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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. Pflx for traveler's diarrhea
Anaphylaxis
Thiazdes; lithium
Fluoroquinolones
<20lb - <1YO - Reacts to pain - Responds to noise

2. bipyramidal - strongly positive birefringent
5+ rads
Calcium oxalate crystals
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stridor - drooling - toxic appearance

3. ADL
Bathing - dressing - eating - transferring - continence - toileting
Bupropion - varenicline - nicotine replacement
Monosodium urate crystals (gout)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

4. IV tx for PID
Ampicillin/sulbactam AND doxycycline
4 yo - copies triangle - catches ball - dresses self
Biopsy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

5. Bisphospohonates sfx
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
16-18 weeks GA
Esophagitis - gastritis - dysphagia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

6. regards hand
6 mo - pincer - crawls - cruises - mamma - dada - byebye
(ofloxacin OR levofloxacin) +/- metronidazole
4mo - sits unsupported - hand transfer - babbles
Starts at contraction. caused by increased vagal tone from fetal head compression.

7. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
Tuberculosis; sarcoidosis; hodgkin disease
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
6-9MO

8. IADL
Nuchal translucency - serum hCG - PAPP-A
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Diphenhydramine - chlorpheniramine - hydroxyzine
Most aggressive melanoma.

9. bacteria causing pharyngitis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Metronidazole or clindamycin

10. Lentigo Maligna
Alpha-1 antitrypsin deficiency
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
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)
Most aggressive melanoma.

11. Fe deficient anemia tx
Bathing - dressing - eating - transferring - continence - toileting
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ferrous sulfate 325mg tid
4mo - sits unsupported - hand transfer - babbles

12. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
6 mo - pincer - crawls - cruises - mamma - dada - byebye

13. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Lung; SCC head & neck; RCC; breast; MM; prostate
= LMP + 7 days - 3 months
Cataracts

14. Pregnancy class C smoking cessation drugs
<20lb - <1YO - Reacts to pain - Responds to noise
Patch - bupropion - varenicline
Steroids + bronchodilators
Diphenhydramine - chlorpheniramine - hydroxyzine

15. Tx bacterial vaginosis
Metronidazole or clindamycin
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
(ofloxacin OR levofloxacin) +/- metronidazole

16. shoulder dystocia
IV penicillin (or ampicillin)
Anterior shoulder cannot readily pass below the pubic symphysis.
Thiazides
Anaphylaxis

17. Screening for 65-76YO male smoker
5 yo - draws person - ties shoes - skips
Aortic aneurysm
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Diphenhydramine - chlorpheniramine - hydroxyzine

18. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
1 mo - eyes follow object to midline - vocalizes
Tdap - influenza - pneumovax
(cefotetan OR cefoxitin) AND doxycycline

19. Sx of hypercalcemia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Diphenhydramine - chlorpheniramine - hydroxyzine
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

20. Improve short-term outcomes in acute exacerbations of COPD - asthma
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Esophagitis - gastritis - dysphagia
5+ rads
Steroids + bronchodilators

21. cystoplasmic inclusions - not birefringent
NAC or IV NaHCO3
Calcium hydroxyapatite crystals
Thiazdes; lithium
16-18 weeks GA

22. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Fluoroquinolones
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anemia

23. 2nd generation antihistamines
5+ rads
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Loratadine - fexofenadine - cetirizine
Bathing - dressing - eating - transferring - continence - toileting

24. Electrolyte abnormality that increases the incidence of torsades de pointes
Metronidazole or clindamycin
Hypomagnesemia
Patch - bupropion - varenicline
0.2-0.5mg aqueous EPI IM/SubQ

25. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Monosodium urate crystals (gout)
1 mo - eyes follow object to midline - vocalizes

26. Immunizations for adult 65YO+
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Esophagitis - gastritis - dysphagia
Tdap - influenza - pneumovax
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

27. Dx bacterial rhinosinusitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Measures strength of contractions
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)
(cefotetan OR cefoxitin) AND doxycycline

28. Tx otitis media
Ceftriaxone 125mg IM
Bupropion - varenicline - nicotine replacement
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium oxalate crystals

29. Oral tx for PID
Thiazides
(cefotetan OR cefoxitin) AND doxycycline
Anaphylaxis
(ofloxacin OR levofloxacin) +/- metronidazole

30. GBS tx
IV penicillin (or ampicillin)
16-18 weeks GA
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

31. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Aortic aneurysm
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Fluoroquinolones

32. parallel play
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

33. 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)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

34. social smile - parent recognition
Fe deficient anemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Calcium pyrophosphate dehydrate crystals (pseudogout)

35. Tx RA (best long-term outcome)
After delivery until delivery of placenta and membranes <30 mins
MTX
Thiazides
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

36. X-ray of ankle?
(cefotetan OR cefoxitin) AND doxycycline
Thiazdes; lithium
Ask - Advise - Assess - Assist - Arrange
Normal mental status; no other injuries; seen within 10 days of injury

37. 1st generation antihistamines
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Fe deficient anemia
Diphenhydramine - chlorpheniramine - hydroxyzine
Nuchal translucency - serum hCG - PAPP-A

38. DOC for HTN in elderly
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Conrtaction monitoring along with fetal heart rate assessment
Thiazides

39. The five A's of smoking cessation
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ask - Advise - Assess - Assist - Arrange
9 mo - walks - throws - 1-3 words - 1-step commands
Angioedema

40. Oral tx for PID
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

41. painless - deep - subQ swelling (periorbital - circumoral - facial)
110-160bpm
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Angioedema
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

42. Optimal time for trisomy screen
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Steroids + bronchodilators
16-18 weeks GA
4 yo - copies triangle - catches ball - dresses self

43. writes name - counts 10 objects
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
5 yo - draws person - ties shoes - skips
Loratadine - fexofenadine - cetirizine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

44. Late deceleration
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Colchicine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
MCC melanoma in Africans/Asians. Under nails - soles - palms.

45. Fetal lie
0.2-0.5mg aqueous EPI IM/SubQ
NAC or IV NaHCO3
Patch - bupropion - varenicline
Long axis of fetus to long axis of mother (longitudinal or transverse)

46. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
6-9MO
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
16-18 weeks GA

47. Four cardinal fetal movements
Diabetes - HTN - GN
After delivery until delivery of placenta and membranes <30 mins
Flexion - internal rotation - extension - external rotation
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

48. Tx for thyroid storm
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
After delivery until delivery of placenta and membranes <30 mins
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

49. Estimated delivery date (Naegele's rule)
Tuberculosis; sarcoidosis; hodgkin disease
Fluoroquinolones
= LMP + 7 days - 3 months
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

50. Only therapy to decrease mortality in stage IV COPD
Hypomagnesemia
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Alpha-1 antitrypsin deficiency
Oxygen intervention 15h/d