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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. Bacteria causing chronic sinusitis
Steroids + bronchodilators
Fe deficient anemia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
MTX

2. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Fe deficient anemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
5 yo - draws person - ties shoes - skips

3. MCC blindness worldwide
Anemia
Cataracts
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Calcium pyrophosphate dehydrate crystals (pseudogout)

4. Corrected serum calcium =

5. Recommended folic acid daily dose
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
DTaP - hepB - Hib - rotavirus - inactivated polio
Loratadine - fexofenadine - cetirizine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

6. regards hand
4mo - sits unsupported - hand transfer - babbles
Bupropion - varenicline - nicotine replacement
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Long axis of fetus to long axis of mother (longitudinal or transverse)

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)
Most aggressive melanoma.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

8. DOC for HTN in elderly
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
NAC or IV NaHCO3
Thiazides

9. Sx epiglottitis
Oxytocin (IV)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Stridor - drooling - toxic appearance
MCC melanoma in Africans/Asians. Under nails - soles - palms.

10. X-ray of ankle?
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Normal mental status; no other injuries; seen within 10 days of injury
3 yo - identify body part - copies square - hops - throws - past tense - story telling
MCC melanoma. Radial growth.

11. Sx of hypercalcemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ask - Advise - Assess - Assist - Arrange
Ear pain - itching - inflammation/swollen canal - exudates/discharge

12. IUPC (intrauterine pressure catheter)
Patch - bupropion - varenicline
Tuberculosis; sarcoidosis; hodgkin disease
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Measures strength of contractions

13. Immunizations at visit for 6MO
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
DTaP - hepB - Hib - rotavirus - inactivated polio

14. Immunizations for COPD patients
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Pneumovax - influenza
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anterior shoulder cannot readily pass below the pubic symphysis.

15. recognizes strangers
MTX
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)
IV penicillin (or ampicillin)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

16. Second stage of labor
Long axis of fetus to long axis of mother (longitudinal or transverse)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

17. Other causes of hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
(cefotetan OR cefoxitin) AND doxycycline
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Alpha-1 antitrypsin deficiency

18. Large - irregularly shaped - prutitic - erythematous wheals
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Urticaria
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

19. Pregnancy class D smoking cessation drugs
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Normal mental status; no other injuries; seen within 10 days of injury
Nicotine inhaler - nasal spray - gum
Fluoroquinolones

20. Tx otitis media
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Measures strength of contractions
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Age-related sensorineural hearing loss (high frequency and speech discrimination)

21. Augments contractions
Oxytocin (IV)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Pneumovax - influenza
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

22. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Anaphylaxis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Calcium hydroxyapatite crystals

23. Tx for thyroid storm
MCC melanoma. Radial growth.
4mo - sits unsupported - hand transfer - babbles
= LMP + 7 days - 3 months
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

24. Dx PID
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Clindamycin AND gentamicin
6-9MO

25. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Bathing - dressing - eating - transferring - continence - toileting
<20lb - <1YO - Reacts to pain - Responds to noise
Alpha-1 antitrypsin deficiency

26. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anterior shoulder cannot readily pass below the pubic symphysis.

27. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Ferrous sulfate 325mg tid
Nuchal translucency - serum hCG - PAPP-A
Diabetes - HTN - GN

28. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Nuchal translucency - serum hCG - PAPP-A
Ferrous sulfate 325mg tid
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. Tx hyperkalemia in CKD
Normal mental status; no other injuries; seen within 10 days of injury
Urticaria
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

30. Fe deficient anemia tx
Ferrous sulfate 325mg tid
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

31. Bisphospohonates sfx
<20lb - <1YO - Reacts to pain - Responds to noise
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
4mo - sits unsupported - hand transfer - babbles
Esophagitis - gastritis - dysphagia

32. GBS tx
IV penicillin (or ampicillin)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Biopsy

33. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Measures strength of contractions
16-18 weeks GA
Calcium hydroxyapatite crystals

34. How much radiation is associated with fetal harm?
Normal mental status; no other injuries; seen within 10 days of injury
Short-acting + 40mg prednisone x 10-14days
Diabetes - HTN - GN
5+ rads

35. Improve short-term outcomes in acute exacerbations of COPD - asthma
1 mo - eyes follow object to midline - vocalizes
Metronidazole or clindamycin
Steroids + bronchodilators
Ferrous sulfate 325mg tid

36. complications of otitis media
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Hypomagnesemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Angioedema

37. 1st generation antihistamines
MCC melanoma in Africans/Asians. Under nails - soles - palms.
9 mo - walks - throws - 1-3 words - 1-step commands
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Diphenhydramine - chlorpheniramine - hydroxyzine

38. Oral tx for PID
Anterior shoulder cannot readily pass below the pubic symphysis.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Esophagitis - gastritis - dysphagia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

39. group play - gender - knows name
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
5+ rads
Conrtaction monitoring along with fetal heart rate assessment
3 yo - identify body part - copies square - hops - throws - past tense - story telling

40. Dx bacterial rhinosinusitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
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)

41. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
110-160bpm
Urinary calcium. Hyper PTH (high) >> FHH (normal)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

42. Tx RA (best long-term outcome)
Prostatitis
Ask - Advise - Assess - Assist - Arrange
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MTX

43. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
5 yo - draws person - ties shoes - skips
Anaphylaxis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

44. Estimated delivery date (Naegele's rule)
0.2-0.5mg aqueous EPI IM/SubQ
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Nicotine inhaler - nasal spray - gum
= LMP + 7 days - 3 months

45. Tx acute gout
Colchicine
Prostatitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Hypomagnesemia

46. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
Angioedema
NAC or IV NaHCO3
110-160bpm

47. IADL
Esophagitis - gastritis - dysphagia
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

48. painless - deep - subQ swelling (periorbital - circumoral - facial)
5+ rads
Anaphylaxis
Colchicine
Angioedema

49. cystoplasmic inclusions - not birefringent
4mo - sits unsupported - hand transfer - babbles
Calcium hydroxyapatite crystals
Short-acting + 40mg prednisone x 10-14days
Bupropion - varenicline - nicotine replacement

50. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
0.2-0.5mg aqueous EPI IM/SubQ
Monosodium urate crystals (gout)
Ask - Advise - Assess - Assist - Arrange