Malignancies with hypercalcemia
5 yo - draws person - ties shoes - skips
Long axis of fetus to long axis of mother (longitudinal or transverse)
Oxygen intervention 15h/d
Lung; SCC head & neck; RCC; breast; MM; prostate

27. Lentigo Maligna
Lung; SCC head & neck; RCC; breast; MM; prostate
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Flexion - internal rotation - extension - external rotation

28. Tx GAS ifxn
Nuchal translucency - serum hCG - PAPP-A
1 mo - eyes follow object to midline - vocalizes
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

29. Other causes of hypercalcemia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
0.2-0.5mg aqueous EPI IM/SubQ

30. Tx acute sinusitis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Patch - bupropion - varenicline
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ask - Advise - Assess - Assist - Arrange

31. social smile - parent recognition
Prostatitis
Steroids + bronchodilators
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Thiazdes; lithium

32. Oral tx for PID
Anemia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

33. Complications of GAS infxn
Bupropion - varenicline - nicotine replacement
<20lb - <1YO - Reacts to pain - Responds to noise
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

34. Causes of CKD
Diphenhydramine - chlorpheniramine - hydroxyzine
Oxygen intervention 15h/d
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Diabetes - HTN - GN

35. Augments contractions
Oxytocin (IV)
Most aggressive melanoma.
(ofloxacin OR levofloxacin) +/- metronidazole
Cataracts

36. Electrolyte abnormality that increases the incidence of torsades de pointes
Colchicine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Clindamycin AND gentamicin
Hypomagnesemia

37. Screening for 65-76YO male smoker
Ceftriaxone 125mg IM
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Stridor - drooling - toxic appearance
Aortic aneurysm

38. Cockcroft-Gault equation
Aortic aneurysm
4mo - sits unsupported - hand transfer - babbles
Ceftriaxone 125mg IM
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

39. bacteria causing pharyngitis
Measures strength of contractions
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Short-acting + 40mg prednisone x 10-14days

40. Fe deficient anemia tx
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ferrous sulfate 325mg tid
Flexion - internal rotation - extension - external rotation

41. Superficial spreading melanoma
Fe deficient anemia
Aortic aneurysm
Clindamycin AND gentamicin
MCC melanoma. Radial growth.

42. needles - strong negative birefringent (yellow crystals parallel light)
Lung; SCC head & neck; RCC; breast; MM; prostate
Monosodium urate crystals (gout)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Metronidazole or clindamycin

43. Sx peritonsillar abscess
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Calcium oxalate crystals
5 yo - draws person - ties shoes - skips
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

44. Sx otitis externa
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
DTaP - hepB - Hib - rotavirus - inactivated polio

45. DOC for HTN in elderly
Normal mental status; no other injuries; seen within 10 days of injury
Pneumovax - influenza
Thiazides
MTX

46. First stage of labor
Onset of labor until cervix dilation
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Flexion - internal rotation - extension - external rotation
Calcium hydroxyapatite crystals

47. Pregnancy class D smoking cessation drugs
Esophagitis - gastritis - dysphagia
3 yo - identify body part - copies square - hops - throws - past tense - story telling
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nicotine inhaler - nasal spray - gum

48. IV tx for PID
Conrtaction monitoring along with fetal heart rate assessment
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Aortic aneurysm
Clindamycin AND gentamicin

49. How much radiation is associated with fetal harm?
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Thiazides
5+ rads
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

50. Smoking cessation agents
Oxytocin (IV)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
6-9MO
Bupropion - varenicline - nicotine replacement