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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 20 minutes. 2 minutes extra for reading the instructions.
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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. explorations
Cataracts
Nicotine inhaler - nasal spray - gum
9 mo - walks - throws - 1-3 words - 1-step commands
Lung; SCC head & neck; RCC; breast; MM; prostate

2. dyspnea - visceral edema - hypotension
Oxygen intervention 15h/d
Loratadine - fexofenadine - cetirizine
Anaphylaxis
Anterior shoulder cannot readily pass below the pubic symphysis.

3. First stage of labor
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Onset of labor until cervix dilation

4. MONA therapy
Stridor - drooling - toxic appearance
(ofloxacin OR levofloxacin) +/- metronidazole
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
DTaP - hepB - Hib - rotavirus - inactivated polio

5. The five A's of smoking cessation
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium hydroxyapatite crystals
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ask - Advise - Assess - Assist - Arrange

6. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ampicillin/sulbactam AND doxycycline
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

7. Screened at 16-20 weeks GA for trisomy
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)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
1 mo - eyes follow object to midline - vocalizes
16-18 weeks GA

8. social smile - parent recognition
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

9. Optimal time for trisomy screen
Cataracts
16-18 weeks GA
Ferrous sulfate 325mg tid
Thiazdes; lithium

10. Oral tx for PID
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Nicotine inhaler - nasal spray - gum
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

11. Recommendations for rear-facing car seat
Measures strength of contractions
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
<20lb - <1YO - Reacts to pain - Responds to noise

12. bacteria causing pharyngitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Calcium oxalate crystals
4 yo - copies triangle - catches ball - dresses self

13. painless - deep - subQ swelling (periorbital - circumoral - facial)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ferrous sulfate 325mg tid
Angioedema

14. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
9 mo - walks - throws - 1-3 words - 1-step commands
Tuberculosis; sarcoidosis; hodgkin disease

15. Unstable angina vs MI Dx tests
Starts at contraction. caused by increased vagal tone from fetal head compression.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Pneumovax - influenza
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

16. Tx of traveler's diarrhea
Ferrous sulfate 325mg tid
Measures strength of contractions
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

17. needles - strong negative birefringent (yellow crystals parallel light)
Stridor - drooling - toxic appearance
After delivery until delivery of placenta and membranes <30 mins
Monosodium urate crystals (gout)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

18. Granulomatous causes of hypercalcemia
Prostatitis
4mo - sits unsupported - hand transfer - babbles
Tuberculosis; sarcoidosis; hodgkin disease
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

19. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Tdap - influenza - pneumovax
Urticaria

20. group play - gender - knows name
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ask - Advise - Assess - Assist - Arrange
Normal mental status; no other injuries; seen within 10 days of injury

21. Low serum iron - low MCV - low ferritin - +stool guaiac
Biopsy
Fe deficient anemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

22. Fe deficient anemia tx
Tdap - influenza - pneumovax
Ferrous sulfate 325mg tid
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Steroids + bronchodilators

23. CKD Stages
Colchicine
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
0.2-0.5mg aqueous EPI IM/SubQ
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

24. Smoking cessation agents
110-160bpm
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Bupropion - varenicline - nicotine replacement

25. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Esophagitis - gastritis - dysphagia
Fe deficient anemia
Nuchal translucency - serum hCG - PAPP-A

26. Screened at 11-13 weeks GA for trisomy
Clindamycin AND gentamicin
Anterior shoulder cannot readily pass below the pubic symphysis.
Nuchal translucency - serum hCG - PAPP-A
Ofloxacin OR levofloxacin +/- metronidazole

27. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
6 yo
DTaP - hepB - Hib - rotavirus - inactivated polio
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

28. Sx otitis media
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Calcium oxalate crystals

29. tx shoulder dystocia

30. Tx otitis media
Conrtaction monitoring along with fetal heart rate assessment
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
5+ rads
Clindamycin AND gentamicin

31. Cockcroft-Gault equation
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
110-160bpm
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

32. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
= LMP + 7 days - 3 months
Nicotine inhaler - nasal spray - gum

33. Late deceleration
(ofloxacin OR levofloxacin) +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thiazdes; lithium

34. bipyramidal - strongly positive birefringent
6-9MO
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Calcium oxalate crystals
Loratadine - fexofenadine - cetirizine

35. Complications of GAS infxn
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Angioedema

36. stranger/separation anxiety
Ear pain - itching - inflammation/swollen canal - exudates/discharge
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
4mo - sits unsupported - hand transfer - babbles
Measures strength of contractions

37. Tx RA (best long-term outcome)
NAC or IV NaHCO3
Aortic aneurysm
MTX
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

38. Tx GAS ifxn
Metronidazole or clindamycin
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
MTX
Bupropion - varenicline - nicotine replacement

39. Dx PID
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Hypomagnesemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ask - Advise - Assess - Assist - Arrange

40. Bacteria causing chronic sinusitis
DTaP - hepB - Hib - rotavirus - inactivated polio
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

41. shoulder dystocia
Prostatitis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Anterior shoulder cannot readily pass below the pubic symphysis.
Nicotine inhaler - nasal spray - gum

42. Corrected serum calcium =

43. Signs of rupture of membranes

44. Mediators released in response to allergen
Anemia
5 yo - draws person - ties shoes - skips
Cataracts
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

45. Pflx for traveler's diarrhea
Fluoroquinolones
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

46. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Stridor - drooling - toxic appearance
4 yo - copies triangle - catches ball - dresses self
Colchicine

47. Immunizations for COPD patients
Patch - bupropion - varenicline
Thiazdes; lithium
Ofloxacin OR levofloxacin +/- metronidazole
Pneumovax - influenza

48. Causes of CKD
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Bupropion - varenicline - nicotine replacement
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Diabetes - HTN - GN

49. Emphysema - <45YO - nonsmoker
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Most aggressive melanoma.
Alpha-1 antitrypsin deficiency
Nuchal translucency - serum hCG - PAPP-A

50. variable deceleration
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Nuchal translucency - serum hCG - PAPP-A
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Normal mental status; no other injuries; seen within 10 days of injury