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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. bipyramidal - strongly positive birefringent
Most aggressive melanoma.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium oxalate crystals

2. tx shoulder dystocia

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3. Four cardinal fetal movements
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ceftriaxone 125mg IM
(ofloxacin OR levofloxacin) +/- metronidazole
Flexion - internal rotation - extension - external rotation

4. Large - irregularly shaped - prutitic - erythematous wheals
Steroids + bronchodilators
Pneumovax - influenza
= LMP + 7 days - 3 months
Urticaria

5. Tx otitis media
Urticaria
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ceftriaxone 125mg IM

6. GBS tx
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
IV penicillin (or ampicillin)
1 mo - eyes follow object to midline - vocalizes

7. Improve short-term outcomes in acute exacerbations of COPD - asthma
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anemia
Ampicillin/sulbactam AND doxycycline
Steroids + bronchodilators

8. Nodular melanoma
Stridor - drooling - toxic appearance
6-9MO
Most aggressive melanoma.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

9. First stage of labor
4mo - sits unsupported - hand transfer - babbles
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Biopsy
Onset of labor until cervix dilation

10. identifies left - right
Calcium hydroxyapatite crystals
6 yo
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

11. Tocodynamometer
Flexion - internal rotation - extension - external rotation
Esophagitis - gastritis - dysphagia
Conrtaction monitoring along with fetal heart rate assessment
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

12. Bisphospohonates sfx
Tdap - influenza - pneumovax
Esophagitis - gastritis - dysphagia
Ceftriaxone 125mg IM
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

13. ADL
Ferrous sulfate 325mg tid
Bathing - dressing - eating - transferring - continence - toileting
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

14. Sx otitis media
Alpha-1 antitrypsin deficiency
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

15. MONA therapy
9 mo - walks - throws - 1-3 words - 1-step commands
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Esophagitis - gastritis - dysphagia
1 mo - eyes follow object to midline - vocalizes

16. Pregnancy class C smoking cessation drugs
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Patch - bupropion - varenicline
Bupropion - varenicline - nicotine replacement
Onset of labor until cervix dilation

17. Dx bacterial rhinosinusitis
4mo - sits unsupported - hand transfer - babbles
Ofloxacin OR levofloxacin +/- metronidazole
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)
(ofloxacin OR levofloxacin) +/- metronidazole

18. How much radiation is associated with fetal harm?
5+ rads
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Alpha-1 antitrypsin deficiency

19. Other causes of hypercalcemia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
IV penicillin (or ampicillin)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

20. group play - gender - knows name
Bupropion - varenicline - nicotine replacement
Anaphylaxis
Clindamycin AND gentamicin
3 yo - identify body part - copies square - hops - throws - past tense - story telling

21. X-ray on knee?
MTX
Anterior shoulder cannot readily pass below the pubic symphysis.
Ofloxacin OR levofloxacin +/- metronidazole
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

22. Malignancies with hypercalcemia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(cefotetan OR cefoxitin) AND doxycycline
Lung; SCC head & neck; RCC; breast; MM; prostate

23. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
After delivery until delivery of placenta and membranes <30 mins
Cataracts
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

24. Tx acute gout
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Colchicine
MCC melanoma. Radial growth.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

25. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Fluoroquinolones

26. Tx bacterial vaginosis
Stridor - drooling - toxic appearance
IV penicillin (or ampicillin)
Metronidazole or clindamycin
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

27. social smile - parent recognition
Tuberculosis; sarcoidosis; hodgkin disease
2 mo - eyes follow object past midline - rolls over - laughs - squeals
= LMP + 7 days - 3 months
Fe deficient anemia

28. 1st generation antihistamines
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diphenhydramine - chlorpheniramine - hydroxyzine
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

29. Rod shaped - rhomboid - weakly positive birefringent
After delivery until delivery of placenta and membranes <30 mins
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Cataracts
Calcium pyrophosphate dehydrate crystals (pseudogout)

30. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Calcium oxalate crystals
110-160bpm
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

31. parallel play
Bathing - dressing - eating - transferring - continence - toileting
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

32. causes of acute bronchitis
Calcium hydroxyapatite crystals
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Prostatitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

33. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

34. Tx for thyroid storm
Fluoroquinolones
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

35. shoulder dystocia
MCC melanoma. Radial growth.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Biopsy
Anterior shoulder cannot readily pass below the pubic symphysis.

36. Dx PID
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
After delivery until delivery of placenta and membranes <30 mins
Thiazdes; lithium
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

37. regards hand
Ask - Advise - Assess - Assist - Arrange
4mo - sits unsupported - hand transfer - babbles
Flexion - internal rotation - extension - external rotation
Anterior shoulder cannot readily pass below the pubic symphysis.

38. Tx GAS ifxn
Thiazides
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Prostatitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

39. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Thiazides
5+ rads
Oxygen intervention 15h/d

40. Low serum iron - low MCV - low ferritin - +stool guaiac
16-18 weeks GA
Diphenhydramine - chlorpheniramine - hydroxyzine
Fe deficient anemia
Short-acting + 40mg prednisone x 10-14days

41. Emphysema - <45YO - nonsmoker
Measures strength of contractions
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Alpha-1 antitrypsin deficiency

42. Augments contractions
Ofloxacin OR levofloxacin +/- metronidazole
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxytocin (IV)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

43. Immunizations for COPD patients
Pneumovax - influenza
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
5+ rads

44. Early deceleration
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Metronidazole or clindamycin
Nicotine inhaler - nasal spray - gum

45. needles - strong negative birefringent (yellow crystals parallel light)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Stridor - drooling - toxic appearance
Monosodium urate crystals (gout)

46. Sx peritonsillar abscess
110-160bpm
Loratadine - fexofenadine - cetirizine
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Pneumovax - influenza

47. Oral tx for PID
5 yo - draws person - ties shoes - skips
Calcium pyrophosphate dehydrate crystals (pseudogout)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
(ofloxacin OR levofloxacin) +/- metronidazole

48. Granulomatous causes of hypercalcemia
Thiazdes; lithium
MTX
Tuberculosis; sarcoidosis; hodgkin disease
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

49. medications causing hypercalcemia
Angioedema
= LMP + 7 days - 3 months
Thiazdes; lithium
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

50. Age by which child says 'mama' and 'dada'
6-9MO
Urticaria
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Nicotine inhaler - nasal spray - gum