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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. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
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)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Calcium oxalate crystals

2. Immunizations at visit for 6MO
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
110-160bpm
DTaP - hepB - Hib - rotavirus - inactivated polio
Hypomagnesemia

3. cystoplasmic inclusions - not birefringent
Bathing - dressing - eating - transferring - continence - toileting
Calcium hydroxyapatite crystals
Stridor - drooling - toxic appearance
After delivery until delivery of placenta and membranes <30 mins

4. Oral tx for PID
Diphenhydramine - chlorpheniramine - hydroxyzine
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Clindamycin AND gentamicin
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

5. writes name - counts 10 objects
5+ rads
Hypomagnesemia
5 yo - draws person - ties shoes - skips
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

6. complications of otitis media
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Metronidazole or clindamycin
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

7. Immunizations for adult 65YO+
Colchicine
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Cataracts
Tdap - influenza - pneumovax

8. Tx acute gout
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
110-160bpm
5 yo - draws person - ties shoes - skips
Colchicine

9. needles - strong negative birefringent (yellow crystals parallel light)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
MCC melanoma. Radial growth.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Monosodium urate crystals (gout)

10. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Patch - bupropion - varenicline
Clindamycin AND gentamicin

11. The five A's of smoking cessation
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ask - Advise - Assess - Assist - Arrange

12. Oral tx for PID
Thiazides
Bupropion - varenicline - nicotine replacement
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
(ofloxacin OR levofloxacin) +/- metronidazole

13. variable deceleration
110-160bpm
Metronidazole or clindamycin
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ampicillin/sulbactam AND doxycycline

14. Dx PID
1 mo - eyes follow object to midline - vocalizes
(cefotetan OR cefoxitin) AND doxycycline
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

15. ADL
Bathing - dressing - eating - transferring - continence - toileting
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
NAC or IV NaHCO3
Fluoroquinolones

16. painless - deep - subQ swelling (periorbital - circumoral - facial)
110-160bpm
Angioedema
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

17. 1st generation antihistamines
Lung; SCC head & neck; RCC; breast; MM; prostate
Angioedema
Diphenhydramine - chlorpheniramine - hydroxyzine
= LMP + 7 days - 3 months

18. Low serum iron - low MCV - low ferritin - +stool guaiac
Ask - Advise - Assess - Assist - Arrange
MTX
Fe deficient anemia
Ceftriaxone 125mg IM

19. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Ofloxacin OR levofloxacin +/- metronidazole
5+ rads

20. Other causes of hypercalcemia
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
IV penicillin (or ampicillin)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ask - Advise - Assess - Assist - Arrange

21. Fetal heart rate range
6 yo
9 mo - walks - throws - 1-3 words - 1-step commands
110-160bpm
Calcium oxalate crystals

22. Emphysema - <45YO - nonsmoker
Ask - Advise - Assess - Assist - Arrange
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Alpha-1 antitrypsin deficiency

23. Tocodynamometer
(cefotetan OR cefoxitin) AND doxycycline
Conrtaction monitoring along with fetal heart rate assessment
Diabetes - HTN - GN
Ofloxacin OR levofloxacin +/- metronidazole

24. social smile - parent recognition
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
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
Angioedema

25. Acral lentinous melanoma
Nuchal translucency - serum hCG - PAPP-A
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Steroids + bronchodilators

26. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Diabetes - HTN - GN
Fluoroquinolones
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Diphenhydramine - chlorpheniramine - hydroxyzine

27. Estimated delivery date (Naegele's rule)
5+ rads
= LMP + 7 days - 3 months
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

28. Cockcroft-Gault equation
After delivery until delivery of placenta and membranes <30 mins
Alpha-1 antitrypsin deficiency
Angioedema
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

29. Fe deficient anemia tx
6 yo
Alpha-1 antitrypsin deficiency
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Ferrous sulfate 325mg tid

30. Pregnancy class D smoking cessation drugs
Urticaria
IV penicillin (or ampicillin)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Nicotine inhaler - nasal spray - gum

31. DOC for HTN in elderly
Thiazides
Tdap - influenza - pneumovax
Esophagitis - gastritis - dysphagia
2 mo - eyes follow object past midline - rolls over - laughs - squeals

32. Superficial spreading melanoma
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Thiazdes; lithium
MCC melanoma. Radial growth.

33. Tx gonorrhea
(ofloxacin OR levofloxacin) +/- metronidazole
Ceftriaxone 125mg IM
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Cataracts

34. Nonfunctioning nodules > 1cm require _____
Flexion - internal rotation - extension - external rotation
Biopsy
110-160bpm
2 mo - eyes follow object past midline - rolls over - laughs - squeals

35. stranger/separation anxiety
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Tuberculosis; sarcoidosis; hodgkin disease

36. DDX for geriatric hearing impairment
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
1 mo - eyes follow object to midline - vocalizes
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

37. Screening for 65-76YO male smoker
Aortic aneurysm
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Calcium pyrophosphate dehydrate crystals (pseudogout)
Pneumovax - influenza

38. Dx bacterial rhinosinusitis
Hypomagnesemia
Short-acting + 40mg prednisone x 10-14days
Prostatitis
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)

39. IV tx for PID
Clindamycin AND gentamicin
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Monosodium urate crystals (gout)
5+ rads

40. GBS tx
Diabetes - HTN - GN
Age-related sensorineural hearing loss (high frequency and speech discrimination)
IV penicillin (or ampicillin)
Prostatitis

41. Fetal lie
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Long axis of fetus to long axis of mother (longitudinal or transverse)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

42. bacteria causing pharyngitis
= LMP + 7 days - 3 months
Tdap - influenza - pneumovax
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

43. Mediators released in response to allergen
Ceftriaxone 125mg IM
Bupropion - varenicline - nicotine replacement
Tuberculosis; sarcoidosis; hodgkin disease
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

44. Late deceleration
Onset of labor until cervix dilation
Long axis of fetus to long axis of mother (longitudinal or transverse)
IV penicillin (or ampicillin)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

45. Optimal time for trisomy screen
MTX
Clindamycin AND gentamicin
16-18 weeks GA
Thiazdes; lithium

46. IADL
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)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fluoroquinolones

47. Dx bacterial vaginosis
Steroids + bronchodilators
MCC melanoma. Radial growth.
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

48. Immunizations for COPD patients
Thiazdes; lithium
Pneumovax - influenza
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

49. Lentigo Maligna
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Starts at contraction. caused by increased vagal tone from fetal head compression.
Tuberculosis; sarcoidosis; hodgkin disease
Anaphylaxis

50. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
Diphenhydramine - chlorpheniramine - hydroxyzine
Aortic aneurysm
9 mo - walks - throws - 1-3 words - 1-step commands