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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. Smoking cessation agents
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Bupropion - varenicline - nicotine replacement
Measures strength of contractions
Oxygen intervention 15h/d

2. regards hand
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
4mo - sits unsupported - hand transfer - babbles
Calcium hydroxyapatite crystals

3. Estimated delivery date (Naegele's rule)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Monosodium urate crystals (gout)
= LMP + 7 days - 3 months
Ferrous sulfate 325mg tid

4. Tx bacterial vaginosis
<20lb - <1YO - Reacts to pain - Responds to noise
After delivery until delivery of placenta and membranes <30 mins
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Metronidazole or clindamycin

5. IV tx for PID
Onset of labor until cervix dilation
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Ofloxacin OR levofloxacin +/- metronidazole
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

6. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Thiazides
Ceftriaxone 125mg IM
Anemia

7. Tx for anaphylaxis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ear pain - itching - inflammation/swollen canal - exudates/discharge
5+ rads
0.2-0.5mg aqueous EPI IM/SubQ

8. Complications of GAS infxn
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Colchicine
Ofloxacin OR levofloxacin +/- metronidazole
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

9. IV tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Ampicillin/sulbactam AND doxycycline
Starts at contraction. caused by increased vagal tone from fetal head compression.
Alpha-1 antitrypsin deficiency

10. dyspnea - visceral edema - hypotension
Anaphylaxis
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
0.2-0.5mg aqueous EPI IM/SubQ

11. needles - strong negative birefringent (yellow crystals parallel light)
5 yo - draws person - ties shoes - skips
Monosodium urate crystals (gout)
Ceftriaxone 125mg IM
Clindamycin AND gentamicin

12. causes of acute bronchitis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Clindamycin AND gentamicin
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

13. Nodular melanoma
Ferrous sulfate 325mg tid
Stridor - drooling - toxic appearance
MTX
Most aggressive melanoma.

14. group play - gender - knows name
3 yo - identify body part - copies square - hops - throws - past tense - story telling
<20lb - <1YO - Reacts to pain - Responds to noise
Monosodium urate crystals (gout)
6 mo - pincer - crawls - cruises - mamma - dada - byebye

15. Mediators released in response to allergen
Diabetes - HTN - GN
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ceftriaxone 125mg IM
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

16. Pflx for traveler's diarrhea
Fluoroquinolones
1 mo - eyes follow object to midline - vocalizes
5 yo - draws person - ties shoes - skips
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

17. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium hydroxyapatite crystals
Onset of labor until cervix dilation

18. complications of otitis media
Aortic aneurysm
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ceftriaxone 125mg IM

19. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Anterior shoulder cannot readily pass below the pubic symphysis.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Steroids + bronchodilators

20. bacteria causing pharyngitis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

21. Superficial spreading melanoma
Fe deficient anemia
Anaphylaxis
MCC melanoma. Radial growth.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

22. Tx for thyroid storm
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
5+ rads
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

23. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Diabetes - HTN - GN
Colchicine

24. Screened at 16-20 weeks GA for trisomy
MCC melanoma. Radial growth.
Colchicine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

25. parallel play
DTaP - hepB - Hib - rotavirus - inactivated polio
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

26. Sx epiglottitis
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Stridor - drooling - toxic appearance
Calcium oxalate crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

27. Dx bacterial vaginosis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium pyrophosphate dehydrate crystals (pseudogout)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

28. Tx of traveler's diarrhea
Starts at contraction. caused by increased vagal tone from fetal head compression.
Thiazdes; lithium
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

29. Late deceleration
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ofloxacin OR levofloxacin +/- metronidazole
Loratadine - fexofenadine - cetirizine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

30. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Thiazdes; lithium
Tdap - influenza - pneumovax
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

31. Immunizations at visit for 6MO
Metronidazole or clindamycin
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
DTaP - hepB - Hib - rotavirus - inactivated polio

32. explorations
5+ rads
9 mo - walks - throws - 1-3 words - 1-step commands
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Calcium oxalate crystals

33. medications causing hypercalcemia
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Thiazdes; lithium
Fe deficient anemia
Alpha-1 antitrypsin deficiency

34. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
(ofloxacin OR levofloxacin) +/- metronidazole
NAC or IV NaHCO3
Urticaria
Patch - bupropion - varenicline

35. Corrected serum calcium =

36. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Aortic aneurysm
Metronidazole or clindamycin
Onset of labor until cervix dilation

37. MCC blindness worldwide
Short-acting + 40mg prednisone x 10-14days
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Bupropion - varenicline - nicotine replacement
Cataracts

38. Optimal time for trisomy screen
16-18 weeks GA
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Diabetes - HTN - GN
Tuberculosis; sarcoidosis; hodgkin disease

39. Early deceleration
Thiazides
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Starts at contraction. caused by increased vagal tone from fetal head compression.
Loratadine - fexofenadine - cetirizine

40. CKD Stages
Ceftriaxone 125mg IM
Diphenhydramine - chlorpheniramine - hydroxyzine
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

41. Signs of rupture of membranes

42. Malignancies with hypercalcemia
9 mo - walks - throws - 1-3 words - 1-step commands
Lung; SCC head & neck; RCC; breast; MM; prostate
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Cataracts

43. Regards human face - eye contact
Age-related sensorineural hearing loss (high frequency and speech discrimination)
1 mo - eyes follow object to midline - vocalizes
Steroids + bronchodilators
Bupropion - varenicline - nicotine replacement

44. Other causes of hypercalcemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ferrous sulfate 325mg tid
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxytocin (IV)

45. Improve short-term outcomes in acute exacerbations of COPD - asthma
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
(cefotetan OR cefoxitin) AND doxycycline
DTaP - hepB - Hib - rotavirus - inactivated polio
Steroids + bronchodilators

46. Sx otitis externa
Ear pain - itching - inflammation/swollen canal - exudates/discharge
4 yo - copies triangle - catches ball - dresses self
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

47. shoulder dystocia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
6 yo
Lung; SCC head & neck; RCC; breast; MM; prostate
Anterior shoulder cannot readily pass below the pubic symphysis.

48. Immunizations for adult 65YO+
5 yo - draws person - ties shoes - skips
Diphenhydramine - chlorpheniramine - hydroxyzine
Tdap - influenza - pneumovax
Ferrous sulfate 325mg tid

49. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Steroids + bronchodilators
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anemia
Thiazides

50. Acral lentinous melanoma
9 mo - walks - throws - 1-3 words - 1-step commands
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Fluoroquinolones
MCC melanoma in Africans/Asians. Under nails - soles - palms.