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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. Second stage of labor
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
MTX
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

2. IUPC (intrauterine pressure catheter)
Thiazides
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Measures strength of contractions
Tuberculosis; sarcoidosis; hodgkin disease

3. Sx epiglottitis
6-9MO
Monosodium urate crystals (gout)
Stridor - drooling - toxic appearance
Colchicine

4. Mediators released in response to allergen
Age-related sensorineural hearing loss (high frequency and speech discrimination)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
= LMP + 7 days - 3 months

5. Screening for 65-76YO male smoker
Most aggressive melanoma.
Aortic aneurysm
NAC or IV NaHCO3
Pneumovax - influenza

6. Dx PID
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Loratadine - fexofenadine - cetirizine
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

7. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Alpha-1 antitrypsin deficiency
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Esophagitis - gastritis - dysphagia

8. shoulder dystocia
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 hydroxyapatite crystals
Angioedema
Anterior shoulder cannot readily pass below the pubic symphysis.

9. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Diphenhydramine - chlorpheniramine - hydroxyzine
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Starts at contraction. caused by increased vagal tone from fetal head compression.

10. Pflx for traveler's diarrhea
Fluoroquinolones
Flexion - internal rotation - extension - external rotation
5+ rads
Colchicine

11. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Colchicine
Steroids + bronchodilators
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

12. needles - strong negative birefringent (yellow crystals parallel light)
Patch - bupropion - varenicline
Monosodium urate crystals (gout)
Biopsy
Loratadine - fexofenadine - cetirizine

13. Tx bacterial vaginosis
Angioedema
Urticaria
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Metronidazole or clindamycin

14. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
MTX
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

15. Augments contractions
Conrtaction monitoring along with fetal heart rate assessment
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Measures strength of contractions
Oxytocin (IV)

16. Immunizations at visit for 6MO
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Patch - bupropion - varenicline
Monosodium urate crystals (gout)
DTaP - hepB - Hib - rotavirus - inactivated polio

17. How much radiation is associated with fetal harm?
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
5+ rads
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Anemia

18. dyspnea - visceral edema - hypotension
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anaphylaxis

19. Complications of GAS infxn
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)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Calcium oxalate crystals
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

20. stranger/separation anxiety
6 mo - pincer - crawls - cruises - mamma - dada - byebye
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Steroids + bronchodilators
Normal mental status; no other injuries; seen within 10 days of injury

21. 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)
Diabetes - HTN - GN
Nicotine inhaler - nasal spray - gum
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

22. writes name - counts 10 objects
Ofloxacin OR levofloxacin +/- metronidazole
5 yo - draws person - ties shoes - skips
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
6 mo - pincer - crawls - cruises - mamma - dada - byebye

23. Tx otitis media
Fe deficient anemia
Anaphylaxis
Nuchal translucency - serum hCG - PAPP-A
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

24. cystoplasmic inclusions - not birefringent
Angioedema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Calcium hydroxyapatite crystals
Colchicine

25. IADL
6 yo
110-160bpm
Ask - Advise - Assess - Assist - Arrange
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

26. Screened at 16-20 weeks GA for trisomy
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
(cefotetan OR cefoxitin) AND doxycycline

27. Acral lentinous melanoma
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
After delivery until delivery of placenta and membranes <30 mins
MCC melanoma in Africans/Asians. Under nails - soles - palms.

28. IV tx for PID
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ofloxacin OR levofloxacin +/- metronidazole
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

29. Tx hyperkalemia in CKD
110-160bpm
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Fe deficient anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

30. Oral tx for PID
5+ rads
(ofloxacin OR levofloxacin) +/- metronidazole
Onset of labor until cervix dilation
Tuberculosis; sarcoidosis; hodgkin disease

31. Bisphospohonates sfx
16-18 weeks GA
Fe deficient anemia
Esophagitis - gastritis - dysphagia
(cefotetan OR cefoxitin) AND doxycycline

32. Oral tx for PID
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
16-18 weeks GA
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

33. Only therapy to decrease mortality in stage IV COPD
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
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)
Oxygen intervention 15h/d

34. Fe deficient anemia tx
Onset of labor until cervix dilation
Bupropion - varenicline - nicotine replacement
Ferrous sulfate 325mg tid
Bathing - dressing - eating - transferring - continence - toileting

35. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Measures strength of contractions

36. Complications of PID
Prostatitis
Oxytocin (IV)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

37. social interaction
4 yo - copies triangle - catches ball - dresses self
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
Calcium oxalate crystals

38. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

39. recognizes strangers
Onset of labor until cervix dilation
Anemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
3 yo - identify body part - copies square - hops - throws - past tense - story telling

40. presbycusis
Stridor - drooling - toxic appearance
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Calcium hydroxyapatite crystals

41. Tx acute gout
Alpha-1 antitrypsin deficiency
Colchicine
Calcium pyrophosphate dehydrate crystals (pseudogout)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

42. Unstable angina vs MI Dx tests
6 mo - pincer - crawls - cruises - mamma - dada - byebye
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
= LMP + 7 days - 3 months
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

43. Tocodynamometer
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Conrtaction monitoring along with fetal heart rate assessment
Prostatitis

44. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diabetes - HTN - GN
Nuchal translucency - serum hCG - PAPP-A

45. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Oxytocin (IV)
Ferrous sulfate 325mg tid

46. Corrected serum calcium =

47. First stage of labor
Onset of labor until cervix dilation
Alpha-1 antitrypsin deficiency
Clindamycin AND gentamicin
Colchicine

48. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Diabetes - HTN - GN
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Patch - bupropion - varenicline

49. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
DTaP - hepB - Hib - rotavirus - inactivated polio
Calcium hydroxyapatite crystals

50. Recommendations for rear-facing car seat
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
16-18 weeks GA
<20lb - <1YO - Reacts to pain - Responds to noise