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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. needles - strong negative birefringent (yellow crystals parallel light)
Ask - Advise - Assess - Assist - Arrange
Monosodium urate crystals (gout)
Lung; SCC head & neck; RCC; breast; MM; prostate
3 yo - identify body part - copies square - hops - throws - past tense - story telling

2. Oral tx for PID
= LMP + 7 days - 3 months
<20lb - <1YO - Reacts to pain - Responds to noise
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
(ofloxacin OR levofloxacin) +/- metronidazole

3. regards hand
4 yo - copies triangle - catches ball - dresses self
4mo - sits unsupported - hand transfer - babbles
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

4. Immunizations for COPD patients
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Diphenhydramine - chlorpheniramine - hydroxyzine
Pneumovax - influenza
MTX

5. painless - deep - subQ swelling (periorbital - circumoral - facial)
Diphenhydramine - chlorpheniramine - hydroxyzine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
IV penicillin (or ampicillin)
Angioedema

6. Tx GAS ifxn
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Loratadine - fexofenadine - cetirizine
Diphenhydramine - chlorpheniramine - hydroxyzine

7. Augments contractions
9 mo - walks - throws - 1-3 words - 1-step commands
Fluoroquinolones
Oxytocin (IV)
Hypomagnesemia

8. Fetal lie
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Monosodium urate crystals (gout)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Calcium oxalate crystals

9. Emphysema - <45YO - nonsmoker
Calcium oxalate crystals
Tuberculosis; sarcoidosis; hodgkin disease
Alpha-1 antitrypsin deficiency
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

10. Dx PID
Ask - Advise - Assess - Assist - Arrange
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ampicillin/sulbactam AND doxycycline
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

11. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
9 mo - walks - throws - 1-3 words - 1-step commands
Long axis of fetus to long axis of mother (longitudinal or transverse)
Fe deficient anemia

12. DOC for HTN in elderly
IV penicillin (or ampicillin)
Thiazides
Most aggressive melanoma.
Diphenhydramine - chlorpheniramine - hydroxyzine

13. social interaction
Anemia
Diphenhydramine - chlorpheniramine - hydroxyzine
4 yo - copies triangle - catches ball - dresses self
MTX

14. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
Monosodium urate crystals (gout)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
(ofloxacin OR levofloxacin) +/- metronidazole

15. complications of otitis media
Prostatitis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
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)
Alpha-1 antitrypsin deficiency

16. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Loratadine - fexofenadine - cetirizine
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

17. First stage of labor
Anaphylaxis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Onset of labor until cervix dilation
Lung; SCC head & neck; RCC; breast; MM; prostate

18. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Pneumovax - influenza

19. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
4 yo - copies triangle - catches ball - dresses self

20. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

21. Screened at 16-20 weeks GA for trisomy
4 yo - copies triangle - catches ball - dresses self
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

22. X-ray on knee?
Prostatitis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Hypomagnesemia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

23. Bacteria causing chronic sinusitis
6-9MO
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
NAC or IV NaHCO3
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

24. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Tdap - influenza - pneumovax

25. IUPC (intrauterine pressure catheter)
(cefotetan OR cefoxitin) AND doxycycline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(ofloxacin OR levofloxacin) +/- metronidazole
Measures strength of contractions

26. tx shoulder dystocia

27. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
2 mo - eyes follow object past midline - rolls over - laughs - squeals
16-18 weeks GA
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

28. Recommendations for rear-facing car seat
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Prostatitis
Tdap - influenza - pneumovax
<20lb - <1YO - Reacts to pain - Responds to noise

29. Screening for 65-76YO male smoker
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Aortic aneurysm
Long axis of fetus to long axis of mother (longitudinal or transverse)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

30. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
4mo - sits unsupported - hand transfer - babbles
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

31. causes of acute bronchitis
Colchicine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
6-9MO
Monosodium urate crystals (gout)

32. recognizes strangers
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Biopsy
MCC melanoma. Radial growth.

33. stranger/separation anxiety
Lung; SCC head & neck; RCC; breast; MM; prostate
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

34. Rod shaped - rhomboid - weakly positive birefringent
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
0.2-0.5mg aqueous EPI IM/SubQ
Monosodium urate crystals (gout)
Calcium pyrophosphate dehydrate crystals (pseudogout)

35. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Steroids + bronchodilators
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Clindamycin AND gentamicin

36. IV tx for PID
MTX
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ofloxacin OR levofloxacin +/- metronidazole
Ask - Advise - Assess - Assist - Arrange

37. Low serum iron - low MCV - low ferritin - +stool guaiac
Cataracts
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxygen intervention 15h/d
Fe deficient anemia

38. CKD Stages
Hypomagnesemia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. bipyramidal - strongly positive birefringent
Bupropion - varenicline - nicotine replacement
Calcium oxalate crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

40. Cockcroft-Gault equation
Cataracts
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Oxytocin (IV)

41. IV tx for PID
Metronidazole or clindamycin
Clindamycin AND gentamicin
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxytocin (IV)

42. identifies left - right
6 yo
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
<20lb - <1YO - Reacts to pain - Responds to noise
MTX

43. Lentigo Maligna
0.2-0.5mg aqueous EPI IM/SubQ
<20lb - <1YO - Reacts to pain - Responds to noise
DTaP - hepB - Hib - rotavirus - inactivated polio
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

44. Sx epiglottitis
Stridor - drooling - toxic appearance
Bathing - dressing - eating - transferring - continence - toileting
Flexion - internal rotation - extension - external rotation
Bupropion - varenicline - nicotine replacement

45. IV tx for PID
16-18 weeks GA
Ampicillin/sulbactam AND doxycycline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

46. Age by which child says 'mama' and 'dada'
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6-9MO
= LMP + 7 days - 3 months
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

47. GBS tx
= LMP + 7 days - 3 months
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
IV penicillin (or ampicillin)
1 mo - eyes follow object to midline - vocalizes

48. Tx for anaphylaxis
Measures strength of contractions
Conrtaction monitoring along with fetal heart rate assessment
0.2-0.5mg aqueous EPI IM/SubQ
Bupropion - varenicline - nicotine replacement

49. Second stage of labor
Stridor - drooling - toxic appearance
Diphenhydramine - chlorpheniramine - hydroxyzine
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ask - Advise - Assess - Assist - Arrange

50. MONA therapy
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
9 mo - walks - throws - 1-3 words - 1-step commands
(ofloxacin OR levofloxacin) +/- metronidazole