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Test your basic knowledge |

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. DDX for geriatric hearing impairment
Fe deficient anemia
6 yo
Cataracts
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

2. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Stridor - drooling - toxic appearance
110-160bpm
Age-related sensorineural hearing loss (high frequency and speech discrimination)
NAC or IV NaHCO3

3. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Diphenhydramine - chlorpheniramine - hydroxyzine
9 mo - walks - throws - 1-3 words - 1-step commands

4. 1st generation antihistamines
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Most aggressive melanoma.
Diphenhydramine - chlorpheniramine - hydroxyzine
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

5. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MCC melanoma. Radial growth.
Monosodium urate crystals (gout)

6. Nonfunctioning nodules > 1cm require _____
Biopsy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

7. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Anemia
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

8. X-ray of ankle?
Biopsy
Tuberculosis; sarcoidosis; hodgkin disease
Normal mental status; no other injuries; seen within 10 days of injury
MTX

9. Regards human face - eye contact
Fluoroquinolones
(cefotetan OR cefoxitin) AND doxycycline
1 mo - eyes follow object to midline - vocalizes
Ear pain - itching - inflammation/swollen canal - exudates/discharge

10. Sx epiglottitis
Ferrous sulfate 325mg tid
Steroids + bronchodilators
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Stridor - drooling - toxic appearance

11. Immunizations for COPD patients
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Pneumovax - influenza
Nicotine inhaler - nasal spray - gum

12. Recommended folic acid daily dose
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
6 yo
NAC or IV NaHCO3
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

13. How much radiation is associated with fetal harm?
5 yo - draws person - ties shoes - skips
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
5+ rads
Nicotine inhaler - nasal spray - gum

14. Malignancies with hypercalcemia
Prostatitis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Lung; SCC head & neck; RCC; breast; MM; prostate
Fe deficient anemia

15. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Anemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Esophagitis - gastritis - dysphagia

16. Augments contractions
Fe deficient anemia
Metronidazole or clindamycin
Oxytocin (IV)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

17. cystoplasmic inclusions - not birefringent
1 mo - eyes follow object to midline - vocalizes
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Calcium hydroxyapatite crystals

18. complications of otitis media
Thiazides
Long axis of fetus to long axis of mother (longitudinal or transverse)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
<20lb - <1YO - Reacts to pain - Responds to noise

19. Mediators released in response to allergen
MCC melanoma. Radial growth.
Metronidazole or clindamycin
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Diabetes - HTN - GN

20. Pregnancy class C smoking cessation drugs
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Patch - bupropion - varenicline
Metronidazole or clindamycin
Bathing - dressing - eating - transferring - continence - toileting

21. Oral tx for PID
Pneumovax - influenza
Alpha-1 antitrypsin deficiency
Fluoroquinolones
(ofloxacin OR levofloxacin) +/- metronidazole

22. parallel play
Steroids + bronchodilators
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

23. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anemia
Hypomagnesemia

24. Tx of traveler's diarrhea
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

25. needles - strong negative birefringent (yellow crystals parallel light)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
DTaP - hepB - Hib - rotavirus - inactivated polio
Monosodium urate crystals (gout)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

26. Tx for anaphylaxis
After delivery until delivery of placenta and membranes <30 mins
0.2-0.5mg aqueous EPI IM/SubQ
Most aggressive melanoma.
6-9MO

27. Superficial spreading melanoma
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Ask - Advise - Assess - Assist - Arrange
MCC melanoma. Radial growth.
Angioedema

28. Nodular melanoma
Most aggressive melanoma.
Metronidazole or clindamycin
Ferrous sulfate 325mg tid
Anaphylaxis

29. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
110-160bpm
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

30. Estimated delivery date (Naegele's rule)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
= LMP + 7 days - 3 months
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Short-acting + 40mg prednisone x 10-14days

31. identifies left - right
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anemia
6 yo
Short-acting + 40mg prednisone x 10-14days

32. Tx gonorrhea
Normal mental status; no other injuries; seen within 10 days of injury
Tdap - influenza - pneumovax
Thiazides
Ceftriaxone 125mg IM

33. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Calcium oxalate crystals
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

34. tx shoulder dystocia

35. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Prostatitis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

36. causes of acute bronchitis
MTX
Nuchal translucency - serum hCG - PAPP-A
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
6 yo

37. Tx chlamydia
Oxytocin (IV)
Ask - Advise - Assess - Assist - Arrange
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

38. Tx otitis media
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Loratadine - fexofenadine - cetirizine
Ask - Advise - Assess - Assist - Arrange

39. writes name - counts 10 objects
Calcium pyrophosphate dehydrate crystals (pseudogout)
5 yo - draws person - ties shoes - skips
<20lb - <1YO - Reacts to pain - Responds to noise
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

40. Fe deficient anemia tx
Tuberculosis; sarcoidosis; hodgkin disease
Cataracts
Calcium hydroxyapatite crystals
Ferrous sulfate 325mg tid

41. shoulder dystocia
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium hydroxyapatite crystals
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Nuchal translucency - serum hCG - PAPP-A

42. Tocodynamometer
Anterior shoulder cannot readily pass below the pubic symphysis.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Conrtaction monitoring along with fetal heart rate assessment
Esophagitis - gastritis - dysphagia

43. IV tx for PID
Clindamycin AND gentamicin
9 mo - walks - throws - 1-3 words - 1-step commands
Thiazdes; lithium
Conrtaction monitoring along with fetal heart rate assessment

44. Dx criteria for RA
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Fluoroquinolones
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Calcium pyrophosphate dehydrate crystals (pseudogout)

45. Late deceleration
Nicotine inhaler - nasal spray - gum
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cataracts

46. Improve short-term outcomes in acute exacerbations of COPD - asthma
Ampicillin/sulbactam AND doxycycline
Calcium oxalate crystals
Ceftriaxone 125mg IM
Steroids + bronchodilators

47. Rod shaped - rhomboid - weakly positive birefringent
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

48. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Steroids + bronchodilators

49. Granulomatous causes of hypercalcemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Steroids + bronchodilators
Tuberculosis; sarcoidosis; hodgkin disease

50. Corrected serum calcium =