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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. Pflx for traveler's diarrhea
Urticaria
Flexion - internal rotation - extension - external rotation
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Fluoroquinolones

2. Tx for anaphylaxis
Metronidazole or clindamycin
NAC or IV NaHCO3
0.2-0.5mg aqueous EPI IM/SubQ
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

3. CKD Stages
Measures strength of contractions
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
0.2-0.5mg aqueous EPI IM/SubQ

4. social smile - parent recognition
Bupropion - varenicline - nicotine replacement
Cataracts
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Alpha-1 antitrypsin deficiency

5. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
DTaP - hepB - Hib - rotavirus - inactivated polio
Ofloxacin OR levofloxacin +/- metronidazole
6 yo

6. X-ray of ankle?
Fe deficient anemia
Normal mental status; no other injuries; seen within 10 days of injury
Colchicine
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)

7. variable deceleration
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
<20lb - <1YO - Reacts to pain - Responds to noise
Ceftriaxone 125mg IM
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

8. Tx GAS ifxn
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Monosodium urate crystals (gout)
Oxytocin (IV)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

9. Fetal heart rate range
= LMP + 7 days - 3 months
110-160bpm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

10. Tocodynamometer
Calcium hydroxyapatite crystals
Conrtaction monitoring along with fetal heart rate assessment
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
4 yo - copies triangle - catches ball - dresses self

11. writes name - counts 10 objects
Colchicine
Bathing - dressing - eating - transferring - continence - toileting
Ceftriaxone 125mg IM
5 yo - draws person - ties shoes - skips

12. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Cataracts
Short-acting + 40mg prednisone x 10-14days
Oxytocin (IV)

13. Screening for 65-76YO male smoker
Ampicillin/sulbactam AND doxycycline
Aortic aneurysm
Anterior shoulder cannot readily pass below the pubic symphysis.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

14. Low serum iron - low MCV - low ferritin - +stool guaiac
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Fe deficient anemia
MCC melanoma. Radial growth.
Age-related sensorineural hearing loss (high frequency and speech discrimination)

15. X-ray on knee?
Urticaria
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ofloxacin OR levofloxacin +/- metronidazole

16. needles - strong negative birefringent (yellow crystals parallel light)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Monosodium urate crystals (gout)
Ask - Advise - Assess - Assist - Arrange
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

17. Bisphospohonates sfx
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Esophagitis - gastritis - dysphagia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

18. social interaction
4 yo - copies triangle - catches ball - dresses self
Diphenhydramine - chlorpheniramine - hydroxyzine
9 mo - walks - throws - 1-3 words - 1-step commands
Esophagitis - gastritis - dysphagia

19. Tx bacterial vaginosis
Flexion - internal rotation - extension - external rotation
Metronidazole or clindamycin
5+ rads
110-160bpm

20. IUPC (intrauterine pressure catheter)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Measures strength of contractions
Tuberculosis; sarcoidosis; hodgkin disease
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

21. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thiazides
1 mo - eyes follow object to midline - vocalizes

22. painless - deep - subQ swelling (periorbital - circumoral - facial)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Angioedema
Calcium hydroxyapatite crystals
Nuchal translucency - serum hCG - PAPP-A

23. Acral lentinous melanoma
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
MCC melanoma in Africans/Asians. Under nails - soles - palms.
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

24. Four cardinal fetal movements
Urticaria
Flexion - internal rotation - extension - external rotation
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

25. Electrolyte abnormality that increases the incidence of torsades de pointes
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ask - Advise - Assess - Assist - Arrange
Hypomagnesemia
Clindamycin AND gentamicin

26. Recommended folic acid daily dose
5 yo - draws person - ties shoes - skips
Fe deficient anemia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anaphylaxis

27. Late deceleration
Normal mental status; no other injuries; seen within 10 days of injury
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Age-related sensorineural hearing loss (high frequency and speech discrimination)
<20lb - <1YO - Reacts to pain - Responds to noise

28. complications of otitis media
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Monosodium urate crystals (gout)
After delivery until delivery of placenta and membranes <30 mins
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

29. Tx chlamydia
Anterior shoulder cannot readily pass below the pubic symphysis.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

30. Granulomatous causes of hypercalcemia
Bupropion - varenicline - nicotine replacement
Bathing - dressing - eating - transferring - continence - toileting
Tuberculosis; sarcoidosis; hodgkin disease
(cefotetan OR cefoxitin) AND doxycycline

31. Sx otitis externa
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
9 mo - walks - throws - 1-3 words - 1-step commands
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Anterior shoulder cannot readily pass below the pubic symphysis.

32. DOC for HTN in elderly
Thiazdes; lithium
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thiazides

33. shoulder dystocia
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Diphenhydramine - chlorpheniramine - hydroxyzine
Calcium hydroxyapatite crystals
Anterior shoulder cannot readily pass below the pubic symphysis.

34. Malignancies with hypercalcemia
Patch - bupropion - varenicline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Lung; SCC head & neck; RCC; breast; MM; prostate
110-160bpm

35. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

36. Estimated delivery date (Naegele's rule)
Hypomagnesemia
Nuchal translucency - serum hCG - PAPP-A
= LMP + 7 days - 3 months
Ceftriaxone 125mg IM

37. Signs of rupture of membranes

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38. ADL
Bathing - dressing - eating - transferring - continence - toileting
9 mo - walks - throws - 1-3 words - 1-step commands
Metronidazole or clindamycin
Steroids + bronchodilators

39. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Loratadine - fexofenadine - cetirizine
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Anemia

40. Oral tx for PID
2 mo - eyes follow object past midline - rolls over - laughs - squeals
(ofloxacin OR levofloxacin) +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

41. medications causing hypercalcemia
6-9MO
Thiazdes; lithium
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

42. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
NAC or IV NaHCO3
5 yo - draws person - ties shoes - skips
(ofloxacin OR levofloxacin) +/- metronidazole

43. Complications of PID
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ampicillin/sulbactam AND doxycycline
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

44. Screened at 11-13 weeks GA for trisomy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Nuchal translucency - serum hCG - PAPP-A
Fe deficient anemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)

45. Bacteria causing chronic sinusitis
Alpha-1 antitrypsin deficiency
Fluoroquinolones
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Angioedema

46. IV tx for PID
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ampicillin/sulbactam AND doxycycline
Diphenhydramine - chlorpheniramine - hydroxyzine
0.2-0.5mg aqueous EPI IM/SubQ

47. Smoking cessation agents
Thiazdes; lithium
Bupropion - varenicline - nicotine replacement
Urinary calcium. Hyper PTH (high) >> FHH (normal)
= LMP + 7 days - 3 months

48. DDX for geriatric hearing impairment
MCC melanoma in Africans/Asians. Under nails - soles - palms.
5+ rads
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

49. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
16-18 weeks GA
110-160bpm
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

50. Tx acute exacerbation COPD
Calcium oxalate crystals
Starts at contraction. caused by increased vagal tone from fetal head compression.
Stridor - drooling - toxic appearance
Short-acting + 40mg prednisone x 10-14days