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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. Tx otitis media
Anaphylaxis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

2. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ofloxacin OR levofloxacin +/- metronidazole
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Bathing - dressing - eating - transferring - continence - toileting

3. bipyramidal - strongly positive birefringent
Most aggressive melanoma.
Nuchal translucency - serum hCG - PAPP-A
Calcium oxalate crystals
Metronidazole or clindamycin

4. 2nd generation antihistamines
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Loratadine - fexofenadine - cetirizine
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

5. Immunizations for COPD patients
Pneumovax - influenza
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
4 yo - copies triangle - catches ball - dresses self

6. Estimated delivery date (Naegele's rule)
Aortic aneurysm
DTaP - hepB - Hib - rotavirus - inactivated polio
2 mo - eyes follow object past midline - rolls over - laughs - squeals
= LMP + 7 days - 3 months

7. How much radiation is associated with fetal harm?
5+ rads
Stridor - drooling - toxic appearance
Calcium hydroxyapatite crystals
Hypomagnesemia

8. Fetal heart rate range
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
NAC or IV NaHCO3
110-160bpm
MCC melanoma in Africans/Asians. Under nails - soles - palms.

9. identifies left - right
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Starts at contraction. caused by increased vagal tone from fetal head compression.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
6 yo

10. Emphysema - <45YO - nonsmoker
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
16-18 weeks GA
Biopsy
Alpha-1 antitrypsin deficiency

11. Recommended folic acid daily dose
Colchicine
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

12. Tx GAS ifxn
Nicotine inhaler - nasal spray - gum
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Cataracts
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

13. Fe deficient anemia tx
Metronidazole or clindamycin
Diabetes - HTN - GN
Ferrous sulfate 325mg tid
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

14. Screened at 11-13 weeks GA for trisomy
Loratadine - fexofenadine - cetirizine
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nuchal translucency - serum hCG - PAPP-A

15. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Starts at contraction. caused by increased vagal tone from fetal head compression.
Nicotine inhaler - nasal spray - gum
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

16. dyspnea - visceral edema - hypotension
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Monosodium urate crystals (gout)
Anaphylaxis

17. Third stage of labor
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Monosodium urate crystals (gout)
Fluoroquinolones
After delivery until delivery of placenta and membranes <30 mins

18. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ask - Advise - Assess - Assist - Arrange
Aortic aneurysm

19. 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)
Tuberculosis; sarcoidosis; hodgkin disease
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

20. Electrolyte abnormality that increases the incidence of torsades de pointes
Metronidazole or clindamycin
(cefotetan OR cefoxitin) AND doxycycline
Hypomagnesemia
Diphenhydramine - chlorpheniramine - hydroxyzine

21. Fetal lie
Tuberculosis; sarcoidosis; hodgkin disease
MTX
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Long axis of fetus to long axis of mother (longitudinal or transverse)

22. Age by which child says 'mama' and 'dada'
Monosodium urate crystals (gout)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
6-9MO

23. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Bupropion - varenicline - nicotine replacement
Oxytocin (IV)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

24. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
4mo - sits unsupported - hand transfer - babbles
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

25. IV tx for PID
Bathing - dressing - eating - transferring - continence - toileting
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Clindamycin AND gentamicin
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

26. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Monosodium urate crystals (gout)
Bupropion - varenicline - nicotine replacement
6 yo

27. Second stage of labor
Ofloxacin OR levofloxacin +/- metronidazole
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Urticaria
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

28. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
110-160bpm
5+ rads
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Steroids + bronchodilators

29. Tocodynamometer
Nuchal translucency - serum hCG - PAPP-A
Prostatitis
Diabetes - HTN - GN
Conrtaction monitoring along with fetal heart rate assessment

30. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium oxalate crystals

31. DOC for HTN in elderly
Thiazides
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
= LMP + 7 days - 3 months

32. Oral tx for PID
Measures strength of contractions
Most aggressive melanoma.
5 yo - draws person - ties shoes - skips
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

33. Nonfunctioning nodules > 1cm require _____
Aortic aneurysm
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Biopsy
Tdap - influenza - pneumovax

34. painless - deep - subQ swelling (periorbital - circumoral - facial)
Ferrous sulfate 325mg tid
Angioedema
IV penicillin (or ampicillin)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

35. X-ray of ankle?
Lung; SCC head & neck; RCC; breast; MM; prostate
Normal mental status; no other injuries; seen within 10 days of injury
Starts at contraction. caused by increased vagal tone from fetal head compression.
(ofloxacin OR levofloxacin) +/- metronidazole

36. Tender - boggy prostate. Dx?
Esophagitis - gastritis - dysphagia
Prostatitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

37. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Long axis of fetus to long axis of mother (longitudinal or transverse)
9 mo - walks - throws - 1-3 words - 1-step commands

38. regards hand
4mo - sits unsupported - hand transfer - babbles
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

39. Sx epiglottitis
Stridor - drooling - toxic appearance
Anaphylaxis
4mo - sits unsupported - hand transfer - babbles
Urticaria

40. Unstable angina vs MI Dx tests
Onset of labor until cervix dilation
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)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Diabetes - HTN - GN

41. Pregnancy class D smoking cessation drugs
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Nicotine inhaler - nasal spray - gum
Metronidazole or clindamycin
Fe deficient anemia

42. Mediators released in response to allergen
Urticaria
Ampicillin/sulbactam AND doxycycline
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Long axis of fetus to long axis of mother (longitudinal or transverse)

43. IV tx for PID
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Alpha-1 antitrypsin deficiency
(cefotetan OR cefoxitin) AND doxycycline
Ampicillin/sulbactam AND doxycycline

44. CKD Stages
Short-acting + 40mg prednisone x 10-14days
Stridor - drooling - toxic appearance
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Patch - bupropion - varenicline

45. Causes of CKD
Diabetes - HTN - GN
Nicotine inhaler - nasal spray - gum
Pneumovax - influenza
Tdap - influenza - pneumovax

46. tx shoulder dystocia

47. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

48. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Loratadine - fexofenadine - cetirizine
Oxytocin (IV)

49. Rod shaped - rhomboid - weakly positive birefringent
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Oxytocin (IV)

50. Regards human face - eye contact
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1 mo - eyes follow object to midline - vocalizes
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)