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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. Tender - boggy prostate. Dx?
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
110-160bpm
Prostatitis
Ampicillin/sulbactam AND doxycycline

2. Sx peritonsillar abscess
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fluoroquinolones
Conrtaction monitoring along with fetal heart rate assessment
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

3. DDX for geriatric hearing impairment
<20lb - <1YO - Reacts to pain - Responds to noise
Ampicillin/sulbactam AND doxycycline
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

4. Fe deficient anemia tx
Stridor - drooling - toxic appearance
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Onset of labor until cervix dilation
Ferrous sulfate 325mg tid

5. Dx bacterial vaginosis
Ceftriaxone 125mg IM
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Normal mental status; no other injuries; seen within 10 days of injury

6. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(cefotetan OR cefoxitin) AND doxycycline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

7. Tx bacterial vaginosis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Metronidazole or clindamycin
Calcium oxalate crystals
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

8. MCC blindness worldwide
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Thiazdes; lithium
Oxytocin (IV)
Cataracts

9. Signs of rupture of membranes

10. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
2 mo - eyes follow object past midline - rolls over - laughs - squeals
3 yo - identify body part - copies square - hops - throws - past tense - story telling
After delivery until delivery of placenta and membranes <30 mins

11. presbycusis
Angioedema
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA

12. recognizes strangers
110-160bpm
Biopsy
Bupropion - varenicline - nicotine replacement
6 mo - pincer - crawls - cruises - mamma - dada - byebye

13. shoulder dystocia
Biopsy
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anterior shoulder cannot readily pass below the pubic symphysis.
Nicotine inhaler - nasal spray - gum

14. Acral lentinous melanoma
Biopsy
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Short-acting + 40mg prednisone x 10-14days

15. Nodular melanoma
Most aggressive melanoma.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
6-9MO
Diphenhydramine - chlorpheniramine - hydroxyzine

16. medications causing hypercalcemia
Thiazdes; lithium
Oxytocin (IV)
= LMP + 7 days - 3 months
Urticaria

17. cystoplasmic inclusions - not birefringent
Normal mental status; no other injuries; seen within 10 days of injury
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
After delivery until delivery of placenta and membranes <30 mins
Calcium hydroxyapatite crystals

18. Tx gonorrhea
5+ rads
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ceftriaxone 125mg IM
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

19. writes name - counts 10 objects
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Measures strength of contractions
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
5 yo - draws person - ties shoes - skips

20. IV tx for PID
(cefotetan OR cefoxitin) AND doxycycline
Tdap - influenza - pneumovax
Clindamycin AND gentamicin
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

21. stranger/separation anxiety
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Ampicillin/sulbactam AND doxycycline
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

22. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
MTX

23. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
0.2-0.5mg aqueous EPI IM/SubQ
Flexion - internal rotation - extension - external rotation
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

24. Sx of hypercalcemia
(ofloxacin OR levofloxacin) +/- metronidazole
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
IV penicillin (or ampicillin)
DTaP - hepB - Hib - rotavirus - inactivated polio

25. Tx for anaphylaxis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Loratadine - fexofenadine - cetirizine
0.2-0.5mg aqueous EPI IM/SubQ
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

26. 1st generation antihistamines
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Diphenhydramine - chlorpheniramine - hydroxyzine
Hypomagnesemia
Fe deficient anemia

27. Dx bacterial rhinosinusitis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Monosodium urate crystals (gout)
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)
Ampicillin/sulbactam AND doxycycline

28. Tx acute gout
Biopsy
Alpha-1 antitrypsin deficiency
Colchicine
Tdap - influenza - pneumovax

29. Corrected serum calcium =

30. First stage of labor
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Onset of labor until cervix dilation
Monosodium urate crystals (gout)
Fluoroquinolones

31. Tx acute exacerbation COPD
4 yo - copies triangle - catches ball - dresses self
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Short-acting + 40mg prednisone x 10-14days
Patch - bupropion - varenicline

32. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Hypomagnesemia
Onset of labor until cervix dilation

33. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ceftriaxone 125mg IM
Long axis of fetus to long axis of mother (longitudinal or transverse)

34. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
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)
Bathing - dressing - eating - transferring - continence - toileting

35. Oral tx for PID
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Bathing - dressing - eating - transferring - continence - toileting
(ofloxacin OR levofloxacin) +/- metronidazole

36. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
= LMP + 7 days - 3 months
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Fe deficient anemia

37. IV tx for PID
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ofloxacin OR levofloxacin +/- metronidazole
MTX
Ferrous sulfate 325mg tid

38. Sx otitis externa
4 yo - copies triangle - catches ball - dresses self
Nuchal translucency - serum hCG - PAPP-A
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ear pain - itching - inflammation/swollen canal - exudates/discharge

39. Tx RA (best long-term outcome)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
MTX
Measures strength of contractions

40. The five A's of smoking cessation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
6-9MO
Ask - Advise - Assess - Assist - Arrange
Patch - bupropion - varenicline

41. Malignancies with hypercalcemia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Lung; SCC head & neck; RCC; breast; MM; prostate
Patch - bupropion - varenicline
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

42. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Thiazdes; lithium
Ferrous sulfate 325mg tid
Ear pain - itching - inflammation/swollen canal - exudates/discharge

43. tx shoulder dystocia

44. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Diphenhydramine - chlorpheniramine - hydroxyzine
Angioedema
5 yo - draws person - ties shoes - skips

45. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Metronidazole or clindamycin
Esophagitis - gastritis - dysphagia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

46. group play - gender - knows name
Starts at contraction. caused by increased vagal tone from fetal head compression.
Angioedema
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

47. Complications of GAS infxn
Prostatitis
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Pneumovax - influenza
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

48. Pregnancy class D smoking cessation drugs
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Nicotine inhaler - nasal spray - gum
Monosodium urate crystals (gout)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

49. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ceftriaxone 125mg IM
Esophagitis - gastritis - dysphagia
Metronidazole or clindamycin

50. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
6 yo
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Angioedema