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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. Nodular melanoma
5 yo - draws person - ties shoes - skips
Most aggressive melanoma.
= LMP + 7 days - 3 months
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

2. painless - deep - subQ swelling (periorbital - circumoral - facial)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Angioedema
<20lb - <1YO - Reacts to pain - Responds to noise
0.2-0.5mg aqueous EPI IM/SubQ

3. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
MCC melanoma in Africans/Asians. Under nails - soles - palms.
6 yo
(cefotetan OR cefoxitin) AND doxycycline

4. Electrolyte abnormality that increases the incidence of torsades de pointes
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Hypomagnesemia
MCC melanoma in Africans/Asians. Under nails - soles - palms.
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

5. Sx otitis externa
Oxytocin (IV)
After delivery until delivery of placenta and membranes <30 mins
Esophagitis - gastritis - dysphagia
Ear pain - itching - inflammation/swollen canal - exudates/discharge

6. Causes of CKD
Diabetes - HTN - GN
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Short-acting + 40mg prednisone x 10-14days
Diphenhydramine - chlorpheniramine - hydroxyzine

7. group play - gender - knows name
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads
Ceftriaxone 125mg IM
3 yo - identify body part - copies square - hops - throws - past tense - story telling

8. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Flexion - internal rotation - extension - external rotation
DTaP - hepB - Hib - rotavirus - inactivated polio
Urinary calcium. Hyper PTH (high) >> FHH (normal)

9. Tx GAS ifxn
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Thiazides
Short-acting + 40mg prednisone x 10-14days
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

10. social interaction
6 yo
Ask - Advise - Assess - Assist - Arrange
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
4 yo - copies triangle - catches ball - dresses self

11. The five A's of smoking cessation
MTX
Ask - Advise - Assess - Assist - Arrange
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

12. identifies left - right
Prostatitis
Fe deficient anemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
6 yo

13. Dx bacterial rhinosinusitis
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)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Normal mental status; no other injuries; seen within 10 days of injury

14. Sx peritonsillar abscess
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
After delivery until delivery of placenta and membranes <30 mins

15. Oral tx for PID
Flexion - internal rotation - extension - external rotation
(ofloxacin OR levofloxacin) +/- metronidazole
MCC melanoma in Africans/Asians. Under nails - soles - palms.
16-18 weeks GA

16. Fetal lie
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Long axis of fetus to long axis of mother (longitudinal or transverse)
Thiazdes; lithium
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

17. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Pneumovax - influenza
Ampicillin/sulbactam AND doxycycline
Clindamycin AND gentamicin

18. ADL
Bathing - dressing - eating - transferring - continence - toileting
Stridor - drooling - toxic appearance
MTX
Ask - Advise - Assess - Assist - Arrange

19. Tx bacterial vaginosis
Metronidazole or clindamycin
Esophagitis - gastritis - dysphagia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ask - Advise - Assess - Assist - Arrange

20. Sx of hypercalcemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

21. Fe deficient anemia tx
Calcium hydroxyapatite crystals
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ferrous sulfate 325mg tid
(cefotetan OR cefoxitin) AND doxycycline

22. 1st generation antihistamines
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Pneumovax - influenza
Diphenhydramine - chlorpheniramine - hydroxyzine
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

23. Lentigo Maligna
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
110-160bpm
Calcium hydroxyapatite crystals

24. Pregnancy class C smoking cessation drugs
Cataracts
Aortic aneurysm
Patch - bupropion - varenicline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

25. Four cardinal fetal movements
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1 mo - eyes follow object to midline - vocalizes
Flexion - internal rotation - extension - external rotation
Cataracts

26. Immunizations for COPD patients
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Pneumovax - influenza
4 yo - copies triangle - catches ball - dresses self
2 mo - eyes follow object past midline - rolls over - laughs - squeals

27. Tender - boggy prostate. Dx?
Prostatitis
Oxytocin (IV)
1 mo - eyes follow object to midline - vocalizes
5+ rads

28. stranger/separation anxiety
Stridor - drooling - toxic appearance
(ofloxacin OR levofloxacin) +/- metronidazole
Starts at contraction. caused by increased vagal tone from fetal head compression.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. Corrected serum calcium =

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30. Optimal time for trisomy screen
16-18 weeks GA
6-9MO
Fluoroquinolones
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

31. Late deceleration
Metronidazole or clindamycin
Prostatitis
Most aggressive melanoma.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

32. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
Anaphylaxis
Calcium pyrophosphate dehydrate crystals (pseudogout)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

33. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Ferrous sulfate 325mg tid
Diphenhydramine - chlorpheniramine - hydroxyzine
Long axis of fetus to long axis of mother (longitudinal or transverse)

34. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Nicotine inhaler - nasal spray - gum
Anemia

35. Estimated delivery date (Naegele's rule)
Tuberculosis; sarcoidosis; hodgkin disease
= LMP + 7 days - 3 months
Measures strength of contractions
4mo - sits unsupported - hand transfer - babbles

36. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Onset of labor until cervix dilation

37. Signs of rupture of membranes

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38. Malignancies with hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Angioedema
Lung; SCC head & neck; RCC; breast; MM; prostate
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

39. Emphysema - <45YO - nonsmoker
6 yo
Alpha-1 antitrypsin deficiency
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Esophagitis - gastritis - dysphagia

40. Screened at 11-13 weeks GA for trisomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Nuchal translucency - serum hCG - PAPP-A

41. Complications of PID
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

42. Bacteria causing chronic sinusitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Calcium pyrophosphate dehydrate crystals (pseudogout)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

43. Nonfunctioning nodules > 1cm require _____
Hypomagnesemia
Biopsy
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anaphylaxis

44. Sx epiglottitis
Tuberculosis; sarcoidosis; hodgkin disease
Calcium oxalate crystals
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)
Stridor - drooling - toxic appearance

45. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Thiazdes; lithium
Anemia
1 mo - eyes follow object to midline - vocalizes
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

46. Screening for 65-76YO male smoker
Aortic aneurysm
Nicotine inhaler - nasal spray - gum
2 mo - eyes follow object past midline - rolls over - laughs - squeals
<20lb - <1YO - Reacts to pain - Responds to noise

47. Tx acute sinusitis
4mo - sits unsupported - hand transfer - babbles
Bathing - dressing - eating - transferring - continence - toileting
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Patch - bupropion - varenicline

48. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

49. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ceftriaxone 125mg IM
Patch - bupropion - varenicline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

50. Unstable angina vs MI Dx tests
Ofloxacin OR levofloxacin +/- metronidazole
Diabetes - HTN - GN
Onset of labor until cervix dilation
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat