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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. Immunizations for COPD patients
Pneumovax - influenza
<20lb - <1YO - Reacts to pain - Responds to noise
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
MCC melanoma in Africans/Asians. Under nails - soles - palms.

2. MONA therapy
Ferrous sulfate 325mg tid
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
3 yo - identify body part - copies square - hops - throws - past tense - story telling

3. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
5 yo - draws person - ties shoes - skips

4. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Clindamycin AND gentamicin
4mo - sits unsupported - hand transfer - babbles
Ampicillin/sulbactam AND doxycycline

5. regards hand
Prostatitis
Steroids + bronchodilators
4mo - sits unsupported - hand transfer - babbles
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

6. Mediators released in response to allergen
Patch - bupropion - varenicline
9 mo - walks - throws - 1-3 words - 1-step commands
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

7. IV tx for PID
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Hypomagnesemia
Clindamycin AND gentamicin
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

8. Fetal lie
Cataracts
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Bupropion - varenicline - nicotine replacement

9. Pflx for traveler's diarrhea
Colchicine
Fluoroquinolones
After delivery until delivery of placenta and membranes <30 mins
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

10. 1st generation antihistamines
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Diphenhydramine - chlorpheniramine - hydroxyzine
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

11. Immunizations at visit for 6MO
Fe deficient anemia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Tdap - influenza - pneumovax
DTaP - hepB - Hib - rotavirus - inactivated polio

12. Third stage of labor
Anterior shoulder cannot readily pass below the pubic symphysis.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
After delivery until delivery of placenta and membranes <30 mins
Diphenhydramine - chlorpheniramine - hydroxyzine

13. group play - gender - knows name
Cataracts
Loratadine - fexofenadine - cetirizine
0.2-0.5mg aqueous EPI IM/SubQ
3 yo - identify body part - copies square - hops - throws - past tense - story telling

14. Second stage of labor
Oxygen intervention 15h/d
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

15. DOC for HTN in elderly
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
9 mo - walks - throws - 1-3 words - 1-step commands
Thiazides
Patch - bupropion - varenicline

16. Bacteria causing chronic sinusitis
Fe deficient anemia
Colchicine
IV penicillin (or ampicillin)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

17. Four cardinal fetal movements
Stridor - drooling - toxic appearance
Ofloxacin OR levofloxacin +/- metronidazole
Flexion - internal rotation - extension - external rotation
Steroids + bronchodilators

18. Malignancies with hypercalcemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Short-acting + 40mg prednisone x 10-14days
Calcium hydroxyapatite crystals
Lung; SCC head & neck; RCC; breast; MM; prostate

19. Tx acute sinusitis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Thiazides
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

20. Sx of hypercalcemia
(cefotetan OR cefoxitin) AND doxycycline
Loratadine - fexofenadine - cetirizine
Tuberculosis; sarcoidosis; hodgkin disease
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

21. Fetal heart rate range
110-160bpm
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Bupropion - varenicline - nicotine replacement
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

22. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Alpha-1 antitrypsin deficiency
DTaP - hepB - Hib - rotavirus - inactivated polio
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

23. Dx PID
MCC melanoma in Africans/Asians. Under nails - soles - palms.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Stridor - drooling - toxic appearance
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

24. Tx RA (best long-term outcome)
Angioedema
Esophagitis - gastritis - dysphagia
MTX
Aortic aneurysm

25. Oral tx for PID
6 yo
Cataracts
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

26. Dx criteria for RA
16-18 weeks GA
5 yo - draws person - ties shoes - skips
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
4mo - sits unsupported - hand transfer - babbles

27. Only therapy to decrease mortality in stage IV COPD
Biopsy
Oxygen intervention 15h/d
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
(ofloxacin OR levofloxacin) +/- metronidazole

28. Pregnancy class C smoking cessation drugs
Normal mental status; no other injuries; seen within 10 days of injury
Starts at contraction. caused by increased vagal tone from fetal head compression.
Long axis of fetus to long axis of mother (longitudinal or transverse)
Patch - bupropion - varenicline

29. ADL
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anaphylaxis
Bathing - dressing - eating - transferring - continence - toileting
5 yo - draws person - ties shoes - skips

30. Superficial spreading melanoma
Bupropion - varenicline - nicotine replacement
Starts at contraction. caused by increased vagal tone from fetal head compression.
(cefotetan OR cefoxitin) AND doxycycline
MCC melanoma. Radial growth.

31. Tx GAS ifxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
After delivery until delivery of placenta and membranes <30 mins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

32. Early deceleration
Calcium hydroxyapatite crystals
After delivery until delivery of placenta and membranes <30 mins
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxygen intervention 15h/d

33. Other causes of hypercalcemia
Urticaria
= LMP + 7 days - 3 months
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Biopsy

34. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Stridor - drooling - toxic appearance
Anemia
9 mo - walks - throws - 1-3 words - 1-step commands

35. Bisphospohonates sfx
Long axis of fetus to long axis of mother (longitudinal or transverse)
Esophagitis - gastritis - dysphagia
= LMP + 7 days - 3 months
Loratadine - fexofenadine - cetirizine

36. Complications of GAS infxn
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

37. Sx otitis externa
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Calcium hydroxyapatite crystals

38. Complications of PID
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

39. presbycusis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Flexion - internal rotation - extension - external rotation

40. GBS tx
Conrtaction monitoring along with fetal heart rate assessment
Normal mental status; no other injuries; seen within 10 days of injury
Diabetes - HTN - GN
IV penicillin (or ampicillin)

41. causes of acute bronchitis
4 yo - copies triangle - catches ball - dresses self
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Normal mental status; no other injuries; seen within 10 days of injury
DTaP - hepB - Hib - rotavirus - inactivated polio

42. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Fe deficient anemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
4 yo - copies triangle - catches ball - dresses self

43. Smoking cessation agents
9 mo - walks - throws - 1-3 words - 1-step commands
Long axis of fetus to long axis of mother (longitudinal or transverse)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bupropion - varenicline - nicotine replacement

44. Recommendations for rear-facing car seat
After delivery until delivery of placenta and membranes <30 mins
Fluoroquinolones
<20lb - <1YO - Reacts to pain - Responds to noise
Fe deficient anemia

45. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
1 mo - eyes follow object to midline - vocalizes
Onset of labor until cervix dilation
5 yo - draws person - ties shoes - skips

46. Cockcroft-Gault equation
6-9MO
Measures strength of contractions
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

47. Pregnancy class D smoking cessation drugs
Ofloxacin OR levofloxacin +/- metronidazole
After delivery until delivery of placenta and membranes <30 mins
Bupropion - varenicline - nicotine replacement
Nicotine inhaler - nasal spray - gum

48. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium oxalate crystals
Metronidazole or clindamycin
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

49. Lentigo Maligna
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Alpha-1 antitrypsin deficiency
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Monosodium urate crystals (gout)

50. needles - strong negative birefringent (yellow crystals parallel light)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Thiazdes; lithium
Monosodium urate crystals (gout)