Test your basic knowledge |

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. Acral lentinous melanoma
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

2. Tx for anaphylaxis
1 mo - eyes follow object to midline - vocalizes
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
0.2-0.5mg aqueous EPI IM/SubQ
NAC or IV NaHCO3

3. identifies left - right
Steroids + bronchodilators
Hypomagnesemia
6 yo
Fluoroquinolones

4. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Tuberculosis; sarcoidosis; hodgkin disease
6 mo - pincer - crawls - cruises - mamma - dada - byebye

5. Screened at 16-20 weeks GA for trisomy
16-18 weeks GA
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

6. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
16-18 weeks GA
Anemia
Clindamycin AND gentamicin
Onset of labor until cervix dilation

7. Sx peritonsillar abscess
Ofloxacin OR levofloxacin +/- metronidazole
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Cataracts
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

8. Regards human face - eye contact
Esophagitis - gastritis - dysphagia
Lung; SCC head & neck; RCC; breast; MM; prostate
(ofloxacin OR levofloxacin) +/- metronidazole
1 mo - eyes follow object to midline - vocalizes

9. IV tx for PID
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Clindamycin AND gentamicin
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
MCC melanoma. Radial growth.

10. Third stage of labor
Metronidazole or clindamycin
After delivery until delivery of placenta and membranes <30 mins
Onset of labor until cervix dilation
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

11. Nonfunctioning nodules > 1cm require _____
Biopsy
Patch - bupropion - varenicline
5 yo - draws person - ties shoes - skips
Urinary calcium. Hyper PTH (high) >> FHH (normal)

12. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Prostatitis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

13. Oral tx for PID
Age-related sensorineural hearing loss (high frequency and speech discrimination)
(ofloxacin OR levofloxacin) +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

14. Corrected serum calcium =

15. Causes of CKD
Diabetes - HTN - GN
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fluoroquinolones
Flexion - internal rotation - extension - external rotation

16. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thiazides

17. Recommended folic acid daily dose
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Steroids + bronchodilators
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

18. Age by which child says 'mama' and 'dada'
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
6-9MO
Hypomagnesemia
Anterior shoulder cannot readily pass below the pubic symphysis.

19. IV tx for PID
Monosodium urate crystals (gout)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MCC melanoma. Radial growth.
(cefotetan OR cefoxitin) AND doxycycline

20. GBS tx
IV penicillin (or ampicillin)
Bupropion - varenicline - nicotine replacement
Cataracts
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

21. Sx otitis media
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)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
DTaP - hepB - Hib - rotavirus - inactivated polio

22. Estimated delivery date (Naegele's rule)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ferrous sulfate 325mg tid
Thiazides
= LMP + 7 days - 3 months

23. Pregnancy class D smoking cessation drugs
Hypomagnesemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
= LMP + 7 days - 3 months
Nicotine inhaler - nasal spray - gum

24. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Angioedema
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
After delivery until delivery of placenta and membranes <30 mins

25. The five A's of smoking cessation
1 mo - eyes follow object to midline - vocalizes
Bupropion - varenicline - nicotine replacement
Ask - Advise - Assess - Assist - Arrange
Calcium pyrophosphate dehydrate crystals (pseudogout)

26. Granulomatous causes of hypercalcemia
Monosodium urate crystals (gout)
Lung; SCC head & neck; RCC; breast; MM; prostate
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Tuberculosis; sarcoidosis; hodgkin disease

27. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Aortic aneurysm
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

28. Sx epiglottitis
Alpha-1 antitrypsin deficiency
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Stridor - drooling - toxic appearance
<20lb - <1YO - Reacts to pain - Responds to noise

29. Tx acute gout
Colchicine
6 yo
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

30. Four cardinal fetal movements
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5 yo - draws person - ties shoes - skips
Flexion - internal rotation - extension - external rotation

31. parallel play
Fe deficient anemia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease

32. 2nd generation antihistamines
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Anemia
Loratadine - fexofenadine - cetirizine
Conrtaction monitoring along with fetal heart rate assessment

33. ADL
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Bathing - dressing - eating - transferring - continence - toileting
Calcium oxalate crystals

34. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Anaphylaxis
Ceftriaxone 125mg IM

35. Smoking cessation agents
Alpha-1 antitrypsin deficiency
1 mo - eyes follow object to midline - vocalizes
Bupropion - varenicline - nicotine replacement
(cefotetan OR cefoxitin) AND doxycycline

36. Large - irregularly shaped - prutitic - erythematous wheals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Urticaria

37. Augments contractions
Oxytocin (IV)
Urticaria
Bathing - dressing - eating - transferring - continence - toileting
Colchicine

38. DDX for geriatric hearing impairment
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Bupropion - varenicline - nicotine replacement
16-18 weeks GA

39. bacteria causing pharyngitis
Diphenhydramine - chlorpheniramine - hydroxyzine
Tdap - influenza - pneumovax
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Starts at contraction. caused by increased vagal tone from fetal head compression.

40. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
= LMP + 7 days - 3 months
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
NAC or IV NaHCO3

41. causes of acute bronchitis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

42. Fe deficient anemia tx
Ferrous sulfate 325mg tid
Ofloxacin OR levofloxacin +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Urticaria

43. Screened at 11-13 weeks GA for trisomy
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ferrous sulfate 325mg tid
Steroids + bronchodilators
Nuchal translucency - serum hCG - PAPP-A

44. Pregnancy class C smoking cessation drugs
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Anemia
Patch - bupropion - varenicline
NAC or IV NaHCO3

45. tx shoulder dystocia

46. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
IV penicillin (or ampicillin)
Ask - Advise - Assess - Assist - Arrange
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

47. Tx GAS ifxn
Ferrous sulfate 325mg tid
Metronidazole or clindamycin
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

48. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Loratadine - fexofenadine - cetirizine

49. Tx bacterial vaginosis
Conrtaction monitoring along with fetal heart rate assessment
Fe deficient anemia
Metronidazole or clindamycin
Urinary calcium. Hyper PTH (high) >> FHH (normal)

50. Low serum iron - low MCV - low ferritin - +stool guaiac
1 mo - eyes follow object to midline - vocalizes
Fe deficient anemia
Normal mental status; no other injuries; seen within 10 days of injury
5+ rads