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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. Smoking cessation agents
Patch - bupropion - varenicline
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Conrtaction monitoring along with fetal heart rate assessment
Bupropion - varenicline - nicotine replacement

2. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Anemia
Ask - Advise - Assess - Assist - Arrange
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

3. Sx otitis externa
MCC melanoma. Radial growth.
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Biopsy
2 mo - eyes follow object past midline - rolls over - laughs - squeals

4. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fluoroquinolones
Monosodium urate crystals (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)

5. variable deceleration
Conrtaction monitoring along with fetal heart rate assessment
Alpha-1 antitrypsin deficiency
DTaP - hepB - Hib - rotavirus - inactivated polio
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

6. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ferrous sulfate 325mg tid
Lung; SCC head & neck; RCC; breast; MM; prostate
6 mo - pincer - crawls - cruises - mamma - dada - byebye

7. Third stage of labor
Flexion - internal rotation - extension - external rotation
After delivery until delivery of placenta and membranes <30 mins
Anterior shoulder cannot readily pass below the pubic symphysis.
Long axis of fetus to long axis of mother (longitudinal or transverse)

8. IUPC (intrauterine pressure catheter)
5+ rads
(cefotetan OR cefoxitin) AND doxycycline
Thiazdes; lithium
Measures strength of contractions

9. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5+ rads
Fluoroquinolones

10. Mediators released in response to allergen
Tuberculosis; sarcoidosis; hodgkin disease
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
After delivery until delivery of placenta and membranes <30 mins
Urticaria

11. causes of acute bronchitis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
MCC melanoma. Radial growth.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

12. Malignancies with hypercalcemia
DTaP - hepB - Hib - rotavirus - inactivated polio
Oxytocin (IV)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Lung; SCC head & neck; RCC; breast; MM; prostate

13. Tx RA (best long-term outcome)
MTX
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cataracts
Starts at contraction. caused by increased vagal tone from fetal head compression.

14. Screened at 11-13 weeks GA for trisomy
Steroids + bronchodilators
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Nuchal translucency - serum hCG - PAPP-A

15. Tx chlamydia
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

16. How much radiation is associated with fetal harm?
Nicotine inhaler - nasal spray - gum
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
5+ rads
Normal mental status; no other injuries; seen within 10 days of injury

17. Sx of hypercalcemia
(cefotetan OR cefoxitin) AND doxycycline
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium hydroxyapatite crystals
Most aggressive melanoma.

18. ADL
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Bathing - dressing - eating - transferring - continence - toileting
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Normal mental status; no other injuries; seen within 10 days of injury

19. shoulder dystocia
DTaP - hepB - Hib - rotavirus - inactivated polio
Anterior shoulder cannot readily pass below the pubic symphysis.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Long axis of fetus to long axis of mother (longitudinal or transverse)

20. Dx PID
16-18 weeks GA
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Anemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

21. group play - gender - knows name
Monosodium urate crystals (gout)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
3 yo - identify body part - copies square - hops - throws - past tense - story telling

22. Sx peritonsillar abscess
Anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MTX

23. medications causing hypercalcemia
MTX
Thiazdes; lithium
Short-acting + 40mg prednisone x 10-14days
Stridor - drooling - toxic appearance

24. Dx bacterial rhinosinusitis
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)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Fluoroquinolones
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

25. dyspnea - visceral edema - hypotension
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Anaphylaxis
Patch - bupropion - varenicline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

26. Optimal time for trisomy screen
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
16-18 weeks GA
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
= LMP + 7 days - 3 months

27. CKD Stages
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Esophagitis - gastritis - dysphagia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
4 yo - copies triangle - catches ball - dresses self

28. Early deceleration
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Starts at contraction. caused by increased vagal tone from fetal head compression.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Starts at contraction. caused by increased vagal tone from fetal head compression.
= LMP + 7 days - 3 months
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

30. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Biopsy
4 yo - copies triangle - catches ball - dresses self
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

31. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cataracts
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
3 yo - identify body part - copies square - hops - throws - past tense - story telling

32. Cockcroft-Gault equation
Nicotine inhaler - nasal spray - gum
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
4 yo - copies triangle - catches ball - dresses self

33. Nonfunctioning nodules > 1cm require _____
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Esophagitis - gastritis - dysphagia
Onset of labor until cervix dilation
Biopsy

34. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
IV penicillin (or ampicillin)
MTX
Thiazdes; lithium

35. 1st generation antihistamines
4mo - sits unsupported - hand transfer - babbles
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Diphenhydramine - chlorpheniramine - hydroxyzine
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

36. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Urinary calcium. Hyper PTH (high) >> FHH (normal)

37. Sx otitis media
Conrtaction monitoring along with fetal heart rate assessment
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

38. Improve short-term outcomes in acute exacerbations of COPD - asthma
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Steroids + bronchodilators

39. Tx acute sinusitis
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)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

40. MONA therapy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Onset of labor until cervix dilation

41. Augments contractions
Loratadine - fexofenadine - cetirizine
Oxytocin (IV)
Hypomagnesemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

42. bacteria causing pharyngitis
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
MCC melanoma. Radial growth.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Monosodium urate crystals (gout)

43. social smile - parent recognition
Nicotine inhaler - nasal spray - gum
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
2 mo - eyes follow object past midline - rolls over - laughs - squeals

44. Other causes of hypercalcemia
9 mo - walks - throws - 1-3 words - 1-step commands
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Thiazides
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

45. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Urticaria
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

46. DDX for geriatric hearing impairment
Ampicillin/sulbactam AND doxycycline
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(cefotetan OR cefoxitin) AND doxycycline

47. cystoplasmic inclusions - not birefringent
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
16-18 weeks GA
Calcium hydroxyapatite crystals
Long axis of fetus to long axis of mother (longitudinal or transverse)

48. Pregnancy class C smoking cessation drugs
MCC melanoma. Radial growth.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Patch - bupropion - varenicline
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

49. DOC for HTN in elderly
Thiazides
= LMP + 7 days - 3 months
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

50. Screening for 65-76YO male smoker
Fe deficient anemia
Bupropion - varenicline - nicotine replacement
Biopsy
Aortic aneurysm