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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. Unstable angina vs MI Dx tests
Tuberculosis; sarcoidosis; hodgkin disease
Bathing - dressing - eating - transferring - continence - toileting
Anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

2. Corrected serum calcium =

3. Tx for thyroid storm
Nuchal translucency - serum hCG - PAPP-A
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Monosodium urate crystals (gout)
Aortic aneurysm

4. Tx acute sinusitis
Fluoroquinolones
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Monosodium urate crystals (gout)

5. Dx PID
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
5 yo - draws person - ties shoes - skips

6. Regards human face - eye contact
(cefotetan OR cefoxitin) AND doxycycline
Flexion - internal rotation - extension - external rotation
1 mo - eyes follow object to midline - vocalizes
Biopsy

7. Immunizations at visit for 6MO
After delivery until delivery of placenta and membranes <30 mins
Nicotine inhaler - nasal spray - gum
<20lb - <1YO - Reacts to pain - Responds to noise
DTaP - hepB - Hib - rotavirus - inactivated polio

8. Tx hyperkalemia in CKD
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anterior shoulder cannot readily pass below the pubic symphysis.
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

9. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Calcium hydroxyapatite crystals
16-18 weeks GA

10. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nicotine inhaler - nasal spray - gum
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Onset of labor until cervix dilation

11. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
(cefotetan OR cefoxitin) AND doxycycline
Ceftriaxone 125mg IM
Most aggressive melanoma.

12. IV tx for PID
Loratadine - fexofenadine - cetirizine
Ofloxacin OR levofloxacin +/- metronidazole
Lung; SCC head & neck; RCC; breast; MM; prostate
Conrtaction monitoring along with fetal heart rate assessment

13. Recommendations for rear-facing car seat
2 mo - eyes follow object past midline - rolls over - laughs - squeals
<20lb - <1YO - Reacts to pain - Responds to noise
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Measures strength of contractions

14. Screened at 11-13 weeks GA for trisomy
Thiazdes; lithium
4mo - sits unsupported - hand transfer - babbles
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Nuchal translucency - serum hCG - PAPP-A

15. Nonfunctioning nodules > 1cm require _____
9 mo - walks - throws - 1-3 words - 1-step commands
Biopsy
16-18 weeks GA
Short-acting + 40mg prednisone x 10-14days

16. IUPC (intrauterine pressure catheter)
Steroids + bronchodilators
Oxytocin (IV)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Measures strength of contractions

17. Fe deficient anemia tx
Short-acting + 40mg prednisone x 10-14days
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ceftriaxone 125mg IM
Ferrous sulfate 325mg tid

18. stranger/separation anxiety
Pneumovax - influenza
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Metronidazole or clindamycin
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

19. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Onset of labor until cervix dilation
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

20. Pregnancy class D smoking cessation drugs
Esophagitis - gastritis - dysphagia
4 yo - copies triangle - catches ball - dresses self
Tuberculosis; sarcoidosis; hodgkin disease
Nicotine inhaler - nasal spray - gum

21. Late deceleration
Diabetes - HTN - GN
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Most aggressive melanoma.
0.2-0.5mg aqueous EPI IM/SubQ

22. Optimal time for trisomy screen
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA

23. Complications of PID
Diabetes - HTN - GN
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Tuberculosis; sarcoidosis; hodgkin disease

24. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Onset of labor until cervix dilation
Measures strength of contractions
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

25. IV tx for PID
6 yo
Alpha-1 antitrypsin deficiency
Anaphylaxis
Clindamycin AND gentamicin

26. Fetal lie
IV penicillin (or ampicillin)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ferrous sulfate 325mg tid
Long axis of fetus to long axis of mother (longitudinal or transverse)

27. shoulder dystocia
Oxygen intervention 15h/d
Anterior shoulder cannot readily pass below the pubic symphysis.
Most aggressive melanoma.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

28. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Short-acting + 40mg prednisone x 10-14days
Ferrous sulfate 325mg tid

29. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ceftriaxone 125mg IM
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

30. Dx criteria for RA
Onset of labor until cervix dilation
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

31. Second stage of labor
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)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
NAC or IV NaHCO3
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

32. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Diphenhydramine - chlorpheniramine - hydroxyzine
4mo - sits unsupported - hand transfer - babbles
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

33. Screened at 16-20 weeks GA for trisomy
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Onset of labor until cervix dilation
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

34. Tx otitis media
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

35. Improve short-term outcomes in acute exacerbations of COPD - asthma
= LMP + 7 days - 3 months
Ceftriaxone 125mg IM
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Steroids + bronchodilators

36. identifies left - right
IV penicillin (or ampicillin)
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)
DTaP - hepB - Hib - rotavirus - inactivated polio
6 yo

37. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
4mo - sits unsupported - hand transfer - babbles
Anterior shoulder cannot readily pass below the pubic symphysis.

38. Signs of rupture of membranes

39. MCC blindness worldwide
Onset of labor until cervix dilation
Ferrous sulfate 325mg tid
Flexion - internal rotation - extension - external rotation
Cataracts

40. Immunizations for adult 65YO+
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Tdap - influenza - pneumovax
Biopsy
Diabetes - HTN - GN

41. Lentigo Maligna
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Measures strength of contractions
Diabetes - HTN - GN
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

42. Estimated delivery date (Naegele's rule)
Measures strength of contractions
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
5 yo - draws person - ties shoes - skips
= LMP + 7 days - 3 months

43. Tx GAS ifxn
After delivery until delivery of placenta and membranes <30 mins
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

44. parallel play
IV penicillin (or ampicillin)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Monosodium urate crystals (gout)
Bupropion - varenicline - nicotine replacement

45. ADL
Bupropion - varenicline - nicotine replacement
Bathing - dressing - eating - transferring - continence - toileting
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
6 mo - pincer - crawls - cruises - mamma - dada - byebye

46. Four cardinal fetal movements
NAC or IV NaHCO3
Colchicine
Biopsy
Flexion - internal rotation - extension - external rotation

47. dyspnea - visceral edema - hypotension
Anaphylaxis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

48. Pregnancy class C smoking cessation drugs
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
6-9MO
Patch - bupropion - varenicline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

49. Sx otitis externa
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Calcium hydroxyapatite crystals
IV penicillin (or ampicillin)

50. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Clindamycin AND gentamicin
Pneumovax - influenza
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption