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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. First stage of labor
6-9MO
Onset of labor until cervix dilation
5 yo - draws person - ties shoes - skips
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

2. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Nicotine inhaler - nasal spray - gum
Tuberculosis; sarcoidosis; hodgkin disease

3. Oral tx for PID
Measures strength of contractions
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
(ofloxacin OR levofloxacin) +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

4. Pregnancy class C smoking cessation drugs
Urticaria
Patch - bupropion - varenicline
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Esophagitis - gastritis - dysphagia

5. social interaction
Bathing - dressing - eating - transferring - continence - toileting
4 yo - copies triangle - catches ball - dresses self
Prostatitis
Anterior shoulder cannot readily pass below the pubic symphysis.

6. Tx for anaphylaxis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Aortic aneurysm
0.2-0.5mg aqueous EPI IM/SubQ
1 mo - eyes follow object to midline - vocalizes

7. Dx bacterial rhinosinusitis
Ear pain - itching - inflammation/swollen canal - exudates/discharge
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)
Lung; SCC head & neck; RCC; breast; MM; prostate

8. shoulder dystocia
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Cataracts
Anterior shoulder cannot readily pass below the pubic symphysis.
Urinary calcium. Hyper PTH (high) >> FHH (normal)

9. Nodular melanoma
Colchicine
Most aggressive melanoma.
Short-acting + 40mg prednisone x 10-14days
Anemia

10. Tx RA (best long-term outcome)
Bathing - dressing - eating - transferring - continence - toileting
MTX
Steroids + bronchodilators
Calcium pyrophosphate dehydrate crystals (pseudogout)

11. IV tx for PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Ampicillin/sulbactam AND doxycycline
Ask - Advise - Assess - Assist - Arrange
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

12. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
5 yo - draws person - ties shoes - skips
Nuchal translucency - serum hCG - PAPP-A
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

13. Tx acute exacerbation COPD
4mo - sits unsupported - hand transfer - babbles
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Short-acting + 40mg prednisone x 10-14days
Ferrous sulfate 325mg tid

14. Third stage of labor
(cefotetan OR cefoxitin) AND doxycycline
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
After delivery until delivery of placenta and membranes <30 mins

15. Improve short-term outcomes in acute exacerbations of COPD - asthma
6 mo - pincer - crawls - cruises - mamma - dada - byebye
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Calcium hydroxyapatite crystals
Steroids + bronchodilators

16. social smile - parent recognition
Ampicillin/sulbactam AND doxycycline
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Monosodium urate crystals (gout)
(cefotetan OR cefoxitin) AND doxycycline

17. complications of otitis media
Hypomagnesemia
Esophagitis - gastritis - dysphagia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

18. regards hand
4mo - sits unsupported - hand transfer - babbles
MTX
Ferrous sulfate 325mg tid
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

19. identifies left - right
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
6 yo
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Metronidazole or clindamycin

20. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ceftriaxone 125mg IM
Diphenhydramine - chlorpheniramine - hydroxyzine
Metronidazole or clindamycin

21. Fe deficient anemia tx
Ferrous sulfate 325mg tid
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Urticaria
Starts at contraction. caused by increased vagal tone from fetal head compression.

22. IV tx for PID
Nicotine inhaler - nasal spray - gum
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ofloxacin OR levofloxacin +/- metronidazole
Biopsy

23. Immunizations for COPD patients
Pneumovax - influenza
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ceftriaxone 125mg IM

24. Unstable angina vs MI Dx tests
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Angioedema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Stridor - drooling - toxic appearance

25. Second stage of labor
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
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)
Calcium oxalate crystals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

26. Early deceleration
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Bupropion - varenicline - nicotine replacement
Starts at contraction. caused by increased vagal tone from fetal head compression.
Tuberculosis; sarcoidosis; hodgkin disease

27. Sx otitis media
NAC or IV NaHCO3
Conrtaction monitoring along with fetal heart rate assessment
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Monosodium urate crystals (gout)

28. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Oxytocin (IV)
Calcium pyrophosphate dehydrate crystals (pseudogout)
1 mo - eyes follow object to midline - vocalizes

29. Mediators released in response to allergen
Ask - Advise - Assess - Assist - Arrange
Colchicine
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Patch - bupropion - varenicline

30. bacteria causing pharyngitis
Urticaria
MCC melanoma. Radial growth.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Diphenhydramine - chlorpheniramine - hydroxyzine

31. Augments contractions
Tdap - influenza - pneumovax
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Oxytocin (IV)
Pneumovax - influenza

32. variable deceleration
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

33. Screening for 65-76YO male smoker
Aortic aneurysm
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Ampicillin/sulbactam AND doxycycline

34. Recommended folic acid daily dose
Prostatitis
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
4 yo - copies triangle - catches ball - dresses self
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

35. Superficial spreading melanoma
MCC melanoma. Radial growth.
5 yo - draws person - ties shoes - skips
Steroids + bronchodilators
Urticaria

36. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Diphenhydramine - chlorpheniramine - hydroxyzine
(cefotetan OR cefoxitin) AND doxycycline

37. Tx for thyroid storm
Onset of labor until cervix dilation
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

38. dyspnea - visceral edema - hypotension
Urticaria
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anaphylaxis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

39. Bacteria causing chronic sinusitis
Nuchal translucency - serum hCG - PAPP-A
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Nicotine inhaler - nasal spray - gum

40. Sx otitis externa
Ofloxacin OR levofloxacin +/- metronidazole
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Tdap - influenza - pneumovax
Ear pain - itching - inflammation/swollen canal - exudates/discharge

41. Smoking cessation agents
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Bupropion - varenicline - nicotine replacement
Tdap - influenza - pneumovax
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

42. Recommendations for rear-facing car seat
<20lb - <1YO - Reacts to pain - Responds to noise
Starts at contraction. caused by increased vagal tone from fetal head compression.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

43. Screened at 11-13 weeks GA for trisomy
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Tdap - influenza - pneumovax
Nuchal translucency - serum hCG - PAPP-A
Bupropion - varenicline - nicotine replacement

44. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
1 mo - eyes follow object to midline - vocalizes
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Urinary calcium. Hyper PTH (high) >> FHH (normal)

45. DDX for geriatric hearing impairment
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

46. Pflx for traveler's diarrhea
<20lb - <1YO - Reacts to pain - Responds to noise
Alpha-1 antitrypsin deficiency
6-9MO
Fluoroquinolones

47. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Thiazides
Alpha-1 antitrypsin deficiency
Biopsy

48. Sx of hypercalcemia
Calcium hydroxyapatite crystals
4mo - sits unsupported - hand transfer - babbles
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Monosodium urate crystals (gout)

49. Tx bacterial vaginosis
Metronidazole or clindamycin
5 yo - draws person - ties shoes - skips
Diphenhydramine - chlorpheniramine - hydroxyzine
Lung; SCC head & neck; RCC; breast; MM; prostate

50. Tx gonorrhea
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Clindamycin AND gentamicin
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Ceftriaxone 125mg IM