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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. Age by which child says 'mama' and 'dada'
6-9MO
Tdap - influenza - pneumovax
Fe deficient anemia
DTaP - hepB - Hib - rotavirus - inactivated polio

2. Pregnancy class C smoking cessation drugs
Anaphylaxis
Calcium hydroxyapatite crystals
Patch - bupropion - varenicline
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

3. Recommended folic acid daily dose
Oxytocin (IV)
9 mo - walks - throws - 1-3 words - 1-step commands
After delivery until delivery of placenta and membranes <30 mins
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

4. group play - gender - knows name
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Metronidazole or clindamycin
3 yo - identify body part - copies square - hops - throws - past tense - story telling
9 mo - walks - throws - 1-3 words - 1-step commands

5. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Fluoroquinolones
Prostatitis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

6. Unstable angina vs MI Dx tests
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Oxytocin (IV)

7. Augments contractions
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Oxytocin (IV)
Lung; SCC head & neck; RCC; breast; MM; prostate
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

8. Tx otitis media
Angioedema
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Diphenhydramine - chlorpheniramine - hydroxyzine

9. IADL
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium oxalate crystals

10. First stage of labor
Onset of labor until cervix dilation
Flexion - internal rotation - extension - external rotation
Bupropion - varenicline - nicotine replacement
Prostatitis

11. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Patch - bupropion - varenicline
DTaP - hepB - Hib - rotavirus - inactivated polio

12. Early deceleration
Onset of labor until cervix dilation
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Starts at contraction. caused by increased vagal tone from fetal head compression.

13. Low serum iron - low MCV - low ferritin - +stool guaiac
Ask - Advise - Assess - Assist - Arrange
Anterior shoulder cannot readily pass below the pubic symphysis.
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Fe deficient anemia

14. shoulder dystocia
Monosodium urate crystals (gout)
4 yo - copies triangle - catches ball - dresses self
Anterior shoulder cannot readily pass below the pubic symphysis.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

15. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Nuchal translucency - serum hCG - PAPP-A
MCC melanoma in Africans/Asians. Under nails - soles - palms.

16. DOC for HTN in elderly
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MCC melanoma. Radial growth.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Thiazides

17. Recommendations for rear-facing car seat
(ofloxacin OR levofloxacin) +/- metronidazole
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
<20lb - <1YO - Reacts to pain - Responds to noise
Bupropion - varenicline - nicotine replacement

18. Estimated delivery date (Naegele's rule)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Starts at contraction. caused by increased vagal tone from fetal head compression.
= LMP + 7 days - 3 months
16-18 weeks GA

19. bipyramidal - strongly positive birefringent
Long axis of fetus to long axis of mother (longitudinal or transverse)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium oxalate crystals
Calcium hydroxyapatite crystals

20. Oral tx for PID
Metronidazole or clindamycin
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Measures strength of contractions
Tuberculosis; sarcoidosis; hodgkin disease

21. cystoplasmic inclusions - not birefringent
Aortic aneurysm
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Calcium hydroxyapatite crystals
Short-acting + 40mg prednisone x 10-14days

22. Screening for 65-76YO male smoker
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Aortic aneurysm
Ampicillin/sulbactam AND doxycycline
4 yo - copies triangle - catches ball - dresses self

23. writes name - counts 10 objects
Urticaria
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Thiazdes; lithium
5 yo - draws person - ties shoes - skips

24. ADL
Alpha-1 antitrypsin deficiency
Bathing - dressing - eating - transferring - continence - toileting
Esophagitis - gastritis - dysphagia
IV penicillin (or ampicillin)

25. Tocodynamometer
DTaP - hepB - Hib - rotavirus - inactivated polio
Conrtaction monitoring along with fetal heart rate assessment
Ampicillin/sulbactam AND doxycycline
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

26. Granulomatous causes of hypercalcemia
(ofloxacin OR levofloxacin) +/- metronidazole
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Tuberculosis; sarcoidosis; hodgkin disease
Starts at contraction. caused by increased vagal tone from fetal head compression.

27. Other causes of hypercalcemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxytocin (IV)
Diabetes - HTN - GN

28. Sx of hypercalcemia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Bupropion - varenicline - nicotine replacement
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

29. regards hand
Clindamycin AND gentamicin
Diabetes - HTN - GN
4mo - sits unsupported - hand transfer - babbles
Prostatitis

30. Tx RA (best long-term outcome)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MTX
Prostatitis
Age-related sensorineural hearing loss (high frequency and speech discrimination)

31. recognizes strangers
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6 mo - pincer - crawls - cruises - mamma - dada - byebye
MTX
Cataracts

32. complications of otitis media
Angioedema
Starts at contraction. caused by increased vagal tone from fetal head compression.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

33. social interaction
Thiazdes; lithium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
4 yo - copies triangle - catches ball - dresses self
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

34. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Ask - Advise - Assess - Assist - Arrange
Ferrous sulfate 325mg tid
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

35. IV tx for PID
Oxygen intervention 15h/d
(ofloxacin OR levofloxacin) +/- metronidazole
Ampicillin/sulbactam AND doxycycline
Oxytocin (IV)

36. identifies left - right
4mo - sits unsupported - hand transfer - babbles
5+ rads
Tdap - influenza - pneumovax
6 yo

37. Tender - boggy prostate. Dx?
Colchicine
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Pneumovax - influenza
Prostatitis

38. Electrolyte abnormality that increases the incidence of torsades de pointes
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Aortic aneurysm
Hypomagnesemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

39. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
<20lb - <1YO - Reacts to pain - Responds to noise
NAC or IV NaHCO3
Lung; SCC head & neck; RCC; breast; MM; prostate

40. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

41. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
<20lb - <1YO - Reacts to pain - Responds to noise
MCC melanoma. Radial growth.
1 mo - eyes follow object to midline - vocalizes

42. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Long axis of fetus to long axis of mother (longitudinal or transverse)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Loratadine - fexofenadine - cetirizine

43. The five A's of smoking cessation
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

44. Late deceleration
4mo - sits unsupported - hand transfer - babbles
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

45. Immunizations for COPD patients
Onset of labor until cervix dilation
Pneumovax - influenza
Lung; SCC head & neck; RCC; breast; MM; prostate
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

46. Tx chlamydia
Oxytocin (IV)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
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)

47. Pflx for traveler's diarrhea
Monosodium urate crystals (gout)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Fluoroquinolones
4mo - sits unsupported - hand transfer - babbles

48. Superficial spreading melanoma
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Tdap - influenza - pneumovax
MCC melanoma. Radial growth.
Urticaria

49. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

50. Fe deficient anemia tx
Steroids + bronchodilators
Ferrous sulfate 325mg tid
Patch - bupropion - varenicline
Calcium pyrophosphate dehydrate crystals (pseudogout)