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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. Regards human face - eye contact
Short-acting + 40mg prednisone x 10-14days
Oxytocin (IV)
Thiazides
1 mo - eyes follow object to midline - vocalizes

2. Signs of rupture of membranes

3. Tx GAS ifxn
NAC or IV NaHCO3
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Calcium hydroxyapatite crystals
Most aggressive melanoma.

4. bipyramidal - strongly positive birefringent
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium oxalate crystals
Metronidazole or clindamycin
Onset of labor until cervix dilation

5. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Diphenhydramine - chlorpheniramine - hydroxyzine
Lung; SCC head & neck; RCC; breast; MM; prostate

6. How much radiation is associated with fetal harm?
5+ rads
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Nicotine inhaler - nasal spray - gum
DTaP - hepB - Hib - rotavirus - inactivated polio

7. Pflx for traveler's diarrhea
Nuchal translucency - serum hCG - PAPP-A
Diabetes - HTN - GN
After delivery until delivery of placenta and membranes <30 mins
Fluoroquinolones

8. Dx bacterial vaginosis
Most aggressive melanoma.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

9. IV tx for PID
Ask - Advise - Assess - Assist - Arrange
(cefotetan OR cefoxitin) AND doxycycline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

10. Bisphospohonates sfx
MCC melanoma. Radial growth.
Esophagitis - gastritis - dysphagia
Oxygen intervention 15h/d
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

11. DDX for geriatric hearing impairment
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
5 yo - draws person - ties shoes - skips
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

12. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Tuberculosis; sarcoidosis; hodgkin disease
1 mo - eyes follow object to midline - vocalizes

13. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
3 yo - identify body part - copies square - hops - throws - past tense - story telling

14. Cockcroft-Gault equation
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Colchicine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Onset of labor until cervix dilation

15. Nodular melanoma
Calcium oxalate crystals
Anaphylaxis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Most aggressive melanoma.

16. presbycusis
5+ rads
Conrtaction monitoring along with fetal heart rate assessment
Fe deficient anemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)

17. shoulder dystocia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Anterior shoulder cannot readily pass below the pubic symphysis.
5+ rads
2 mo - eyes follow object past midline - rolls over - laughs - squeals

18. Augments contractions
Aortic aneurysm
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Oxytocin (IV)

19. Tx gonorrhea
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Thiazides
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ceftriaxone 125mg IM

20. Sx epiglottitis
6 yo
Oxytocin (IV)
Stridor - drooling - toxic appearance
Fluoroquinolones

21. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
16-18 weeks GA
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

22. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Tuberculosis; sarcoidosis; hodgkin disease
Clindamycin AND gentamicin
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

23. identifies left - right
Calcium hydroxyapatite crystals
<20lb - <1YO - Reacts to pain - Responds to noise
6 yo
Ofloxacin OR levofloxacin +/- metronidazole

24. IV tx for PID
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Metronidazole or clindamycin
Ofloxacin OR levofloxacin +/- metronidazole
Anaphylaxis

25. X-ray of ankle?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stridor - drooling - toxic appearance
Normal mental status; no other injuries; seen within 10 days of injury
Monosodium urate crystals (gout)

26. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stridor - drooling - toxic appearance
Nuchal translucency - serum hCG - PAPP-A
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

27. tx shoulder dystocia

28. Age by which child says 'mama' and 'dada'
6-9MO
MCC melanoma. Radial growth.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Clindamycin AND gentamicin

29. bacteria causing pharyngitis
Cataracts
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

30. 2nd generation antihistamines
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
(ofloxacin OR levofloxacin) +/- metronidazole
Ferrous sulfate 325mg tid
Loratadine - fexofenadine - cetirizine

31. Dx bacterial rhinosinusitis
6 yo
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)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

32. explorations
Aortic aneurysm
Prostatitis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
9 mo - walks - throws - 1-3 words - 1-step commands

33. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Patch - bupropion - varenicline
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

34. Sx of hypercalcemia
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)
Bathing - dressing - eating - transferring - continence - toileting
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

35. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
1 mo - eyes follow object to midline - vocalizes
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Bupropion - varenicline - nicotine replacement

36. cystoplasmic inclusions - not birefringent
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Calcium hydroxyapatite crystals
110-160bpm
= LMP + 7 days - 3 months

37. Second stage of labor
Anaphylaxis
16-18 weeks GA
Calcium pyrophosphate dehydrate crystals (pseudogout)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

38. CKD Stages
= LMP + 7 days - 3 months
Thiazdes; lithium
6 yo
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. IV tx for PID
Nuchal translucency - serum hCG - PAPP-A
Ampicillin/sulbactam AND doxycycline
Ceftriaxone 125mg IM
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

40. Pregnancy class C smoking cessation drugs
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Patch - bupropion - varenicline
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

41. Superficial spreading melanoma
Oxygen intervention 15h/d
Pneumovax - influenza
MCC melanoma. Radial growth.
Monosodium urate crystals (gout)

42. Tocodynamometer
16-18 weeks GA
Anaphylaxis
Conrtaction monitoring along with fetal heart rate assessment
Angioedema

43. needles - strong negative birefringent (yellow crystals parallel light)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Monosodium urate crystals (gout)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Clindamycin AND gentamicin

44. Smoking cessation agents
Flexion - internal rotation - extension - external rotation
Bupropion - varenicline - nicotine replacement
Angioedema
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

45. painless - deep - subQ swelling (periorbital - circumoral - facial)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Angioedema
Ofloxacin OR levofloxacin +/- metronidazole
Cataracts

46. DOC for HTN in elderly
Thiazides
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Anterior shoulder cannot readily pass below the pubic symphysis.

47. Improve short-term outcomes in acute exacerbations of COPD - asthma
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
NAC or IV NaHCO3
Steroids + bronchodilators

48. Pregnancy class D smoking cessation drugs
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)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Nicotine inhaler - nasal spray - gum

49. Estimated delivery date (Naegele's rule)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Pneumovax - influenza
= LMP + 7 days - 3 months
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

50. MCC blindness worldwide
Oxytocin (IV)
Cataracts
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)