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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. complications of otitis media
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Patch - bupropion - varenicline
Cataracts
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

2. 1st generation antihistamines
IV penicillin (or ampicillin)
Diphenhydramine - chlorpheniramine - hydroxyzine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

3. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ofloxacin OR levofloxacin +/- metronidazole

4. First stage of labor
1 mo - eyes follow object to midline - vocalizes
16-18 weeks GA
Onset of labor until cervix dilation
3 yo - identify body part - copies square - hops - throws - past tense - story telling

5. Tocodynamometer
Onset of labor until cervix dilation
4mo - sits unsupported - hand transfer - babbles
Conrtaction monitoring along with fetal heart rate assessment
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

6. Recommended folic acid daily dose
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

7. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
5 yo - draws person - ties shoes - skips
Age-related sensorineural hearing loss (high frequency and speech discrimination)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

8. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
110-160bpm
Cataracts

9. painless - deep - subQ swelling (periorbital - circumoral - facial)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ofloxacin OR levofloxacin +/- metronidazole
Angioedema
16-18 weeks GA

10. Tx bacterial vaginosis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Metronidazole or clindamycin
Oxytocin (IV)
Pneumovax - influenza

11. Tx gonorrhea
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anterior shoulder cannot readily pass below the pubic symphysis.
Ceftriaxone 125mg IM
Monosodium urate crystals (gout)

12. bacteria causing pharyngitis
Conrtaction monitoring along with fetal heart rate assessment
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
5+ rads

13. MONA therapy
Calcium pyrophosphate dehydrate crystals (pseudogout)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Bathing - dressing - eating - transferring - continence - toileting

14. How much radiation is associated with fetal harm?
5+ rads
Thiazides
6-9MO
4 yo - copies triangle - catches ball - dresses self

15. Sx otitis media
NAC or IV NaHCO3
Urticaria
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Tuberculosis; sarcoidosis; hodgkin disease

16. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Bupropion - varenicline - nicotine replacement
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tuberculosis; sarcoidosis; hodgkin disease

17. Sx otitis externa
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)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Alpha-1 antitrypsin deficiency

18. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
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)
Thiazdes; lithium
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

19. Fe deficient anemia tx
Calcium hydroxyapatite crystals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ferrous sulfate 325mg tid
(ofloxacin OR levofloxacin) +/- metronidazole

20. tx shoulder dystocia

21. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
After delivery until delivery of placenta and membranes <30 mins
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

22. identifies left - right
Patch - bupropion - varenicline
2 mo - eyes follow object past midline - rolls over - laughs - squeals
After delivery until delivery of placenta and membranes <30 mins
6 yo

23. Tx GAS ifxn
1 mo - eyes follow object to midline - vocalizes
Aortic aneurysm
Biopsy
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

24. Tx acute exacerbation COPD
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Most aggressive melanoma.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Short-acting + 40mg prednisone x 10-14days

25. IV tx for PID
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ofloxacin OR levofloxacin +/- metronidazole
Stridor - drooling - toxic appearance

26. Immunizations for COPD patients
Pneumovax - influenza
Onset of labor until cervix dilation
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Bathing - dressing - eating - transferring - continence - toileting

27. dyspnea - visceral edema - hypotension
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
4mo - sits unsupported - hand transfer - babbles
Anaphylaxis
Pneumovax - influenza

28. Unstable angina vs MI Dx tests
6 yo
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

29. Third stage of labor
Pneumovax - influenza
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
After delivery until delivery of placenta and membranes <30 mins

30. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
After delivery until delivery of placenta and membranes <30 mins
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

31. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Short-acting + 40mg prednisone x 10-14days
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

32. Tx RA (best long-term outcome)
MTX
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Fluoroquinolones
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

33. Tx otitis media
Metronidazole or clindamycin
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Prostatitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

34. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Flexion - internal rotation - extension - external rotation

35. Augments contractions
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Oxytocin (IV)
Starts at contraction. caused by increased vagal tone from fetal head compression.
4 yo - copies triangle - catches ball - dresses self

36. Screened at 11-13 weeks GA for trisomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nuchal translucency - serum hCG - PAPP-A
Pneumovax - influenza

37. Tx for thyroid storm
4 yo - copies triangle - catches ball - dresses self
Calcium hydroxyapatite crystals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

38. Age by which child says 'mama' and 'dada'
Bupropion - varenicline - nicotine replacement
6-9MO
(cefotetan OR cefoxitin) AND doxycycline
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

39. shoulder dystocia
Biopsy
DTaP - hepB - Hib - rotavirus - inactivated polio
Most aggressive melanoma.
Anterior shoulder cannot readily pass below the pubic symphysis.

40. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(cefotetan OR cefoxitin) AND doxycycline
Conrtaction monitoring along with fetal heart rate assessment

41. Tx acute gout
5+ rads
Flexion - internal rotation - extension - external rotation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Colchicine

42. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Normal mental status; no other injuries; seen within 10 days of injury
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
(cefotetan OR cefoxitin) AND doxycycline

43. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Nuchal translucency - serum hCG - PAPP-A
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

44. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

45. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
4 yo - copies triangle - catches ball - dresses self
= LMP + 7 days - 3 months
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

46. Pflx for traveler's diarrhea
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Fluoroquinolones

47. Other causes of hypercalcemia
Colchicine
Diphenhydramine - chlorpheniramine - hydroxyzine
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5 yo - draws person - ties shoes - skips

48. Optimal time for trisomy screen
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Anaphylaxis
16-18 weeks GA

49. Immunizations for adult 65YO+
Ampicillin/sulbactam AND doxycycline
Tdap - influenza - pneumovax
16-18 weeks GA
Long axis of fetus to long axis of mother (longitudinal or transverse)

50. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1 mo - eyes follow object to midline - vocalizes
Anaphylaxis