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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. Regards human face - eye contact
6 mo - pincer - crawls - cruises - mamma - dada - byebye
0.2-0.5mg aqueous EPI IM/SubQ
Ferrous sulfate 325mg tid
1 mo - eyes follow object to midline - vocalizes

2. 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)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
IV penicillin (or ampicillin)

3. Dx bacterial vaginosis
Fluoroquinolones
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

4. CKD Stages
MTX
Normal mental status; no other injuries; seen within 10 days of injury
Short-acting + 40mg prednisone x 10-14days
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

5. Fetal heart rate range
3 yo - identify body part - copies square - hops - throws - past tense - story telling
110-160bpm
Bupropion - varenicline - nicotine replacement
Calcium hydroxyapatite crystals

6. Screened at 11-13 weeks GA for trisomy
Patch - bupropion - varenicline
<20lb - <1YO - Reacts to pain - Responds to noise
Nuchal translucency - serum hCG - PAPP-A
Hypomagnesemia

7. Dx bacterial rhinosinusitis
Angioedema
Cataracts
Steroids + bronchodilators
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)

8. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 mo - eyes follow object to midline - vocalizes
Measures strength of contractions
0.2-0.5mg aqueous EPI IM/SubQ

9. bipyramidal - strongly positive birefringent
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)
Fe deficient anemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

10. Tx chlamydia
Thiazdes; lithium
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

11. Granulomatous causes of hypercalcemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Tuberculosis; sarcoidosis; hodgkin disease
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Nuchal translucency - serum hCG - PAPP-A

12. Tender - boggy prostate. Dx?
Onset of labor until cervix dilation
Prostatitis
6 mo - pincer - crawls - cruises - mamma - dada - byebye
IV penicillin (or ampicillin)

13. Tx bacterial vaginosis
After delivery until delivery of placenta and membranes <30 mins
Metronidazole or clindamycin
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fluoroquinolones

14. GBS tx
IV penicillin (or ampicillin)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
4mo - sits unsupported - hand transfer - babbles

15. Nonfunctioning nodules > 1cm require _____
Thiazdes; lithium
Biopsy
(ofloxacin OR levofloxacin) +/- metronidazole
2 mo - eyes follow object past midline - rolls over - laughs - squeals

16. MONA therapy
Cataracts
Oxytocin (IV)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

17. Second stage of labor
16-18 weeks GA
Colchicine
Calcium pyrophosphate dehydrate crystals (pseudogout)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

18. MCC blindness worldwide
Bupropion - varenicline - nicotine replacement
(ofloxacin OR levofloxacin) +/- metronidazole
Cataracts
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

19. Recommended folic acid daily dose
Calcium pyrophosphate dehydrate crystals (pseudogout)
9 mo - walks - throws - 1-3 words - 1-step commands
Tdap - influenza - pneumovax
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

20. X-ray on knee?
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

21. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
110-160bpm
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Angioedema

22. Unstable angina vs MI Dx tests
Fe deficient anemia
NAC or IV NaHCO3
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

23. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Bathing - dressing - eating - transferring - continence - toileting
Alpha-1 antitrypsin deficiency

24. cystoplasmic inclusions - not birefringent
Angioedema
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Calcium hydroxyapatite crystals
Oxygen intervention 15h/d

25. Corrected serum calcium =

26. Bacteria causing chronic sinusitis
Pneumovax - influenza
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Clindamycin AND gentamicin
Anterior shoulder cannot readily pass below the pubic symphysis.

27. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
4mo - sits unsupported - hand transfer - babbles
Alpha-1 antitrypsin deficiency
Anaphylaxis

28. 1st generation antihistamines
Loratadine - fexofenadine - cetirizine
Diphenhydramine - chlorpheniramine - hydroxyzine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

29. Tx gonorrhea
After delivery until delivery of placenta and membranes <30 mins
Ceftriaxone 125mg IM
DTaP - hepB - Hib - rotavirus - inactivated polio
Bathing - dressing - eating - transferring - continence - toileting

30. Tx for thyroid storm
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Thiazdes; lithium

31. painless - deep - subQ swelling (periorbital - circumoral - facial)
Clindamycin AND gentamicin
Angioedema
6 yo
= LMP + 7 days - 3 months

32. How much radiation is associated with fetal harm?
Thiazdes; lithium
Anterior shoulder cannot readily pass below the pubic symphysis.
5+ rads
Measures strength of contractions

33. Age by which child says 'mama' and 'dada'
6-9MO
9 mo - walks - throws - 1-3 words - 1-step commands
Tuberculosis; sarcoidosis; hodgkin disease
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

34. IUPC (intrauterine pressure catheter)
Prostatitis
Measures strength of contractions
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

35. writes name - counts 10 objects
5 yo - draws person - ties shoes - skips
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
(cefotetan OR cefoxitin) AND doxycycline

36. The five A's of smoking cessation
Anemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ask - Advise - Assess - Assist - Arrange
Steroids + bronchodilators

37. DDX for geriatric hearing impairment
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Measures strength of contractions
9 mo - walks - throws - 1-3 words - 1-step commands

38. Screened at 16-20 weeks GA for trisomy
Monosodium urate crystals (gout)
Prostatitis
1 mo - eyes follow object to midline - vocalizes
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

39. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
= LMP + 7 days - 3 months
NAC or IV NaHCO3
Diabetes - HTN - GN
Measures strength of contractions

40. Recommendations for rear-facing car seat
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
0.2-0.5mg aqueous EPI IM/SubQ
Age-related sensorineural hearing loss (high frequency and speech discrimination)
<20lb - <1YO - Reacts to pain - Responds to noise

41. Tx RA (best long-term outcome)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
MTX
5+ rads

42. Pregnancy class C smoking cessation drugs
Pneumovax - influenza
Patch - bupropion - varenicline
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Steroids + bronchodilators

43. ADL
(cefotetan OR cefoxitin) AND doxycycline
9 mo - walks - throws - 1-3 words - 1-step commands
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Bathing - dressing - eating - transferring - continence - toileting

44. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
Anaphylaxis
Angioedema
110-160bpm

45. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Alpha-1 antitrypsin deficiency
Anemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
110-160bpm

46. bacteria causing pharyngitis
Thiazdes; lithium
Stridor - drooling - toxic appearance
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Normal mental status; no other injuries; seen within 10 days of injury

47. Causes of CKD
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Diabetes - HTN - GN
5 yo - draws person - ties shoes - skips

48. Fetal lie
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Long axis of fetus to long axis of mother (longitudinal or transverse)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
16-18 weeks GA

49. Smoking cessation agents
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anterior shoulder cannot readily pass below the pubic symphysis.
Colchicine
Bupropion - varenicline - nicotine replacement

50. Pflx for traveler's diarrhea
Fluoroquinolones
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
2 mo - eyes follow object past midline - rolls over - laughs - squeals