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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. medications causing hypercalcemia
Long axis of fetus to long axis of mother (longitudinal or transverse)
4mo - sits unsupported - hand transfer - babbles
Thiazdes; lithium
Biopsy

2. Tx acute sinusitis
IV penicillin (or ampicillin)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

3. group play - gender - knows name
Fluoroquinolones
Metronidazole or clindamycin
3 yo - identify body part - copies square - hops - throws - past tense - story telling
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

4. First stage of labor
Aortic aneurysm
Onset of labor until cervix dilation
Ask - Advise - Assess - Assist - Arrange
= LMP + 7 days - 3 months

5. Age by which child says 'mama' and 'dada'
Normal mental status; no other injuries; seen within 10 days of injury
6 mo - pincer - crawls - cruises - mamma - dada - byebye
6-9MO
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

6. Tx RA (best long-term outcome)
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
MTX
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Anterior shoulder cannot readily pass below the pubic symphysis.

7. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
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)
110-160bpm

8. MCC blindness worldwide
Biopsy
Cataracts
Diabetes - HTN - GN
Ask - Advise - Assess - Assist - Arrange

9. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Pneumovax - influenza
Patch - bupropion - varenicline
4mo - sits unsupported - hand transfer - babbles

10. Superficial spreading melanoma
Anterior shoulder cannot readily pass below the pubic symphysis.
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
MCC melanoma. Radial growth.
Metronidazole or clindamycin

11. Nodular melanoma
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6 yo
Most aggressive melanoma.
Tdap - influenza - pneumovax

12. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Aortic aneurysm

13. Four cardinal fetal movements
Thiazides
0.2-0.5mg aqueous EPI IM/SubQ
110-160bpm
Flexion - internal rotation - extension - external rotation

14. Fetal heart rate range
6 yo
Calcium pyrophosphate dehydrate crystals (pseudogout)
110-160bpm
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

15. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Bupropion - varenicline - nicotine replacement
Diabetes - HTN - GN
3 yo - identify body part - copies square - hops - throws - past tense - story telling

16. CKD Stages
Ampicillin/sulbactam AND doxycycline
6-9MO
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
16-18 weeks GA

17. Fetal lie
IV penicillin (or ampicillin)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Long axis of fetus to long axis of mother (longitudinal or transverse)
Alpha-1 antitrypsin deficiency

18. Recommended folic acid daily dose
Age-related sensorineural hearing loss (high frequency and speech discrimination)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
16-18 weeks GA
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

19. Immunizations for COPD patients
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
MCC melanoma. Radial growth.
Pneumovax - influenza
Oxytocin (IV)

20. Bacteria causing chronic sinusitis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Cataracts
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nuchal translucency - serum hCG - PAPP-A

21. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anemia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

22. recognizes strangers
Angioedema
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Onset of labor until cervix dilation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

23. Improve short-term outcomes in acute exacerbations of COPD - asthma
Diphenhydramine - chlorpheniramine - hydroxyzine
Steroids + bronchodilators
Anemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

24. Screening for 65-76YO male smoker
After delivery until delivery of placenta and membranes <30 mins
Aortic aneurysm
Steroids + bronchodilators
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

25. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ferrous sulfate 325mg tid
Onset of labor until cervix dilation
NAC or IV NaHCO3

26. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
1 mo - eyes follow object to midline - vocalizes
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Nicotine inhaler - nasal spray - gum
Anemia

27. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Long axis of fetus to long axis of mother (longitudinal or transverse)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

28. Oral tx for PID
110-160bpm
(ofloxacin OR levofloxacin) +/- metronidazole
Urticaria
Fluoroquinolones

29. 2nd generation antihistamines
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Esophagitis - gastritis - dysphagia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Loratadine - fexofenadine - cetirizine

30. Screened at 11-13 weeks GA for trisomy
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Nuchal translucency - serum hCG - PAPP-A
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

31. MONA therapy
Conrtaction monitoring along with fetal heart rate assessment
Fluoroquinolones
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

32. Mediators released in response to allergen
Colchicine
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Prostatitis

33. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Anaphylaxis
(ofloxacin OR levofloxacin) +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)

34. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
(cefotetan OR cefoxitin) AND doxycycline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

35. Sx otitis externa
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Pneumovax - influenza
Patch - bupropion - varenicline
Ear pain - itching - inflammation/swollen canal - exudates/discharge

36. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5 yo - draws person - ties shoes - skips
Oxygen intervention 15h/d
Tuberculosis; sarcoidosis; hodgkin disease

37. Tx hyperkalemia in CKD
Ask - Advise - Assess - Assist - Arrange
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Tuberculosis; sarcoidosis; hodgkin disease

38. Optimal time for trisomy screen
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
16-18 weeks GA
Clindamycin AND gentamicin
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

39. Sx epiglottitis
Stridor - drooling - toxic appearance
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Flexion - internal rotation - extension - external rotation
Diphenhydramine - chlorpheniramine - hydroxyzine

40. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Colchicine
Ask - Advise - Assess - Assist - Arrange
Tuberculosis; sarcoidosis; hodgkin disease

41. Pflx for traveler's diarrhea
Metronidazole or clindamycin
Most aggressive melanoma.
Fluoroquinolones
Monosodium urate crystals (gout)

42. complications of otitis media
Tdap - influenza - pneumovax
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium pyrophosphate dehydrate crystals (pseudogout)

43. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ceftriaxone 125mg IM
Nicotine inhaler - nasal spray - gum

44. explorations
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Aortic aneurysm
9 mo - walks - throws - 1-3 words - 1-step commands
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

45. Sx peritonsillar abscess
Ferrous sulfate 325mg tid
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
5 yo - draws person - ties shoes - skips
Colchicine

46. shoulder dystocia
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anterior shoulder cannot readily pass below the pubic symphysis.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

47. Emphysema - <45YO - nonsmoker
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Colchicine
Alpha-1 antitrypsin deficiency
Diabetes - HTN - GN

48. Tx acute gout
Colchicine
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Calcium hydroxyapatite crystals

49. IV tx for PID
Hypomagnesemia
Tdap - influenza - pneumovax
(cefotetan OR cefoxitin) AND doxycycline
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

50. presbycusis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
DTaP - hepB - Hib - rotavirus - inactivated polio
MCC melanoma. Radial growth.
Age-related sensorineural hearing loss (high frequency and speech discrimination)