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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. stranger/separation anxiety
Anaphylaxis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium oxalate crystals
Urinary calcium. Hyper PTH (high) >> FHH (normal)

2. bipyramidal - strongly positive birefringent
16-18 weeks GA
Monosodium urate crystals (gout)
Steroids + bronchodilators
Calcium oxalate crystals

3. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

4. Late deceleration
Bupropion - varenicline - nicotine replacement
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
NAC or IV NaHCO3
Loratadine - fexofenadine - cetirizine

5. Lentigo Maligna
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Tuberculosis; sarcoidosis; hodgkin disease
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Fluoroquinolones

6. Fetal heart rate range
Nicotine inhaler - nasal spray - gum
Urticaria
Anemia
110-160bpm

7. Causes of CKD
Oxygen intervention 15h/d
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
16-18 weeks GA
Diabetes - HTN - GN

8. The five A's of smoking cessation
Diabetes - HTN - GN
Ask - Advise - Assess - Assist - Arrange
(ofloxacin OR levofloxacin) +/- metronidazole
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

9. medications causing hypercalcemia
Patch - bupropion - varenicline
Starts at contraction. caused by increased vagal tone from fetal head compression.
IV penicillin (or ampicillin)
Thiazdes; lithium

10. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

11. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
6-9MO
1 mo - eyes follow object to midline - vocalizes
After delivery until delivery of placenta and membranes <30 mins

12. Nodular melanoma
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Short-acting + 40mg prednisone x 10-14days
NAC or IV NaHCO3
Most aggressive melanoma.

13. bacteria causing pharyngitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
<20lb - <1YO - Reacts to pain - Responds to noise
Angioedema
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

14. Recommendations for rear-facing car seat
Aortic aneurysm
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
<20lb - <1YO - Reacts to pain - Responds to noise

15. Tx for anaphylaxis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
0.2-0.5mg aqueous EPI IM/SubQ
MTX
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

16. Regards human face - eye contact
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
1 mo - eyes follow object to midline - vocalizes
Ferrous sulfate 325mg tid

17. Signs of rupture of membranes

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18. Estimated delivery date (Naegele's rule)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Monosodium urate crystals (gout)
5 yo - draws person - ties shoes - skips
= LMP + 7 days - 3 months

19. Age by which child says 'mama' and 'dada'
110-160bpm
Oxytocin (IV)
6-9MO
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

20. Tx otitis media
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
NAC or IV NaHCO3
Colchicine
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

21. Tx hyperkalemia in CKD
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Most aggressive melanoma.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

22. social interaction
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
4 yo - copies triangle - catches ball - dresses self

23. Emphysema - <45YO - nonsmoker
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Tuberculosis; sarcoidosis; hodgkin disease
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Alpha-1 antitrypsin deficiency

24. cystoplasmic inclusions - not birefringent
Tuberculosis; sarcoidosis; hodgkin disease
Monosodium urate crystals (gout)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Calcium hydroxyapatite crystals

25. Only therapy to decrease mortality in stage IV COPD
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)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Oxygen intervention 15h/d
Flexion - internal rotation - extension - external rotation

26. Pregnancy class D smoking cessation drugs
Pneumovax - influenza
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid
Ampicillin/sulbactam AND doxycycline

27. Tx for thyroid storm
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thiazdes; lithium
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Most aggressive melanoma.

28. Improve short-term outcomes in acute exacerbations of COPD - asthma
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Steroids + bronchodilators
Pneumovax - influenza

29. social smile - parent recognition
MTX
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Tuberculosis; sarcoidosis; hodgkin disease
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

30. Four cardinal fetal movements
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Flexion - internal rotation - extension - external rotation
Anterior shoulder cannot readily pass below the pubic symphysis.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

31. X-ray on knee?
Calcium pyrophosphate dehydrate crystals (pseudogout)
Urticaria
3 yo - identify body part - copies square - hops - throws - past tense - story telling
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

32. Dx criteria for RA
Loratadine - fexofenadine - cetirizine
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Tdap - influenza - pneumovax
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

33. presbycusis
Thiazides
Conrtaction monitoring along with fetal heart rate assessment
Thiazdes; lithium
Age-related sensorineural hearing loss (high frequency and speech discrimination)

34. Screening for 65-76YO male smoker
Aortic aneurysm
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Loratadine - fexofenadine - cetirizine
Thiazdes; lithium

35. Second stage of labor
Bathing - dressing - eating - transferring - continence - toileting
Ofloxacin OR levofloxacin +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
3 yo - identify body part - copies square - hops - throws - past tense - story telling

36. Tx acute sinusitis
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

37. IV tx for PID
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Biopsy
Ofloxacin OR levofloxacin +/- metronidazole
6 yo

38. IADL
Stridor - drooling - toxic appearance
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Nicotine inhaler - nasal spray - gum

39. Malignancies with hypercalcemia
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Loratadine - fexofenadine - cetirizine
Lung; SCC head & neck; RCC; breast; MM; prostate
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

40. Tender - boggy prostate. Dx?
Prostatitis
After delivery until delivery of placenta and membranes <30 mins
Anemia
Cataracts

41. Immunizations for COPD patients
0.2-0.5mg aqueous EPI IM/SubQ
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Pneumovax - influenza
NAC or IV NaHCO3

42. recognizes strangers
IV penicillin (or ampicillin)
Measures strength of contractions
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
6 mo - pincer - crawls - cruises - mamma - dada - byebye

43. Third stage of labor
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Calcium oxalate crystals
After delivery until delivery of placenta and membranes <30 mins

44. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Tuberculosis; sarcoidosis; hodgkin disease
Angioedema

45. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
= LMP + 7 days - 3 months
1 mo - eyes follow object to midline - vocalizes
Clindamycin AND gentamicin

46. CKD Stages
Nicotine inhaler - nasal spray - gum
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

47. Tx RA (best long-term outcome)
MTX
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Measures strength of contractions

48. explorations
5 yo - draws person - ties shoes - skips
9 mo - walks - throws - 1-3 words - 1-step commands
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
(ofloxacin OR levofloxacin) +/- metronidazole

49. DDX for geriatric hearing impairment
Nicotine inhaler - nasal spray - gum
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
6-9MO
MCC melanoma. Radial growth.

50. Oral tx for PID
6 yo
Starts at contraction. caused by increased vagal tone from fetal head compression.
After delivery until delivery of placenta and membranes <30 mins
(ofloxacin OR levofloxacin) +/- metronidazole