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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. IV tx for PID
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ofloxacin OR levofloxacin +/- metronidazole
Ampicillin/sulbactam AND doxycycline
(cefotetan OR cefoxitin) AND doxycycline

2. 2nd generation antihistamines
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(ofloxacin OR levofloxacin) +/- metronidazole
Loratadine - fexofenadine - cetirizine
Steroids + bronchodilators

3. Tx bacterial vaginosis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxytocin (IV)
110-160bpm
Metronidazole or clindamycin

4. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
DTaP - hepB - Hib - rotavirus - inactivated polio
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Hypomagnesemia

5. identifies left - right
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Steroids + bronchodilators
6 yo
Tdap - influenza - pneumovax

6. Tx hyperkalemia in CKD
Anterior shoulder cannot readily pass below the pubic symphysis.
Biopsy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ampicillin/sulbactam AND doxycycline

7. Unstable angina vs MI Dx tests
1 mo - eyes follow object to midline - vocalizes
Ceftriaxone 125mg IM
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Diabetes - HTN - GN

8. IV tx for PID
Normal mental status; no other injuries; seen within 10 days of injury
(cefotetan OR cefoxitin) AND doxycycline
Biopsy
Onset of labor until cervix dilation

9. Screening for 65-76YO male smoker
Metronidazole or clindamycin
Clindamycin AND gentamicin
Aortic aneurysm
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

10. Dx bacterial vaginosis
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)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
NAC or IV NaHCO3
Calcium pyrophosphate dehydrate crystals (pseudogout)

11. Second stage of labor
Starts at contraction. caused by increased vagal tone from fetal head compression.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
(ofloxacin OR levofloxacin) +/- metronidazole
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

12. Granulomatous causes of hypercalcemia
5+ rads
Tuberculosis; sarcoidosis; hodgkin disease
NAC or IV NaHCO3
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

13. Emphysema - <45YO - nonsmoker
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Alpha-1 antitrypsin deficiency
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
6 mo - pincer - crawls - cruises - mamma - dada - byebye

14. Acral lentinous melanoma
<20lb - <1YO - Reacts to pain - Responds to noise
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Anemia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

15. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Monosodium urate crystals (gout)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

16. Nonfunctioning nodules > 1cm require _____
Ceftriaxone 125mg IM
Age-related sensorineural hearing loss (high frequency and speech discrimination)
5 yo - draws person - ties shoes - skips
Biopsy

17. Optimal time for trisomy screen
After delivery until delivery of placenta and membranes <30 mins
16-18 weeks GA
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Monosodium urate crystals (gout)

18. Immunizations for COPD patients
Ceftriaxone 125mg IM
Pneumovax - influenza
Onset of labor until cervix dilation
Ask - Advise - Assess - Assist - Arrange

19. Tx GAS ifxn
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ofloxacin OR levofloxacin +/- metronidazole

20. Tx for anaphylaxis
IV penicillin (or ampicillin)
Urticaria
Measures strength of contractions
0.2-0.5mg aqueous EPI IM/SubQ

21. variable deceleration
Thiazides
Metronidazole or clindamycin
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

22. Smoking cessation agents
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Bupropion - varenicline - nicotine replacement
(ofloxacin OR levofloxacin) +/- metronidazole

23. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Urticaria
Anemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Nicotine inhaler - nasal spray - gum

24. Oral tx for PID
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)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thiazides
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

25. Large - irregularly shaped - prutitic - erythematous wheals
Onset of labor until cervix dilation
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Urticaria

26. Nodular melanoma
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Most aggressive melanoma.
Tuberculosis; sarcoidosis; hodgkin disease
2 mo - eyes follow object past midline - rolls over - laughs - squeals

27. dyspnea - visceral edema - hypotension
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Anaphylaxis
4mo - sits unsupported - hand transfer - babbles

28. DDX for geriatric hearing impairment
Nicotine inhaler - nasal spray - gum
16-18 weeks GA
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

29. IUPC (intrauterine pressure catheter)
5 yo - draws person - ties shoes - skips
Most aggressive melanoma.
Measures strength of contractions
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

30. Fe deficient anemia tx
Anemia
Patch - bupropion - varenicline
Ferrous sulfate 325mg tid
MCC melanoma. Radial growth.

31. recognizes strangers
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Thiazdes; lithium
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

32. DOC for HTN in elderly
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thiazides
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ceftriaxone 125mg IM

33. Tx of traveler's diarrhea
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Steroids + bronchodilators
Angioedema

34. cystoplasmic inclusions - not birefringent
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium hydroxyapatite crystals
Long axis of fetus to long axis of mother (longitudinal or transverse)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

35. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
110-160bpm
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

36. Augments contractions
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Conrtaction monitoring along with fetal heart rate assessment
Lung; SCC head & neck; RCC; breast; MM; prostate
Oxytocin (IV)

37. Early deceleration
= LMP + 7 days - 3 months
Starts at contraction. caused by increased vagal tone from fetal head compression.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
2 mo - eyes follow object past midline - rolls over - laughs - squeals

38. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Metronidazole or clindamycin

39. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
5+ rads
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Steroids + bronchodilators

40. Pregnancy class D smoking cessation drugs
Cataracts
Prostatitis
4 yo - copies triangle - catches ball - dresses self
Nicotine inhaler - nasal spray - gum

41. medications causing hypercalcemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Colchicine
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thiazdes; lithium

42. Tx otitis media
Tuberculosis; sarcoidosis; hodgkin disease
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Urticaria
Normal mental status; no other injuries; seen within 10 days of injury

43. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ofloxacin OR levofloxacin +/- metronidazole
Ferrous sulfate 325mg tid

44. Pflx for traveler's diarrhea
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Monosodium urate crystals (gout)
After delivery until delivery of placenta and membranes <30 mins
Fluoroquinolones

45. IV tx for PID
Oxygen intervention 15h/d
110-160bpm
Ofloxacin OR levofloxacin +/- metronidazole
Hypomagnesemia

46. Late deceleration
16-18 weeks GA
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
(ofloxacin OR levofloxacin) +/- metronidazole
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

47. Regards human face - eye contact
Bupropion - varenicline - nicotine replacement
1 mo - eyes follow object to midline - vocalizes
MTX
6 mo - pincer - crawls - cruises - mamma - dada - byebye

48. Cockcroft-Gault equation
Diabetes - HTN - GN
After delivery until delivery of placenta and membranes <30 mins
DTaP - hepB - Hib - rotavirus - inactivated polio
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

49. presbycusis
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
110-160bpm
Age-related sensorineural hearing loss (high frequency and speech discrimination)

50. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Conrtaction monitoring along with fetal heart rate assessment