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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.
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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)
Prostatitis
Short-acting + 40mg prednisone x 10-14days
Measures strength of contractions
Age-related sensorineural hearing loss (high frequency and speech discrimination)

2. IV tx for PID
Ampicillin/sulbactam AND doxycycline
0.2-0.5mg aqueous EPI IM/SubQ
1 mo - eyes follow object to midline - vocalizes
9 mo - walks - throws - 1-3 words - 1-step commands

3. Mediators released in response to allergen
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1 mo - eyes follow object to midline - vocalizes

4. Tx bacterial vaginosis
Ceftriaxone 125mg IM
1 mo - eyes follow object to midline - vocalizes
Ask - Advise - Assess - Assist - Arrange
Metronidazole or clindamycin

5. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Oxygen intervention 15h/d
Ear pain - itching - inflammation/swollen canal - exudates/discharge

6. Age by which child says 'mama' and 'dada'
Bathing - dressing - eating - transferring - continence - toileting
Monosodium urate crystals (gout)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
6-9MO

7. First stage of labor
Onset of labor until cervix dilation
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Anemia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

8. Electrolyte abnormality that increases the incidence of torsades de pointes
Anterior shoulder cannot readily pass below the pubic symphysis.
5 yo - draws person - ties shoes - skips
Hypomagnesemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

9. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Nuchal translucency - serum hCG - PAPP-A
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Metronidazole or clindamycin
Anemia

10. Sx otitis media
Colchicine
0.2-0.5mg aqueous EPI IM/SubQ
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
4mo - sits unsupported - hand transfer - babbles

11. Immunizations at visit for 6MO
Esophagitis - gastritis - dysphagia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
DTaP - hepB - Hib - rotavirus - inactivated polio
Ofloxacin OR levofloxacin +/- metronidazole

12. causes of acute bronchitis
Fluoroquinolones
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ceftriaxone 125mg IM
Diphenhydramine - chlorpheniramine - hydroxyzine

13. Rod shaped - rhomboid - weakly positive birefringent
4mo - sits unsupported - hand transfer - babbles
Calcium pyrophosphate dehydrate crystals (pseudogout)
6 yo
Oxygen intervention 15h/d

14. Only therapy to decrease mortality in stage IV COPD
Hypomagnesemia
Colchicine
Oxygen intervention 15h/d
Fe deficient anemia

15. Screened at 16-20 weeks GA for trisomy
Aortic aneurysm
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Urticaria
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

16. medications causing hypercalcemia
1 mo - eyes follow object to midline - vocalizes
Thiazdes; lithium
Starts at contraction. caused by increased vagal tone from fetal head compression.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

17. Acral lentinous melanoma
Steroids + bronchodilators
MCC melanoma in Africans/Asians. Under nails - soles - palms.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

18. Augments contractions
Oxytocin (IV)
6 yo
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium hydroxyapatite crystals

19. IADL
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Oxytocin (IV)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

20. Pflx for traveler's diarrhea
Bupropion - varenicline - nicotine replacement
Lung; SCC head & neck; RCC; breast; MM; prostate
Patch - bupropion - varenicline
Fluoroquinolones

21. Nodular melanoma
Most aggressive melanoma.
<20lb - <1YO - Reacts to pain - Responds to noise
Thiazdes; lithium
Conrtaction monitoring along with fetal heart rate assessment

22. The five A's of smoking cessation
Normal mental status; no other injuries; seen within 10 days of injury
Prostatitis
Aortic aneurysm
Ask - Advise - Assess - Assist - Arrange

23. CKD Stages
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Fe deficient anemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

24. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Clindamycin AND gentamicin
Normal mental status; no other injuries; seen within 10 days of injury
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

25. writes name - counts 10 objects
16-18 weeks GA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
5 yo - draws person - ties shoes - skips
110-160bpm

26. Corrected serum calcium =

27. shoulder dystocia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Anterior shoulder cannot readily pass below the pubic symphysis.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

28. Cockcroft-Gault equation
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Tdap - influenza - pneumovax
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

29. IV tx for PID
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Clindamycin AND gentamicin
Normal mental status; no other injuries; seen within 10 days of injury
Nicotine inhaler - nasal spray - gum

30. Screening for 65-76YO male smoker
Tdap - influenza - pneumovax
Ampicillin/sulbactam AND doxycycline
Aortic aneurysm
16-18 weeks GA

31. Fe deficient anemia tx
Diabetes - HTN - GN
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Patch - bupropion - varenicline
Ferrous sulfate 325mg tid

32. Screened at 11-13 weeks GA for trisomy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
<20lb - <1YO - Reacts to pain - Responds to noise
Nuchal translucency - serum hCG - PAPP-A
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

33. Tx gonorrhea
Measures strength of contractions
(cefotetan OR cefoxitin) AND doxycycline
Ceftriaxone 125mg IM
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

34. Bisphospohonates sfx
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)
Bathing - dressing - eating - transferring - continence - toileting
6-9MO

35. Dx PID
Most aggressive melanoma.
Thiazides
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Prostatitis

36. Causes of CKD
Diabetes - HTN - GN
Conrtaction monitoring along with fetal heart rate assessment
(ofloxacin OR levofloxacin) +/- metronidazole
9 mo - walks - throws - 1-3 words - 1-step commands

37. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

38. Sx otitis externa
Ampicillin/sulbactam AND doxycycline
Biopsy
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Colchicine

39. painless - deep - subQ swelling (periorbital - circumoral - facial)
Ask - Advise - Assess - Assist - Arrange
DTaP - hepB - Hib - rotavirus - inactivated polio
Angioedema
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

40. bipyramidal - strongly positive birefringent
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Lung; SCC head & neck; RCC; breast; MM; prostate
Calcium oxalate crystals

41. DOC for HTN in elderly
Thiazides
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
5+ rads
Calcium hydroxyapatite crystals

42. Complications of PID
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Urticaria

43. Estimated delivery date (Naegele's rule)
Anemia
Stridor - drooling - toxic appearance
Angioedema
= LMP + 7 days - 3 months

44. recognizes strangers
Long axis of fetus to long axis of mother (longitudinal or transverse)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Clindamycin AND gentamicin
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

45. dyspnea - visceral edema - hypotension
Anaphylaxis
Flexion - internal rotation - extension - external rotation
Bupropion - varenicline - nicotine replacement
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

46. Dx bacterial vaginosis
4mo - sits unsupported - hand transfer - babbles
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
4 yo - copies triangle - catches ball - dresses self
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

47. IV tx for PID
Conrtaction monitoring along with fetal heart rate assessment
Ofloxacin OR levofloxacin +/- metronidazole
Tuberculosis; sarcoidosis; hodgkin disease
Monosodium urate crystals (gout)

48. explorations
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
9 mo - walks - throws - 1-3 words - 1-step commands
Stridor - drooling - toxic appearance
1 mo - eyes follow object to midline - vocalizes

49. Tender - boggy prostate. Dx?
Prostatitis
Thiazdes; lithium
5 yo - draws person - ties shoes - skips
Ofloxacin OR levofloxacin +/- metronidazole

50. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Nicotine inhaler - nasal spray - gum
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins