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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. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
0.2-0.5mg aqueous EPI IM/SubQ

2. Tender - boggy prostate. Dx?
Bupropion - varenicline - nicotine replacement
Starts at contraction. caused by increased vagal tone from fetal head compression.
Hypomagnesemia
Prostatitis

3. MONA therapy
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
6-9MO
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

4. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Anemia
Thiazdes; lithium
Conrtaction monitoring along with fetal heart rate assessment

5. Only therapy to decrease mortality in stage IV COPD
Thiazides
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Oxygen intervention 15h/d

6. 1st generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

7. Optimal time for trisomy screen
Starts at contraction. caused by increased vagal tone from fetal head compression.
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
16-18 weeks GA

8. Sx peritonsillar abscess
Esophagitis - gastritis - dysphagia
4 yo - copies triangle - catches ball - dresses self
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

9. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Normal mental status; no other injuries; seen within 10 days of injury
Anterior shoulder cannot readily pass below the pubic symphysis.

10. Oral tx for PID
Lung; SCC head & neck; RCC; breast; MM; prostate
Oxygen intervention 15h/d
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

11. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Short-acting + 40mg prednisone x 10-14days
Colchicine
Ampicillin/sulbactam AND doxycycline

12. dyspnea - visceral edema - hypotension
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Anaphylaxis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Urticaria

13. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Anaphylaxis
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Flexion - internal rotation - extension - external rotation

14. Pregnancy class C smoking cessation drugs
Bathing - dressing - eating - transferring - continence - toileting
Patch - bupropion - varenicline
Oxytocin (IV)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

15. IV tx for PID
Aortic aneurysm
Clindamycin AND gentamicin
Short-acting + 40mg prednisone x 10-14days
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

16. Early deceleration
Fe deficient anemia
Prostatitis
Starts at contraction. caused by increased vagal tone from fetal head compression.
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

17. Dx bacterial rhinosinusitis
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)
Prostatitis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Oxytocin (IV)

18. IV tx for PID
Conrtaction monitoring along with fetal heart rate assessment
Calcium hydroxyapatite crystals
Ceftriaxone 125mg IM
Ampicillin/sulbactam AND doxycycline

19. Complications of PID
Tuberculosis; sarcoidosis; hodgkin disease
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
16-18 weeks GA

20. Smoking cessation agents
Fe deficient anemia
Bupropion - varenicline - nicotine replacement
Ceftriaxone 125mg IM
5+ rads

21. Tx for thyroid storm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
MTX
MCC melanoma. Radial growth.

22. Screening for 65-76YO male smoker
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Flexion - internal rotation - extension - external rotation
Stridor - drooling - toxic appearance
Aortic aneurysm

23. Fetal heart rate range
Diphenhydramine - chlorpheniramine - hydroxyzine
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
110-160bpm
Metronidazole or clindamycin

24. Cockcroft-Gault equation
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Colchicine
Starts at contraction. caused by increased vagal tone from fetal head compression.

25. Causes of CKD
Diabetes - HTN - GN
Colchicine
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

26. IUPC (intrauterine pressure catheter)
4 yo - copies triangle - catches ball - dresses self
Measures strength of contractions
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
<20lb - <1YO - Reacts to pain - Responds to noise

27. Augments contractions
Bathing - dressing - eating - transferring - continence - toileting
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Oxytocin (IV)
Urinary calcium. Hyper PTH (high) >> FHH (normal)

28. Immunizations for COPD patients
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Pneumovax - influenza
6-9MO
Urticaria

29. Rod shaped - rhomboid - weakly positive birefringent
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium pyrophosphate dehydrate crystals (pseudogout)
DTaP - hepB - Hib - rotavirus - inactivated polio
After delivery until delivery of placenta and membranes <30 mins

30. Large - irregularly shaped - prutitic - erythematous wheals
Steroids + bronchodilators
Urticaria
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Long axis of fetus to long axis of mother (longitudinal or transverse)

31. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Short-acting + 40mg prednisone x 10-14days

32. IV tx for PID
5 yo - draws person - ties shoes - skips
Esophagitis - gastritis - dysphagia
Normal mental status; no other injuries; seen within 10 days of injury
(cefotetan OR cefoxitin) AND doxycycline

33. Screened at 16-20 weeks GA for trisomy
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Short-acting + 40mg prednisone x 10-14days
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

34. Recommended folic acid daily dose
Urticaria
Ferrous sulfate 325mg tid
Flexion - internal rotation - extension - external rotation
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

35. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
6 yo
Monosodium urate crystals (gout)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

36. recognizes strangers
Biopsy
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ceftriaxone 125mg IM
MCC melanoma. Radial growth.

37. Improve short-term outcomes in acute exacerbations of COPD - asthma
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Steroids + bronchodilators
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Monosodium urate crystals (gout)

38. Dx bacterial vaginosis
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Thiazdes; lithium

39. Malignancies with hypercalcemia
Lung; SCC head & neck; RCC; breast; MM; prostate
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: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Measures strength of contractions

40. How much radiation is associated with fetal harm?
5+ rads
IV penicillin (or ampicillin)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
<20lb - <1YO - Reacts to pain - Responds to noise

41. presbycusis
= LMP + 7 days - 3 months
Measures strength of contractions
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Age-related sensorineural hearing loss (high frequency and speech discrimination)

42. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
NAC or IV NaHCO3
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
MCC melanoma. Radial growth.

43. medications causing hypercalcemia
Colchicine
(ofloxacin OR levofloxacin) +/- metronidazole
Nicotine inhaler - nasal spray - gum
Thiazdes; lithium

44. Unstable angina vs MI Dx tests
Fluoroquinolones
Ear pain - itching - inflammation/swollen canal - exudates/discharge
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

45. Tx bacterial vaginosis
Metronidazole or clindamycin
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Urticaria
Onset of labor until cervix dilation

46. Complications of GAS infxn
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Nicotine inhaler - nasal spray - gum
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

47. Lentigo Maligna
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Urticaria
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

48. bacteria causing pharyngitis
110-160bpm
Anaphylaxis
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

49. First stage of labor
Onset of labor until cervix dilation
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Short-acting + 40mg prednisone x 10-14days
Nicotine inhaler - nasal spray - gum

50. group play - gender - knows name
Diphenhydramine - chlorpheniramine - hydroxyzine
Thiazides
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
3 yo - identify body part - copies square - hops - throws - past tense - story telling