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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 peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange
Ferrous sulfate 325mg tid

2. dyspnea - visceral edema - hypotension
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anaphylaxis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

3. Nodular melanoma
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Most aggressive melanoma.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

4. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Normal mental status; no other injuries; seen within 10 days of injury
Measures strength of contractions

5. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Calcium hydroxyapatite crystals
6 yo
Steroids + bronchodilators

6. GBS tx
IV penicillin (or ampicillin)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Biopsy

7. Smoking cessation agents
Tdap - influenza - pneumovax
Normal mental status; no other injuries; seen within 10 days of injury
9 mo - walks - throws - 1-3 words - 1-step commands
Bupropion - varenicline - nicotine replacement

8. social interaction
4 yo - copies triangle - catches ball - dresses self
Pneumovax - influenza
Urticaria
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

9. Sx epiglottitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
<20lb - <1YO - Reacts to pain - Responds to noise
Stridor - drooling - toxic appearance
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

10. Regards human face - eye contact
<20lb - <1YO - Reacts to pain - Responds to noise
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Long axis of fetus to long axis of mother (longitudinal or transverse)
1 mo - eyes follow object to midline - vocalizes

11. parallel play
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nuchal translucency - serum hCG - PAPP-A

12. Tx acute exacerbation COPD
5+ rads
Metronidazole or clindamycin
Short-acting + 40mg prednisone x 10-14days
Hypomagnesemia

13. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Pneumovax - influenza
Conrtaction monitoring along with fetal heart rate assessment
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

14. Pflx for traveler's diarrhea
Fluoroquinolones
110-160bpm
Onset of labor until cervix dilation
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

15. medications causing hypercalcemia
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Thiazdes; lithium
Patch - bupropion - varenicline
3 yo - identify body part - copies square - hops - throws - past tense - story telling

16. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Anaphylaxis
Fluoroquinolones

17. Oral tx for PID
Ceftriaxone 125mg IM
110-160bpm
Tdap - influenza - pneumovax
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

18. X-ray of ankle?
Prostatitis
Fluoroquinolones
Ceftriaxone 125mg IM
Normal mental status; no other injuries; seen within 10 days of injury

19. MONA therapy
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

20. Tx otitis media
Biopsy
Tdap - influenza - pneumovax
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

21. Tx for anaphylaxis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Bathing - dressing - eating - transferring - continence - toileting
0.2-0.5mg aqueous EPI IM/SubQ
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

22. Recommended folic acid daily dose
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Most aggressive melanoma.
Aortic aneurysm
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

23. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Lung; SCC head & neck; RCC; breast; MM; prostate
Calcium oxalate crystals
4 yo - copies triangle - catches ball - dresses self

24. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Ofloxacin OR levofloxacin +/- metronidazole
DTaP - hepB - Hib - rotavirus - inactivated polio
Short-acting + 40mg prednisone x 10-14days

25. Large - irregularly shaped - prutitic - erythematous wheals
Tuberculosis; sarcoidosis; hodgkin disease
Urticaria
Conrtaction monitoring along with fetal heart rate assessment
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

26. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
6-9MO
Oxytocin (IV)

27. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Flexion - internal rotation - extension - external rotation
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

28. Emphysema - <45YO - nonsmoker
Ampicillin/sulbactam AND doxycycline
Prostatitis
Alpha-1 antitrypsin deficiency
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. Recommendations for rear-facing car seat
Stridor - drooling - toxic appearance
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
<20lb - <1YO - Reacts to pain - Responds to noise
Flexion - internal rotation - extension - external rotation

30. tx shoulder dystocia

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31. 1st generation antihistamines
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
DTaP - hepB - Hib - rotavirus - inactivated polio
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Diphenhydramine - chlorpheniramine - hydroxyzine

32. Screening for 65-76YO male smoker
Aortic aneurysm
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ask - Advise - Assess - Assist - Arrange

33. Fe deficient anemia tx
MTX
Ferrous sulfate 325mg tid
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
After delivery until delivery of placenta and membranes <30 mins

34. Tx bacterial vaginosis
After delivery until delivery of placenta and membranes <30 mins
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Metronidazole or clindamycin
Ofloxacin OR levofloxacin +/- metronidazole

35. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ask - Advise - Assess - Assist - Arrange
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Prostatitis

36. Tx hyperkalemia in CKD
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Prostatitis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
9 mo - walks - throws - 1-3 words - 1-step commands

37. Sx otitis externa
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
6 yo

38. Unstable angina vs MI Dx tests
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Age-related sensorineural hearing loss (high frequency and speech discrimination)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

39. First stage of labor
Thiazdes; lithium
Onset of labor until cervix dilation
Prostatitis
Lung; SCC head & neck; RCC; breast; MM; prostate

40. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Fe deficient anemia
NAC or IV NaHCO3
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

41. writes name - counts 10 objects
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
5 yo - draws person - ties shoes - skips
Patch - bupropion - varenicline
(cefotetan OR cefoxitin) AND doxycycline

42. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Nicotine inhaler - nasal spray - gum
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Diphenhydramine - chlorpheniramine - hydroxyzine

43. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anemia

44. regards hand
Thiazides
4mo - sits unsupported - hand transfer - babbles
Flexion - internal rotation - extension - external rotation
Nuchal translucency - serum hCG - PAPP-A

45. 2nd generation antihistamines
Aortic aneurysm
Loratadine - fexofenadine - cetirizine
Diabetes - HTN - GN
Nicotine inhaler - nasal spray - gum

46. Low serum iron - low MCV - low ferritin - +stool guaiac
Angioedema
<20lb - <1YO - Reacts to pain - Responds to noise
Lung; SCC head & neck; RCC; breast; MM; prostate
Fe deficient anemia

47. needles - strong negative birefringent (yellow crystals parallel light)
Thiazdes; lithium
Monosodium urate crystals (gout)
5+ rads
IV penicillin (or ampicillin)

48. Dx criteria for RA
Esophagitis - gastritis - dysphagia
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Most aggressive melanoma.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

49. Sx otitis media
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Ceftriaxone 125mg IM
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

50. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6 yo
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR