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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. Late deceleration
Pneumovax - influenza
16-18 weeks GA
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

2. MCC blindness worldwide
Lung; SCC head & neck; RCC; breast; MM; prostate
Cataracts
Loratadine - fexofenadine - cetirizine
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

3. shoulder dystocia
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)
Anterior shoulder cannot readily pass below the pubic symphysis.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Monosodium urate crystals (gout)

4. Electrolyte abnormality that increases the incidence of torsades de pointes
Bathing - dressing - eating - transferring - continence - toileting
Hypomagnesemia
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Oxytocin (IV)

5. Mediators released in response to allergen
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Steroids + bronchodilators

6. Tx hyperkalemia in CKD
Tuberculosis; sarcoidosis; hodgkin disease
5 yo - draws person - ties shoes - skips
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)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

7. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Tuberculosis; sarcoidosis; hodgkin disease

8. Nonfunctioning nodules > 1cm require _____
Diphenhydramine - chlorpheniramine - hydroxyzine
Biopsy
Conrtaction monitoring along with fetal heart rate assessment
16-18 weeks GA

9. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Colchicine
MCC melanoma. Radial growth.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

10. Immunizations for adult 65YO+
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)
Tdap - influenza - pneumovax
Long axis of fetus to long axis of mother (longitudinal or transverse)

11. Bacteria causing chronic sinusitis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
4 yo - copies triangle - catches ball - dresses self
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

12. social interaction
4 yo - copies triangle - catches ball - dresses self
16-18 weeks GA
<20lb - <1YO - Reacts to pain - Responds to noise
Tdap - influenza - pneumovax

13. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Colchicine
Oxytocin (IV)

14. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
After delivery until delivery of placenta and membranes <30 mins
Stridor - drooling - toxic appearance
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

15. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Hypomagnesemia
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

16. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Patch - bupropion - varenicline
Anemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

17. Third stage of labor
5 yo - draws person - ties shoes - skips
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
After delivery until delivery of placenta and membranes <30 mins
Patch - bupropion - varenicline

18. regards hand
Metronidazole or clindamycin
4mo - sits unsupported - hand transfer - babbles
Lung; SCC head & neck; RCC; breast; MM; prostate
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

19. Second stage of labor
6 mo - pincer - crawls - cruises - mamma - dada - byebye
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Steroids + bronchodilators
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

20. Sx otitis externa
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

21. 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)
Bupropion - varenicline - nicotine replacement
Ampicillin/sulbactam AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

22. Early deceleration
Pneumovax - influenza
Most aggressive melanoma.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Starts at contraction. caused by increased vagal tone from fetal head compression.

23. Four cardinal fetal movements
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Urticaria
Flexion - internal rotation - extension - external rotation
2 mo - eyes follow object past midline - rolls over - laughs - squeals

24. bacteria causing pharyngitis
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Hypomagnesemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

25. X-ray on knee?
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bupropion - varenicline - nicotine replacement
DTaP - hepB - Hib - rotavirus - inactivated polio

26. Oral tx for PID
Clindamycin AND gentamicin
Calcium pyrophosphate dehydrate crystals (pseudogout)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
(ofloxacin OR levofloxacin) +/- metronidazole

27. Tx otitis media
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Tdap - influenza - pneumovax
Biopsy

28. writes name - counts 10 objects
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
5 yo - draws person - ties shoes - skips
Steroids + bronchodilators
Calcium pyrophosphate dehydrate crystals (pseudogout)

29. Pflx for traveler's diarrhea
Steroids + bronchodilators
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Fluoroquinolones
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

30. First stage of labor
(cefotetan OR cefoxitin) AND doxycycline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Onset of labor until cervix dilation
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

31. Bisphospohonates sfx
1 mo - eyes follow object to midline - vocalizes
Oxytocin (IV)
Esophagitis - gastritis - dysphagia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

32. Improve short-term outcomes in acute exacerbations of COPD - asthma
Colchicine
Nicotine inhaler - nasal spray - gum
Steroids + bronchodilators
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

33. dyspnea - visceral edema - hypotension
9 mo - walks - throws - 1-3 words - 1-step commands
Flexion - internal rotation - extension - external rotation
Bathing - dressing - eating - transferring - continence - toileting
Anaphylaxis

34. causes of acute bronchitis
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

35. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
0.2-0.5mg aqueous EPI IM/SubQ
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

36. Pregnancy class D smoking cessation drugs
Age-related sensorineural hearing loss (high frequency and speech discrimination)
= LMP + 7 days - 3 months
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Nicotine inhaler - nasal spray - gum

37. X-ray of ankle?
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Normal mental status; no other injuries; seen within 10 days of injury
Flexion - internal rotation - extension - external rotation
(ofloxacin OR levofloxacin) +/- metronidazole

38. IV tx for PID
Cataracts
Ask - Advise - Assess - Assist - Arrange
Ofloxacin OR levofloxacin +/- metronidazole
Most aggressive melanoma.

39. Tx RA (best long-term outcome)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
MTX
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

40. Fetal heart rate range
Normal mental status; no other injuries; seen within 10 days of injury
Pneumovax - influenza
110-160bpm
6 mo - pincer - crawls - cruises - mamma - dada - byebye

41. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Nuchal translucency - serum hCG - PAPP-A
4 yo - copies triangle - catches ball - dresses self
Ceftriaxone 125mg IM

42. Tx gonorrhea
Cataracts
Ceftriaxone 125mg IM
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

43. Nodular melanoma
Most aggressive melanoma.
Biopsy
1 mo - eyes follow object to midline - vocalizes
110-160bpm

44. Age by which child says 'mama' and 'dada'
9 mo - walks - throws - 1-3 words - 1-step commands
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6-9MO
Steroids + bronchodilators

45. Causes of CKD
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Long axis of fetus to long axis of mother (longitudinal or transverse)
Diabetes - HTN - GN
After delivery until delivery of placenta and membranes <30 mins

46. Cockcroft-Gault equation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Anemia

47. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Oxytocin (IV)
Esophagitis - gastritis - dysphagia

48. Dx bacterial vaginosis
Urticaria
Patch - bupropion - varenicline
Tdap - influenza - pneumovax
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

49. needles - strong negative birefringent (yellow crystals parallel light)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Monosodium urate crystals (gout)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anemia

50. Immunizations for COPD patients
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Pneumovax - influenza
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)