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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. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Esophagitis - gastritis - dysphagia

2. First stage of labor
Onset of labor until cervix dilation
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Diphenhydramine - chlorpheniramine - hydroxyzine
4mo - sits unsupported - hand transfer - babbles

3. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Short-acting + 40mg prednisone x 10-14days
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
(cefotetan OR cefoxitin) AND doxycycline

4. Tender - boggy prostate. Dx?
Normal mental status; no other injuries; seen within 10 days of injury
Prostatitis
After delivery until delivery of placenta and membranes <30 mins
Bupropion - varenicline - nicotine replacement

5. Sx otitis media
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Anaphylaxis

6. Complications of PID
Calcium oxalate crystals
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Onset of labor until cervix dilation

7. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Monosodium urate crystals (gout)
Aortic aneurysm
Diphenhydramine - chlorpheniramine - hydroxyzine

8. Tx chlamydia
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Lung; SCC head & neck; RCC; breast; MM; prostate
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Nicotine inhaler - nasal spray - gum

9. Tx GAS ifxn
Prostatitis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

10. Pregnancy class C smoking cessation drugs
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Patch - bupropion - varenicline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
= LMP + 7 days - 3 months

11. Tx acute sinusitis
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
(ofloxacin OR levofloxacin) +/- metronidazole
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

12. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Fluoroquinolones
Patch - bupropion - varenicline
Urinary calcium. Hyper PTH (high) >> FHH (normal)

13. IV tx for PID
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
(cefotetan OR cefoxitin) AND doxycycline
16-18 weeks GA
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

14. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
MCC melanoma. Radial growth.

15. needles - strong negative birefringent (yellow crystals parallel light)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Monosodium urate crystals (gout)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

16. Large - irregularly shaped - prutitic - erythematous wheals
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Diabetes - HTN - GN
Urticaria
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

17. bipyramidal - strongly positive birefringent
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Stridor - drooling - toxic appearance
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Calcium oxalate crystals

18. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Tdap - influenza - pneumovax
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide

19. IUPC (intrauterine pressure catheter)
4 yo - copies triangle - catches ball - dresses self
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Measures strength of contractions
Calcium oxalate crystals

20. Tx of traveler's diarrhea
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
IV penicillin (or ampicillin)
4 yo - copies triangle - catches ball - dresses self
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

21. Tx gonorrhea
Anemia
Ceftriaxone 125mg IM
DTaP - hepB - Hib - rotavirus - inactivated polio
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

22. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Short-acting + 40mg prednisone x 10-14days
110-160bpm
Metronidazole or clindamycin
NAC or IV NaHCO3

23. Only therapy to decrease mortality in stage IV COPD
Diphenhydramine - chlorpheniramine - hydroxyzine
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Oxygen intervention 15h/d

24. Low serum iron - low MCV - low ferritin - +stool guaiac
Steroids + bronchodilators
Aortic aneurysm
Fe deficient anemia
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

25. IV tx for PID
Alpha-1 antitrypsin deficiency
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Lung; SCC head & neck; RCC; breast; MM; prostate
Clindamycin AND gentamicin

26. complications of otitis media
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Steroids + bronchodilators

27. shoulder dystocia
(cefotetan OR cefoxitin) AND doxycycline
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
0.2-0.5mg aqueous EPI IM/SubQ
Anterior shoulder cannot readily pass below the pubic symphysis.

28. Dx bacterial rhinosinusitis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
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)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Biopsy

29. Regards human face - eye contact
IV penicillin (or ampicillin)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1 mo - eyes follow object to midline - vocalizes
5 yo - draws person - ties shoes - skips

30. Dx criteria for RA
Monosodium urate crystals (gout)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
3 yo - identify body part - copies square - hops - throws - past tense - story telling

31. Superficial spreading melanoma
<20lb - <1YO - Reacts to pain - Responds to noise
Colchicine
16-18 weeks GA
MCC melanoma. Radial growth.

32. CKD Stages
Diabetes - HTN - GN
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Ask - Advise - Assess - Assist - Arrange
6 yo

33. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ask - Advise - Assess - Assist - Arrange
2 mo - eyes follow object past midline - rolls over - laughs - squeals

34. DDX for geriatric hearing impairment
= LMP + 7 days - 3 months
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

35. Unstable angina vs MI Dx tests
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

36. recognizes strangers
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Colchicine
1 mo - eyes follow object to midline - vocalizes

37. presbycusis
Loratadine - fexofenadine - cetirizine
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
IV penicillin (or ampicillin)

38. Sx epiglottitis
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Esophagitis - gastritis - dysphagia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Stridor - drooling - toxic appearance

39. Fe deficient anemia tx
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ferrous sulfate 325mg tid
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Fluoroquinolones

40. group play - gender - knows name
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Lung; SCC head & neck; RCC; breast; MM; prostate
3 yo - identify body part - copies square - hops - throws - past tense - story telling

41. Lentigo Maligna
MCC melanoma. Radial growth.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nicotine inhaler - nasal spray - gum
1 mo - eyes follow object to midline - vocalizes

42. stranger/separation anxiety
5+ rads
Flexion - internal rotation - extension - external rotation
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
(cefotetan OR cefoxitin) AND doxycycline

43. Corrected serum calcium =

44. Fetal heart rate range
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
110-160bpm
Starts at contraction. caused by increased vagal tone from fetal head compression.

45. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Colchicine
Ferrous sulfate 325mg tid
6 yo

46. tx shoulder dystocia

47. Immunizations for COPD patients
Thiazides
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Pneumovax - influenza
Angioedema

48. How much radiation is associated with fetal harm?
Anterior shoulder cannot readily pass below the pubic symphysis.
5+ rads
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

49. Immunizations at visit for 6MO
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Calcium oxalate crystals
DTaP - hepB - Hib - rotavirus - inactivated polio

50. Pregnancy class D smoking cessation drugs
Nicotine inhaler - nasal spray - gum
IV penicillin (or ampicillin)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Age-related sensorineural hearing loss (high frequency and speech discrimination)