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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. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Thiazdes; lithium
Age-related sensorineural hearing loss (high frequency and speech discrimination)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

2. Sx of hypercalcemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
4 yo - copies triangle - catches ball - dresses self

3. IV tx for PID
IV penicillin (or ampicillin)
Ofloxacin OR levofloxacin +/- metronidazole
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Monosodium urate crystals (gout)

4. recognizes strangers
Thiazides
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Conrtaction monitoring along with fetal heart rate assessment

5. IADL
Patch - bupropion - varenicline
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Steroids + bronchodilators
Calcium pyrophosphate dehydrate crystals (pseudogout)

6. Unstable angina vs MI Dx tests
Bupropion - varenicline - nicotine replacement
Fe deficient anemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
= LMP + 7 days - 3 months

7. 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)
Anterior shoulder cannot readily pass below the pubic symphysis.
Metronidazole or clindamycin
NAC or IV NaHCO3

8. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Flexion - internal rotation - extension - external rotation
Thiazdes; lithium
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

9. Screening for 65-76YO male smoker
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Aortic aneurysm
Calcium hydroxyapatite crystals

10. Low serum iron - low MCV - low ferritin - +stool guaiac
Flexion - internal rotation - extension - external rotation
Fe deficient anemia
MCC melanoma. Radial growth.
Thiazides

11. Tx of traveler's diarrhea
Starts at contraction. caused by increased vagal tone from fetal head compression.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

12. Causes of CKD
MTX
Diabetes - HTN - GN
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ampicillin/sulbactam AND doxycycline

13. identifies left - right
Anemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6 yo

14. Recommended folic acid daily dose
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
9 mo - walks - throws - 1-3 words - 1-step commands
NAC or IV NaHCO3

15. Augments contractions
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Angioedema
Oxytocin (IV)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

16. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Normal mental status; no other injuries; seen within 10 days of injury
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Monosodium urate crystals (gout)

17. X-ray on knee?
Normal mental status; no other injuries; seen within 10 days of injury
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
6 yo
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

18. Only therapy to decrease mortality in stage IV COPD
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Oxygen intervention 15h/d
6-9MO
Ofloxacin OR levofloxacin +/- metronidazole

19. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
(ofloxacin OR levofloxacin) +/- metronidazole
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)

20. Corrected serum calcium =

21. Malignancies with hypercalcemia
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Lung; SCC head & neck; RCC; breast; MM; prostate
Thiazdes; lithium
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

22. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Alpha-1 antitrypsin deficiency
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

23. complications of otitis media
Loratadine - fexofenadine - cetirizine
Thiazdes; lithium
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Metronidazole or clindamycin

24. GBS tx
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ferrous sulfate 325mg tid
IV penicillin (or ampicillin)
Ask - Advise - Assess - Assist - Arrange

25. writes name - counts 10 objects
9 mo - walks - throws - 1-3 words - 1-step commands
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
(ofloxacin OR levofloxacin) +/- metronidazole
5 yo - draws person - ties shoes - skips

26. The five A's of smoking cessation
Calcium oxalate crystals
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Biopsy
Ask - Advise - Assess - Assist - Arrange

27. How much radiation is associated with fetal harm?
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
4 yo - copies triangle - catches ball - dresses self
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads

28. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
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)

29. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Thiazdes; lithium
Most aggressive melanoma.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

30. First stage of labor
= LMP + 7 days - 3 months
Colchicine
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Onset of labor until cervix dilation

31. IUPC (intrauterine pressure catheter)
NAC or IV NaHCO3
6-9MO
Measures strength of contractions
5 yo - draws person - ties shoes - skips

32. Pregnancy class D smoking cessation drugs
5+ rads
Calcium hydroxyapatite crystals
Esophagitis - gastritis - dysphagia
Nicotine inhaler - nasal spray - gum

33. Complications of PID
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Thiazdes; lithium

34. Tx acute exacerbation COPD
4 yo - copies triangle - catches ball - dresses self
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Short-acting + 40mg prednisone x 10-14days
Calcium pyrophosphate dehydrate crystals (pseudogout)

35. IV tx for PID
Clindamycin AND gentamicin
Thiazdes; lithium
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

36. dyspnea - visceral edema - hypotension
Anaphylaxis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
NAC or IV NaHCO3

37. Tx for thyroid storm
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
6 yo
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

38. Third stage of labor
Ampicillin/sulbactam AND doxycycline
After delivery until delivery of placenta and membranes <30 mins
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Monosodium urate crystals (gout)

39. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Hypomagnesemia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

40. ADL
Bathing - dressing - eating - transferring - continence - toileting
Flexion - internal rotation - extension - external rotation
Most aggressive melanoma.
Measures strength of contractions

41. Emphysema - <45YO - nonsmoker
Short-acting + 40mg prednisone x 10-14days
Alpha-1 antitrypsin deficiency
Bathing - dressing - eating - transferring - continence - toileting
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

42. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Hypomagnesemia
Anemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

43. Screened at 16-20 weeks GA for trisomy
DTaP - hepB - Hib - rotavirus - inactivated polio
Diphenhydramine - chlorpheniramine - hydroxyzine
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Monosodium urate crystals (gout)

44. Dx bacterial vaginosis
16-18 weeks GA
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Long axis of fetus to long axis of mother (longitudinal or transverse)

45. Fetal lie
Calcium pyrophosphate dehydrate crystals (pseudogout)
Lung; SCC head & neck; RCC; breast; MM; prostate
Colchicine
Long axis of fetus to long axis of mother (longitudinal or transverse)

46. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

47. Late deceleration
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

48. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
DTaP - hepB - Hib - rotavirus - inactivated polio
Diabetes - HTN - GN
Monosodium urate crystals (gout)

49. Immunizations at visit for 6MO
Thiazides
DTaP - hepB - Hib - rotavirus - inactivated polio
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Loratadine - fexofenadine - cetirizine

50. Screened at 11-13 weeks GA for trisomy
Urticaria
Nuchal translucency - serum hCG - PAPP-A
Onset of labor until cervix dilation
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat