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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. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Cataracts
Bupropion - varenicline - nicotine replacement
Colchicine

2. DOC for HTN in elderly
5+ rads
Thiazides
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Anterior shoulder cannot readily pass below the pubic symphysis.

3. medications causing hypercalcemia
Anemia
Thiazdes; lithium
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
= LMP + 7 days - 3 months

4. Other causes of hypercalcemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
(cefotetan OR cefoxitin) AND doxycycline
Angioedema
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

5. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Steroids + bronchodilators
110-160bpm
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

6. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ampicillin/sulbactam AND doxycycline
NAC or IV NaHCO3
MCC melanoma in Africans/Asians. Under nails - soles - palms.

7. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Measures strength of contractions
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium hydroxyapatite crystals

8. Complications of GAS infxn
16-18 weeks GA
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Calcium oxalate crystals
Urticaria

9. Electrolyte abnormality that increases the incidence of torsades de pointes
DTaP - hepB - Hib - rotavirus - inactivated polio
Starts at contraction. caused by increased vagal tone from fetal head compression.
Hypomagnesemia
Long axis of fetus to long axis of mother (longitudinal or transverse)

10. Bacteria causing chronic sinusitis
Flexion - internal rotation - extension - external rotation
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

11. stranger/separation anxiety
Nicotine inhaler - nasal spray - gum
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Calcium oxalate crystals
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

12. IUPC (intrauterine pressure catheter)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Measures strength of contractions

13. complications of otitis media
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Angioedema
Oxygen intervention 15h/d
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

14. Tender - boggy prostate. Dx?
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate
Prostatitis
MTX

15. Tx acute sinusitis
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)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Clindamycin AND gentamicin
Short-acting + 40mg prednisone x 10-14days

16. 1st generation antihistamines
1 mo - eyes follow object to midline - vocalizes
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Diphenhydramine - chlorpheniramine - hydroxyzine
Anaphylaxis

17. Dx criteria for RA
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
MCC melanoma. Radial growth.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Long axis of fetus to long axis of mother (longitudinal or transverse)

18. social smile - parent recognition
Diabetes - HTN - GN
Patch - bupropion - varenicline
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Short-acting + 40mg prednisone x 10-14days

19. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Most aggressive melanoma.

20. recognizes strangers
Most aggressive melanoma.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Starts at contraction. caused by increased vagal tone from fetal head compression.

21. CKD Stages
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)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Oxygen intervention 15h/d
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

22. 2nd generation antihistamines
Esophagitis - gastritis - dysphagia
Loratadine - fexofenadine - cetirizine
Long axis of fetus to long axis of mother (longitudinal or transverse)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

23. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Fluoroquinolones
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

24. tx shoulder dystocia

25. Tx chlamydia
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

26. Tx gonorrhea
Aortic aneurysm
Ceftriaxone 125mg IM
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
IV penicillin (or ampicillin)

27. Four cardinal fetal movements
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Flexion - internal rotation - extension - external rotation
5 yo - draws person - ties shoes - skips
Tuberculosis; sarcoidosis; hodgkin disease

28. Tx RA (best long-term outcome)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Prostatitis
Aortic aneurysm
MTX

29. Tx hyperkalemia in CKD
Anemia
Ampicillin/sulbactam AND doxycycline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Oxytocin (IV)

30. GBS tx
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Nicotine inhaler - nasal spray - gum
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
IV penicillin (or ampicillin)

31. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
9 mo - walks - throws - 1-3 words - 1-step commands
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Tuberculosis; sarcoidosis; hodgkin disease

32. Signs of rupture of membranes

33. Age by which child says 'mama' and 'dada'
<20lb - <1YO - Reacts to pain - Responds to noise
MTX
1 mo - eyes follow object to midline - vocalizes
6-9MO

34. presbycusis
(cefotetan OR cefoxitin) AND doxycycline
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

35. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Tuberculosis; sarcoidosis; hodgkin disease
Steroids + bronchodilators
Fe deficient anemia

36. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
5+ rads
Ferrous sulfate 325mg tid
Ceftriaxone 125mg IM

37. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Urticaria
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

38. Third stage of labor
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
After delivery until delivery of placenta and membranes <30 mins
9 mo - walks - throws - 1-3 words - 1-step commands
Fe deficient anemia

39. Unstable angina vs MI Dx tests
Alpha-1 antitrypsin deficiency
Starts at contraction. caused by increased vagal tone from fetal head compression.
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

40. Estimated delivery date (Naegele's rule)
Fe deficient anemia
Loratadine - fexofenadine - cetirizine
Colchicine
= LMP + 7 days - 3 months

41. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
MCC melanoma. Radial growth.
Measures strength of contractions
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

42. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise
Calcium oxalate crystals
MCC melanoma in Africans/Asians. Under nails - soles - palms.

43. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
110-160bpm

44. Rod shaped - rhomboid - weakly positive birefringent
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Patch - bupropion - varenicline

45. Complications of PID
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Cataracts
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

46. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Esophagitis - gastritis - dysphagia
Flexion - internal rotation - extension - external rotation
110-160bpm

47. Nonfunctioning nodules > 1cm require _____
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Biopsy
Starts at contraction. caused by increased vagal tone from fetal head compression.
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

48. Dx PID
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
NAC or IV NaHCO3
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Urticaria

49. Lentigo Maligna
Bathing - dressing - eating - transferring - continence - toileting
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

50. needles - strong negative birefringent (yellow crystals parallel light)
Onset of labor until cervix dilation
Monosodium urate crystals (gout)
Ofloxacin OR levofloxacin +/- metronidazole
DTaP - hepB - Hib - rotavirus - inactivated polio