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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. cystoplasmic inclusions - not birefringent
(ofloxacin OR levofloxacin) +/- metronidazole
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Clindamycin AND gentamicin
Calcium hydroxyapatite crystals

2. Bisphospohonates sfx
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Esophagitis - gastritis - dysphagia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

3. IV tx for PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Lung; SCC head & neck; RCC; breast; MM; prostate
Clindamycin AND gentamicin

4. Fetal heart rate range
After delivery until delivery of placenta and membranes <30 mins
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
110-160bpm

5. IV tx for PID
Bupropion - varenicline - nicotine replacement
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Urinary calcium. Hyper PTH (high) >> FHH (normal)
(cefotetan OR cefoxitin) AND doxycycline

6. MONA therapy
Long axis of fetus to long axis of mother (longitudinal or transverse)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Oxygen intervention 15h/d

7. Immunizations for COPD patients
5+ rads
Anemia
6-9MO
Pneumovax - influenza

8. Augments contractions
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Oxytocin (IV)
5 yo - draws person - ties shoes - skips
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

9. Four cardinal fetal movements
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Flexion - internal rotation - extension - external rotation
4 yo - copies triangle - catches ball - dresses self

10. Regards human face - eye contact
Metronidazole or clindamycin
Long axis of fetus to long axis of mother (longitudinal or transverse)
1 mo - eyes follow object to midline - vocalizes
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

11. Tx bacterial vaginosis
Urticaria
Angioedema
Metronidazole or clindamycin
Loratadine - fexofenadine - cetirizine

12. recognizes strangers
MTX
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

13. Recommended folic acid daily dose
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ferrous sulfate 325mg tid
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

14. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
IV penicillin (or ampicillin)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

15. Screened at 16-20 weeks GA for trisomy
Ferrous sulfate 325mg tid
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Oxytocin (IV)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

16. medications causing hypercalcemia
Thiazdes; lithium
Cataracts
Normal mental status; no other injuries; seen within 10 days of injury
Tuberculosis; sarcoidosis; hodgkin disease

17. MCC blindness worldwide
Patch - bupropion - varenicline
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Flexion - internal rotation - extension - external rotation
Cataracts

18. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Ceftriaxone 125mg IM
Long axis of fetus to long axis of mother (longitudinal or transverse)
Anterior shoulder cannot readily pass below the pubic symphysis.

19. tx shoulder dystocia

20. Tx for anaphylaxis
16-18 weeks GA
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
0.2-0.5mg aqueous EPI IM/SubQ
Ferrous sulfate 325mg tid

21. bacteria causing pharyngitis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Oxytocin (IV)
2 mo - eyes follow object past midline - rolls over - laughs - squeals

22. group play - gender - knows name
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
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)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

23. X-ray of ankle?
Anaphylaxis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Normal mental status; no other injuries; seen within 10 days of injury

24. Early deceleration
5 yo - draws person - ties shoes - skips
= LMP + 7 days - 3 months
Aortic aneurysm
Starts at contraction. caused by increased vagal tone from fetal head compression.

25. dyspnea - visceral edema - hypotension
1 mo - eyes follow object to midline - vocalizes
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
<20lb - <1YO - Reacts to pain - Responds to noise
Anaphylaxis

26. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ceftriaxone 125mg IM
Urinary calcium. Hyper PTH (high) >> FHH (normal)

27. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Calcium hydroxyapatite crystals
Colchicine
Anemia
16-18 weeks GA

28. Tx acute gout
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Colchicine
Patch - bupropion - varenicline

29. ADL
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Bathing - dressing - eating - transferring - continence - toileting
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

30. Fe deficient anemia tx
Ceftriaxone 125mg IM
Ferrous sulfate 325mg tid
16-18 weeks GA
Starts at contraction. caused by increased vagal tone from fetal head compression.

31. social smile - parent recognition
Conrtaction monitoring along with fetal heart rate assessment
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Monosodium urate crystals (gout)

32. Tx RA (best long-term outcome)
Patch - bupropion - varenicline
MTX
Tdap - influenza - pneumovax
Loratadine - fexofenadine - cetirizine

33. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

34. Smoking cessation agents
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Bupropion - varenicline - nicotine replacement
16-18 weeks GA

35. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Ask - Advise - Assess - Assist - Arrange
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Urinary calcium. Hyper PTH (high) >> FHH (normal)

36. causes of acute bronchitis
Steroids + bronchodilators
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Angioedema

37. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Lung; SCC head & neck; RCC; breast; MM; prostate
Onset of labor until cervix dilation
Loratadine - fexofenadine - cetirizine

38. Sx otitis externa
(cefotetan OR cefoxitin) AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

39. GBS tx
Short-acting + 40mg prednisone x 10-14days
<20lb - <1YO - Reacts to pain - Responds to noise
(ofloxacin OR levofloxacin) +/- metronidazole
IV penicillin (or ampicillin)

40. shoulder dystocia
Short-acting + 40mg prednisone x 10-14days
Anterior shoulder cannot readily pass below the pubic symphysis.
Urinary calcium. Hyper PTH (high) >> FHH (normal)
6-9MO

41. Age by which child says 'mama' and 'dada'
Pneumovax - influenza
6-9MO
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Nuchal translucency - serum hCG - PAPP-A

42. writes name - counts 10 objects
Anaphylaxis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
5 yo - draws person - ties shoes - skips
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

43. Rod shaped - rhomboid - weakly positive birefringent
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Short-acting + 40mg prednisone x 10-14days
Calcium pyrophosphate dehydrate crystals (pseudogout)

44. Sx epiglottitis
Nuchal translucency - serum hCG - PAPP-A
Stridor - drooling - toxic appearance
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ear pain - itching - inflammation/swollen canal - exudates/discharge

45. identifies left - right
6 yo
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
1 mo - eyes follow object to midline - vocalizes

46. Sx peritonsillar abscess
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

47. Bacteria causing chronic sinusitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Hypomagnesemia

48. Unstable angina vs MI Dx tests
Stridor - drooling - toxic appearance
Diphenhydramine - chlorpheniramine - hydroxyzine
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.

49. DDX for geriatric hearing impairment
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Conrtaction monitoring along with fetal heart rate assessment

50. CKD Stages
Loratadine - fexofenadine - cetirizine
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Urticaria
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis