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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. IUPC (intrauterine pressure catheter)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Colchicine
Measures strength of contractions
Loratadine - fexofenadine - cetirizine

2. ADL
0.2-0.5mg aqueous EPI IM/SubQ
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Conrtaction monitoring along with fetal heart rate assessment
Bathing - dressing - eating - transferring - continence - toileting

3. Acral lentinous melanoma
Calcium pyrophosphate dehydrate crystals (pseudogout)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Onset of labor until cervix dilation
1 mo - eyes follow object to midline - vocalizes

4. Pflx for traveler's diarrhea
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
MTX
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Fluoroquinolones

5. Malignancies with hypercalcemia
Anaphylaxis
Esophagitis - gastritis - dysphagia
Lung; SCC head & neck; RCC; breast; MM; prostate
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

6. Smoking cessation agents
Aortic aneurysm
IV penicillin (or ampicillin)
Bupropion - varenicline - nicotine replacement
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

7. tx shoulder dystocia

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8. Mediators released in response to allergen
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Clindamycin AND gentamicin

9. Sx otitis externa
Calcium pyrophosphate dehydrate crystals (pseudogout)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ear pain - itching - inflammation/swollen canal - exudates/discharge

10. Third stage of labor
5+ rads
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
After delivery until delivery of placenta and membranes <30 mins

11. Screening for 65-76YO male smoker
4mo - sits unsupported - hand transfer - babbles
Aortic aneurysm
Most aggressive melanoma.
Patch - bupropion - varenicline

12. IV tx for PID
Ceftriaxone 125mg IM
Onset of labor until cervix dilation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ofloxacin OR levofloxacin +/- metronidazole

13. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Oxytocin (IV)
Anemia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
NAC or IV NaHCO3

14. GBS tx
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
9 mo - walks - throws - 1-3 words - 1-step commands
IV penicillin (or ampicillin)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

15. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Tdap - influenza - pneumovax
6-9MO
Nicotine inhaler - nasal spray - gum

16. Electrolyte abnormality that increases the incidence of torsades de pointes
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Urticaria
Hypomagnesemia

17. Rod shaped - rhomboid - weakly positive birefringent
Anterior shoulder cannot readily pass below the pubic symphysis.
Starts at contraction. caused by increased vagal tone from fetal head compression.
Calcium pyrophosphate dehydrate crystals (pseudogout)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

18. Emphysema - <45YO - nonsmoker
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium oxalate crystals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Alpha-1 antitrypsin deficiency

19. Tx acute exacerbation COPD
Monosodium urate crystals (gout)
Short-acting + 40mg prednisone x 10-14days
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

20. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Cataracts
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

21. Tx GAS ifxn
Lung; SCC head & neck; RCC; breast; MM; prostate
Ask - Advise - Assess - Assist - Arrange
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Hypomagnesemia

22. Pregnancy class D smoking cessation drugs
After delivery until delivery of placenta and membranes <30 mins
6 mo - pincer - crawls - cruises - mamma - dada - byebye
NAC or IV NaHCO3
Nicotine inhaler - nasal spray - gum

23. Unstable angina vs MI Dx tests
Anaphylaxis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
NAC or IV NaHCO3
(ofloxacin OR levofloxacin) +/- metronidazole

24. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Nicotine inhaler - nasal spray - gum
Measures strength of contractions

25. Immunizations at visit for 6MO
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
DTaP - hepB - Hib - rotavirus - inactivated polio
6-9MO
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

26. identifies left - right
6 yo
Nuchal translucency - serum hCG - PAPP-A
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Diabetes - HTN - GN

27. Estimated delivery date (Naegele's rule)
4 yo - copies triangle - catches ball - dresses self
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)
MTX
= LMP + 7 days - 3 months

28. Tx for anaphylaxis
Alpha-1 antitrypsin deficiency
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment
0.2-0.5mg aqueous EPI IM/SubQ

29. social interaction
6 mo - pincer - crawls - cruises - mamma - dada - byebye
4 yo - copies triangle - catches ball - dresses self
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Onset of labor until cervix dilation

30. Tx bacterial vaginosis
Stridor - drooling - toxic appearance
Metronidazole or clindamycin
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Esophagitis - gastritis - dysphagia

31. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Oxytocin (IV)
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

32. Optimal time for trisomy screen
Anaphylaxis
16-18 weeks GA
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Oxytocin (IV)

33. X-ray of ankle?
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Normal mental status; no other injuries; seen within 10 days of injury
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

34. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
NAC or IV NaHCO3
5 yo - draws person - ties shoes - skips

35. Granulomatous causes of hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

36. Complications of GAS infxn
Anemia
Ampicillin/sulbactam AND doxycycline
Cataracts
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

37. group play - gender - knows name
Ofloxacin OR levofloxacin +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise
3 yo - identify body part - copies square - hops - throws - past tense - story telling
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

38. Tender - boggy prostate. Dx?
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Prostatitis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

39. MCC blindness worldwide
Metronidazole or clindamycin
Cataracts
6-9MO
Steroids + bronchodilators

40. Dx criteria for RA
Calcium oxalate crystals
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anterior shoulder cannot readily pass below the pubic symphysis.

41. Fe deficient anemia tx
Ferrous sulfate 325mg tid
6 yo
Biopsy
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

42. Early deceleration
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Starts at contraction. caused by increased vagal tone from fetal head compression.
4mo - sits unsupported - hand transfer - babbles
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

43. Oral tx for PID
Flexion - internal rotation - extension - external rotation
DTaP - hepB - Hib - rotavirus - inactivated polio
2 mo - eyes follow object past midline - rolls over - laughs - squeals
(ofloxacin OR levofloxacin) +/- metronidazole

44. Signs of rupture of membranes

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45. First stage of labor
Metronidazole or clindamycin
After delivery until delivery of placenta and membranes <30 mins
Onset of labor until cervix dilation
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

46. Other causes of hypercalcemia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Most aggressive melanoma.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

47. MONA therapy
Fe deficient anemia
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

48. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
1 mo - eyes follow object to midline - vocalizes
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

49. cystoplasmic inclusions - not birefringent
Bupropion - varenicline - nicotine replacement
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ceftriaxone 125mg IM
Calcium hydroxyapatite crystals

50. bacteria causing pharyngitis
Nuchal translucency - serum hCG - PAPP-A
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Bathing - dressing - eating - transferring - continence - toileting