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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. Cockcroft-Gault equation
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Prostatitis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

2. dyspnea - visceral edema - hypotension
Oxytocin (IV)
Anaphylaxis
Diphenhydramine - chlorpheniramine - hydroxyzine
Tdap - influenza - pneumovax

3. Oral tx for PID
Cataracts
Oxytocin (IV)
(ofloxacin OR levofloxacin) +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

4. Pflx for traveler's diarrhea
Fluoroquinolones
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

5. regards hand
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
4mo - sits unsupported - hand transfer - babbles
Prostatitis
Nicotine inhaler - nasal spray - gum

6. Regards human face - eye contact
Thiazdes; lithium
0.2-0.5mg aqueous EPI IM/SubQ
1 mo - eyes follow object to midline - vocalizes
Starts at contraction. caused by increased vagal tone from fetal head compression.

7. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
NAC or IV NaHCO3

8. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Biopsy
IV penicillin (or ampicillin)
Flexion - internal rotation - extension - external rotation

9. social interaction
MCC melanoma. Radial growth.
4 yo - copies triangle - catches ball - dresses self
Anterior shoulder cannot readily pass below the pubic symphysis.
Cataracts

10. Tx for thyroid storm
Calcium pyrophosphate dehydrate crystals (pseudogout)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
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)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

11. painless - deep - subQ swelling (periorbital - circumoral - facial)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Angioedema
Calcium hydroxyapatite crystals
Aortic aneurysm

12. Sx peritonsillar abscess
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

13. Granulomatous causes of hypercalcemia
Cataracts
Loratadine - fexofenadine - cetirizine
Tuberculosis; sarcoidosis; hodgkin disease
Ear pain - itching - inflammation/swollen canal - exudates/discharge

14. First stage of labor
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bathing - dressing - eating - transferring - continence - toileting
Onset of labor until cervix dilation
Anemia

15. CKD Stages
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Oxygen intervention 15h/d

16. Tx of traveler's diarrhea
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Patch - bupropion - varenicline

17. X-ray on knee?
Ask - Advise - Assess - Assist - Arrange
Ceftriaxone 125mg IM
Anaphylaxis
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

18. IUPC (intrauterine pressure catheter)
1 mo - eyes follow object to midline - vocalizes
Alpha-1 antitrypsin deficiency
MTX
Measures strength of contractions

19. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
DTaP - hepB - Hib - rotavirus - inactivated polio
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
9 mo - walks - throws - 1-3 words - 1-step commands

20. IV tx for PID
Cataracts
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(cefotetan OR cefoxitin) AND doxycycline
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

21. Late deceleration
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Loratadine - fexofenadine - cetirizine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

22. Lentigo Maligna
Ear pain - itching - inflammation/swollen canal - exudates/discharge
9 mo - walks - throws - 1-3 words - 1-step commands
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

23. Tx acute gout
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)
Normal mental status; no other injuries; seen within 10 days of injury
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Colchicine

24. tx shoulder dystocia

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25. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Ferrous sulfate 325mg tid
Oxygen intervention 15h/d
3 yo - identify body part - copies square - hops - throws - past tense - story telling

26. Large - irregularly shaped - prutitic - erythematous wheals
MCC melanoma. Radial growth.
NAC or IV NaHCO3
6 yo
Urticaria

27. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
Nuchal translucency - serum hCG - PAPP-A
Tuberculosis; sarcoidosis; hodgkin disease
6 yo

28. GBS tx
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium pyrophosphate dehydrate crystals (pseudogout)
Anterior shoulder cannot readily pass below the pubic symphysis.
IV penicillin (or ampicillin)

29. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ampicillin/sulbactam AND doxycycline
Hypomagnesemia

30. Tx gonorrhea
Ofloxacin OR levofloxacin +/- metronidazole
(ofloxacin OR levofloxacin) +/- metronidazole
IV penicillin (or ampicillin)
Ceftriaxone 125mg IM

31. Malignancies with hypercalcemia
Urticaria
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate
Clindamycin AND gentamicin

32. explorations
Urinary calcium. Hyper PTH (high) >> FHH (normal)
MTX
9 mo - walks - throws - 1-3 words - 1-step commands
6 yo

33. recognizes strangers
Cataracts
6 mo - pincer - crawls - cruises - mamma - dada - byebye
6-9MO
Bathing - dressing - eating - transferring - continence - toileting

34. Only therapy to decrease mortality in stage IV COPD
Thiazdes; lithium
MTX
Oxygen intervention 15h/d
6 yo

35. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Biopsy
Anterior shoulder cannot readily pass below the pubic symphysis.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

36. Tx bacterial vaginosis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Clindamycin AND gentamicin
Metronidazole or clindamycin

37. Immunizations at visit for 6MO
IV penicillin (or ampicillin)
DTaP - hepB - Hib - rotavirus - inactivated polio
Hypomagnesemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

38. Immunizations for COPD patients
Cataracts
Short-acting + 40mg prednisone x 10-14days
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Pneumovax - influenza

39. Low serum iron - low MCV - low ferritin - +stool guaiac
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Fe deficient anemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Metronidazole or clindamycin

40. Tx chlamydia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Nuchal translucency - serum hCG - PAPP-A

41. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Ferrous sulfate 325mg tid
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Calcium oxalate crystals

42. Corrected serum calcium =

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43. Fetal lie
Calcium oxalate crystals
Long axis of fetus to long axis of mother (longitudinal or transverse)
Tuberculosis; sarcoidosis; hodgkin disease
Oxytocin (IV)

44. Estimated delivery date (Naegele's rule)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ceftriaxone 125mg IM
= LMP + 7 days - 3 months
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

45. MCC blindness worldwide
MTX
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
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)
Cataracts

46. Acral lentinous melanoma
Ask - Advise - Assess - Assist - Arrange
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Diphenhydramine - chlorpheniramine - hydroxyzine
Bupropion - varenicline - nicotine replacement

47. Sx otitis externa
Fe deficient anemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

48. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Patch - bupropion - varenicline
Ferrous sulfate 325mg tid
Colchicine

49. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Monosodium urate crystals (gout)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

50. Rod shaped - rhomboid - weakly positive birefringent
Biopsy
Tdap - influenza - pneumovax
Normal mental status; no other injuries; seen within 10 days of injury
Calcium pyrophosphate dehydrate crystals (pseudogout)