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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 pharyngitis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Calcium hydroxyapatite crystals

2. Optimal time for trisomy screen
16-18 weeks GA
Anaphylaxis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Loratadine - fexofenadine - cetirizine

3. Improve short-term outcomes in acute exacerbations of COPD - asthma
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Angioedema
Bathing - dressing - eating - transferring - continence - toileting
Steroids + bronchodilators

4. Immunizations for COPD patients
Pneumovax - influenza
Anemia
Metronidazole or clindamycin
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

5. Tx for anaphylaxis
Anaphylaxis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Patch - bupropion - varenicline
0.2-0.5mg aqueous EPI IM/SubQ

6. Recommended folic acid daily dose
IV penicillin (or ampicillin)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Bupropion - varenicline - nicotine replacement
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

7. Third stage of labor
Ferrous sulfate 325mg tid
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
2 mo - eyes follow object past midline - rolls over - laughs - squeals
After delivery until delivery of placenta and membranes <30 mins

8. Augments contractions
Monosodium urate crystals (gout)
Nicotine inhaler - nasal spray - gum
Oxytocin (IV)
Long axis of fetus to long axis of mother (longitudinal or transverse)

9. IV tx for PID
MCC melanoma in Africans/Asians. Under nails - soles - palms.
6-9MO
Ampicillin/sulbactam AND doxycycline
Flexion - internal rotation - extension - external rotation

10. Complications of GAS infxn
Ferrous sulfate 325mg tid
Anemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Bupropion - varenicline - nicotine replacement

11. Tx acute sinusitis
Alpha-1 antitrypsin deficiency
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Colchicine
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

12. DOC for HTN in elderly
Thiazides
Lung; SCC head & neck; RCC; breast; MM; prostate
Biopsy
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

13. 1st generation antihistamines
Oxytocin (IV)
Calcium oxalate crystals
Diphenhydramine - chlorpheniramine - hydroxyzine
(cefotetan OR cefoxitin) AND doxycycline

14. dyspnea - visceral edema - hypotension
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anaphylaxis

15. regards hand
Bathing - dressing - eating - transferring - continence - toileting
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
4mo - sits unsupported - hand transfer - babbles
Cataracts

16. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
5 yo - draws person - ties shoes - skips
Prostatitis

17. tx shoulder dystocia

18. Screened at 16-20 weeks GA for trisomy
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Urticaria
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
4 yo - copies triangle - catches ball - dresses self

19. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
1 mo - eyes follow object to midline - vocalizes
Angioedema

20. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

21. cystoplasmic inclusions - not birefringent
= LMP + 7 days - 3 months
16-18 weeks GA
Ofloxacin OR levofloxacin +/- metronidazole
Calcium hydroxyapatite crystals

22. recognizes strangers
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
6 mo - pincer - crawls - cruises - mamma - dada - byebye
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Patch - bupropion - varenicline

23. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MTX
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Tuberculosis; sarcoidosis; hodgkin disease

24. Pregnancy class D smoking cessation drugs
Ceftriaxone 125mg IM
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Nicotine inhaler - nasal spray - gum
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

25. How much radiation is associated with fetal harm?
Colchicine
6 yo
Urinary calcium. Hyper PTH (high) >> FHH (normal)
5+ rads

26. Emphysema - <45YO - nonsmoker
Anemia
Alpha-1 antitrypsin deficiency
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
IV penicillin (or ampicillin)

27. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Thiazdes; lithium
Diphenhydramine - chlorpheniramine - hydroxyzine
Biopsy

28. 2nd generation antihistamines
Loratadine - fexofenadine - cetirizine
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Esophagitis - gastritis - dysphagia
Lung; SCC head & neck; RCC; breast; MM; prostate

29. Sx otitis externa
Calcium hydroxyapatite crystals
Most aggressive melanoma.
MCC melanoma. Radial growth.
Ear pain - itching - inflammation/swollen canal - exudates/discharge

30. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
NAC or IV NaHCO3

31. identifies left - right
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Normal mental status; no other injuries; seen within 10 days of injury
6 yo

32. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
9 mo - walks - throws - 1-3 words - 1-step commands
Ampicillin/sulbactam AND doxycycline
Stridor - drooling - toxic appearance

33. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
4 yo - copies triangle - catches ball - dresses self
IV penicillin (or ampicillin)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

34. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
(cefotetan OR cefoxitin) AND doxycycline
Anemia
MCC melanoma. Radial growth.

35. Pflx for traveler's diarrhea
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Anemia
Fluoroquinolones
16-18 weeks GA

36. Tx gonorrhea
Ceftriaxone 125mg IM
Steroids + bronchodilators
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Bupropion - varenicline - nicotine replacement

37. First stage of labor
Ofloxacin OR levofloxacin +/- metronidazole
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Onset of labor until cervix dilation

38. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Clindamycin AND gentamicin
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

39. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Ofloxacin OR levofloxacin +/- metronidazole
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Tdap - influenza - pneumovax

40. shoulder dystocia
Anemia
Anterior shoulder cannot readily pass below the pubic symphysis.
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

41. Complications of PID
Short-acting + 40mg prednisone x 10-14days
Biopsy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

42. Superficial spreading melanoma
After delivery until delivery of placenta and membranes <30 mins
MCC melanoma. Radial growth.
Clindamycin AND gentamicin
Short-acting + 40mg prednisone x 10-14days

43. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
16-18 weeks GA
(cefotetan OR cefoxitin) AND doxycycline
NAC or IV NaHCO3

44. Tx bacterial vaginosis
Metronidazole or clindamycin
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Loratadine - fexofenadine - cetirizine
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

45. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thiazdes; lithium
5+ rads
Ear pain - itching - inflammation/swollen canal - exudates/discharge

46. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Steroids + bronchodilators
3 yo - identify body part - copies square - hops - throws - past tense - story telling

47. Tx of traveler's diarrhea
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
<20lb - <1YO - Reacts to pain - Responds to noise

48. Nonfunctioning nodules > 1cm require _____
Biopsy
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

49. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Anterior shoulder cannot readily pass below the pubic symphysis.
4 yo - copies triangle - catches ball - dresses self

50. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
Measures strength of contractions
Urticaria
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name