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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. Sx epiglottitis
Tdap - influenza - pneumovax
After delivery until delivery of placenta and membranes <30 mins
Stridor - drooling - toxic appearance
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

2. tx shoulder dystocia

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3. MCC blindness worldwide
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Cataracts
Oxygen intervention 15h/d
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

4. social interaction
Calcium oxalate crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

5. Cockcroft-Gault equation
Diabetes - HTN - GN
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6 yo

6. DOC for HTN in elderly
Thiazides
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Urticaria
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

7. GBS tx
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)
Calcium oxalate crystals
Anterior shoulder cannot readily pass below the pubic symphysis.

8. Screening for 65-76YO male smoker
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
110-160bpm
Aortic aneurysm

9. Dx bacterial vaginosis
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
Colchicine
MTX

10. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Biopsy
Ampicillin/sulbactam AND doxycycline

11. DDX for geriatric hearing impairment
Diphenhydramine - chlorpheniramine - hydroxyzine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Biopsy
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

12. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
<20lb - <1YO - Reacts to pain - Responds to noise
Steroids + bronchodilators
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

13. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Flexion - internal rotation - extension - external rotation
Measures strength of contractions
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

14. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ferrous sulfate 325mg tid
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
0.2-0.5mg aqueous EPI IM/SubQ

15. Other causes of hypercalcemia
Onset of labor until cervix dilation
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Pneumovax - influenza
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

16. X-ray on knee?
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Nicotine inhaler - nasal spray - gum
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

17. Third stage of labor
Monosodium urate crystals (gout)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
After delivery until delivery of placenta and membranes <30 mins
Thiazdes; lithium

18. stranger/separation anxiety
Diphenhydramine - chlorpheniramine - hydroxyzine
Ear pain - itching - inflammation/swollen canal - exudates/discharge
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Oxygen intervention 15h/d

19. Sx of hypercalcemia
Ceftriaxone 125mg IM
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diabetes - HTN - GN

20. medications causing hypercalcemia
Thiazdes; lithium
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Nuchal translucency - serum hCG - PAPP-A
Oxytocin (IV)

21. IUPC (intrauterine pressure catheter)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Fluoroquinolones
Measures strength of contractions

22. Immunizations for COPD patients
6 yo
MTX
DTaP - hepB - Hib - rotavirus - inactivated polio
Pneumovax - influenza

23. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Lung; SCC head & neck; RCC; breast; MM; prostate
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
NAC or IV NaHCO3
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

24. Improve short-term outcomes in acute exacerbations of COPD - asthma
16-18 weeks GA
Steroids + bronchodilators
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
2 mo - eyes follow object past midline - rolls over - laughs - squeals

25. Tx for thyroid storm
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Flexion - internal rotation - extension - external rotation
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

26. Fe deficient anemia tx
Ferrous sulfate 325mg tid
<20lb - <1YO - Reacts to pain - Responds to noise
Most aggressive melanoma.
Lung; SCC head & neck; RCC; breast; MM; prostate

27. Signs of rupture of membranes

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28. Pflx for traveler's diarrhea
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Prostatitis
Fluoroquinolones

29. Early deceleration
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Urinary calcium. Hyper PTH (high) >> FHH (normal)

30. social smile - parent recognition
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Diphenhydramine - chlorpheniramine - hydroxyzine

31. Tx acute sinusitis
= LMP + 7 days - 3 months
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Bathing - dressing - eating - transferring - continence - toileting
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

32. Regards human face - eye contact
Bupropion - varenicline - nicotine replacement
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium hydroxyapatite crystals
1 mo - eyes follow object to midline - vocalizes

33. parallel play
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)
Steroids + bronchodilators
Lung; SCC head & neck; RCC; breast; MM; prostate
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

34. needles - strong negative birefringent (yellow crystals parallel light)
Aortic aneurysm
Ampicillin/sulbactam AND doxycycline
Monosodium urate crystals (gout)
5+ rads

35. First stage of labor
Lung; SCC head & neck; RCC; breast; MM; prostate
Onset of labor until cervix dilation
Loratadine - fexofenadine - cetirizine
Urticaria

36. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

37. Superficial spreading melanoma
Metronidazole or clindamycin
MCC melanoma. Radial growth.
Short-acting + 40mg prednisone x 10-14days
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

38. Tx chlamydia
Urticaria
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Anemia
Ofloxacin OR levofloxacin +/- metronidazole

39. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Oxytocin (IV)

40. cystoplasmic inclusions - not birefringent
Ampicillin/sulbactam AND doxycycline
Ferrous sulfate 325mg tid
Calcium hydroxyapatite crystals
Thiazides

41. writes name - counts 10 objects
Bathing - dressing - eating - transferring - continence - toileting
Prostatitis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
5 yo - draws person - ties shoes - skips

42. Nonfunctioning nodules > 1cm require _____
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Biopsy
Thiazdes; lithium

43. Augments contractions
Calcium oxalate crystals
Angioedema
Thiazides
Oxytocin (IV)

44. Tx gonorrhea
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ceftriaxone 125mg IM
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

45. Four cardinal fetal movements
Diabetes - HTN - GN
Calcium hydroxyapatite crystals
(ofloxacin OR levofloxacin) +/- metronidazole
Flexion - internal rotation - extension - external rotation

46. Rod shaped - rhomboid - weakly positive birefringent
Angioedema
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Calcium pyrophosphate dehydrate crystals (pseudogout)

47. Sx otitis externa
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diphenhydramine - chlorpheniramine - hydroxyzine
= LMP + 7 days - 3 months
Ear pain - itching - inflammation/swollen canal - exudates/discharge

48. Second stage of labor
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Short-acting + 40mg prednisone x 10-14days
5+ rads
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

49. Immunizations for adult 65YO+
Bathing - dressing - eating - transferring - continence - toileting
Stridor - drooling - toxic appearance
Long axis of fetus to long axis of mother (longitudinal or transverse)
Tdap - influenza - pneumovax

50. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry