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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. bipyramidal - strongly positive birefringent
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Calcium oxalate crystals
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Stridor - drooling - toxic appearance

2. Tx RA (best long-term outcome)
(cefotetan OR cefoxitin) AND doxycycline
MTX
Bupropion - varenicline - nicotine replacement
Conrtaction monitoring along with fetal heart rate assessment

3. Improve short-term outcomes in acute exacerbations of COPD - asthma
Loratadine - fexofenadine - cetirizine
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ferrous sulfate 325mg tid
Steroids + bronchodilators

4. Complications of PID
Bathing - dressing - eating - transferring - continence - toileting
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Metronidazole or clindamycin

5. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Hypomagnesemia
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

6. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Ofloxacin OR levofloxacin +/- metronidazole
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Anaphylaxis
Thiazdes; lithium

7. Oral tx for PID
Patch - bupropion - varenicline
(ofloxacin OR levofloxacin) +/- metronidazole
0.2-0.5mg aqueous EPI IM/SubQ
Urticaria

8. Granulomatous causes of hypercalcemia
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Tuberculosis; sarcoidosis; hodgkin disease
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

9. Large - irregularly shaped - prutitic - erythematous wheals
Loratadine - fexofenadine - cetirizine
Urticaria
Diabetes - HTN - GN
4 yo - copies triangle - catches ball - dresses self

10. causes of acute bronchitis
Cataracts
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
4 yo - copies triangle - catches ball - dresses self
Patch - bupropion - varenicline

11. Recommended folic acid daily dose
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Measures strength of contractions
Normal mental status; no other injuries; seen within 10 days of injury
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

12. How much radiation is associated with fetal harm?
Prostatitis
Nuchal translucency - serum hCG - PAPP-A
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
5+ rads

13. Sx peritonsillar abscess
IV penicillin (or ampicillin)
5 yo - draws person - ties shoes - skips
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

14. Tx of traveler's diarrhea
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

15. needles - strong negative birefringent (yellow crystals parallel light)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Anemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Monosodium urate crystals (gout)

16. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Most aggressive melanoma.
Thiazdes; lithium

17. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Diphenhydramine - chlorpheniramine - hydroxyzine
= LMP + 7 days - 3 months
Fluoroquinolones

18. Oral tx for PID
Diphenhydramine - chlorpheniramine - hydroxyzine
Loratadine - fexofenadine - cetirizine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
110-160bpm

19. Tx bacterial vaginosis
Measures strength of contractions
Metronidazole or clindamycin
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thiazides

20. Nodular melanoma
Angioedema
Clindamycin AND gentamicin
Most aggressive melanoma.
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

21. Electrolyte abnormality that increases the incidence of torsades de pointes
MCC melanoma. Radial growth.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Hypomagnesemia
Pneumovax - influenza

22. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
5+ rads
NAC or IV NaHCO3
Calcium pyrophosphate dehydrate crystals (pseudogout)

23. Dx bacterial vaginosis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Esophagitis - gastritis - dysphagia

24. MONA therapy
Oxygen intervention 15h/d
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Nuchal translucency - serum hCG - PAPP-A

25. Lentigo Maligna
NAC or IV NaHCO3
Clindamycin AND gentamicin
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Angioedema

26. Early deceleration
<20lb - <1YO - Reacts to pain - Responds to noise
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Starts at contraction. caused by increased vagal tone from fetal head compression.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

27. Tx gonorrhea
Ferrous sulfate 325mg tid
Ceftriaxone 125mg IM
Colchicine
DTaP - hepB - Hib - rotavirus - inactivated polio

28. Tx otitis media
Ear pain - itching - inflammation/swollen canal - exudates/discharge
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium pyrophosphate dehydrate crystals (pseudogout)

29. regards hand
4mo - sits unsupported - hand transfer - babbles
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
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)
Calcium oxalate crystals

30. Age by which child says 'mama' and 'dada'
6-9MO
5 yo - draws person - ties shoes - skips
Nuchal translucency - serum hCG - PAPP-A
Anterior shoulder cannot readily pass below the pubic symphysis.

31. Recommendations for rear-facing car seat
Hypomagnesemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Bupropion - varenicline - nicotine replacement
<20lb - <1YO - Reacts to pain - Responds to noise

32. Corrected serum calcium =

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33. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Biopsy
Thiazdes; lithium
Ear pain - itching - inflammation/swollen canal - exudates/discharge

34. MCC blindness worldwide
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)
Cataracts
Prostatitis
Calcium pyrophosphate dehydrate crystals (pseudogout)

35. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Flexion - internal rotation - extension - external rotation
(ofloxacin OR levofloxacin) +/- metronidazole
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

36. GBS tx
IV penicillin (or ampicillin)
9 mo - walks - throws - 1-3 words - 1-step commands
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

37. Tx GAS ifxn
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
(cefotetan OR cefoxitin) AND doxycycline

38. Estimated delivery date (Naegele's rule)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
= LMP + 7 days - 3 months

39. Augments contractions
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Oxytocin (IV)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

40. The five A's of smoking cessation
Thiazdes; lithium
Ask - Advise - Assess - Assist - Arrange
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
5+ rads

41. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
Esophagitis - gastritis - dysphagia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

42. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
DTaP - hepB - Hib - rotavirus - inactivated polio
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Diphenhydramine - chlorpheniramine - hydroxyzine

43. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
4mo - sits unsupported - hand transfer - babbles
Oxytocin (IV)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

44. IV tx for PID
6 yo
5 yo - draws person - ties shoes - skips
Ampicillin/sulbactam AND doxycycline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

45. X-ray on knee?
Aortic aneurysm
1 mo - eyes follow object to midline - vocalizes
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

46. Dx PID
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

47. Tx for thyroid storm
Ask - Advise - Assess - Assist - Arrange
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Monosodium urate crystals (gout)

48. Tender - boggy prostate. Dx?
Prostatitis
Esophagitis - gastritis - dysphagia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Onset of labor until cervix dilation

49. DOC for HTN in elderly
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Lung; SCC head & neck; RCC; breast; MM; prostate
Thiazides
Pneumovax - influenza

50. Sx epiglottitis
Tuberculosis; sarcoidosis; hodgkin disease
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Stridor - drooling - toxic appearance