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Family Medicine/ambulatory 1

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. Tocodynamometer
Age-related sensorineural hearing loss (high frequency and speech discrimination)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Metronidazole or clindamycin
Conrtaction monitoring along with fetal heart rate assessment

2. Screening for 65-76YO male smoker
Thiazides
Lung; SCC head & neck; RCC; breast; MM; prostate
Thiazdes; lithium
Aortic aneurysm

3. Tx acute gout
Colchicine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at contraction. caused by increased vagal tone from fetal head compression.

4. IUPC (intrauterine pressure catheter)
DTaP - hepB - Hib - rotavirus - inactivated polio
Pneumovax - influenza
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Measures strength of contractions

5. medications causing hypercalcemia
Fluoroquinolones
Thiazdes; lithium
16-18 weeks GA
Calcium hydroxyapatite crystals

6. stranger/separation anxiety
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
1 mo - eyes follow object to midline - vocalizes
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

7. cystoplasmic inclusions - not birefringent
5+ rads
Calcium hydroxyapatite crystals
MCC melanoma. Radial growth.
16-18 weeks GA

8. Oral tx for PID
Diabetes - HTN - GN
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

9. Tx of traveler's diarrhea
Alpha-1 antitrypsin deficiency
Most aggressive melanoma.
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)

10. DOC for HTN in elderly
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)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Thiazides
Ask - Advise - Assess - Assist - Arrange

11. 1st generation antihistamines
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Colchicine
Diphenhydramine - chlorpheniramine - hydroxyzine
Oxytocin (IV)

12. Tx bacterial vaginosis
Anaphylaxis
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Metronidazole or clindamycin
Fluoroquinolones

13. X-ray of ankle?
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Normal mental status; no other injuries; seen within 10 days of injury
Clindamycin AND gentamicin

14. Superficial spreading melanoma
Thiazdes; lithium
MCC melanoma. Radial growth.
Ampicillin/sulbactam AND doxycycline
Anterior shoulder cannot readily pass below the pubic symphysis.

15. Low serum iron - low MCV - low ferritin - +stool guaiac
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Thiazdes; lithium
Fe deficient anemia
Stridor - drooling - toxic appearance

16. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Calcium oxalate crystals
Steroids + bronchodilators
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

17. Augments contractions
Measures strength of contractions
<20lb - <1YO - Reacts to pain - Responds to noise
Oxytocin (IV)
Ask - Advise - Assess - Assist - Arrange

18. regards hand
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Steroids + bronchodilators
4mo - sits unsupported - hand transfer - babbles

19. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Conrtaction monitoring along with fetal heart rate assessment
Flexion - internal rotation - extension - external rotation
Monosodium urate crystals (gout)

20. X-ray on knee?
0.2-0.5mg aqueous EPI IM/SubQ
5 yo - draws person - ties shoes - skips
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

21. Sx of hypercalcemia
Alpha-1 antitrypsin deficiency
Fe deficient anemia
Esophagitis - gastritis - dysphagia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

22. Rod shaped - rhomboid - weakly positive birefringent
Nuchal translucency - serum hCG - PAPP-A
Oxytocin (IV)
Anemia
Calcium pyrophosphate dehydrate crystals (pseudogout)

23. Unstable angina vs MI Dx tests
MCC melanoma. Radial growth.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Diphenhydramine - chlorpheniramine - hydroxyzine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

24. Pregnancy class C smoking cessation drugs
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Patch - bupropion - varenicline
Anterior shoulder cannot readily pass below the pubic symphysis.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

25. Improve short-term outcomes in acute exacerbations of COPD - asthma
Anaphylaxis
Steroids + bronchodilators
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

26. tx shoulder dystocia

27. Dx bacterial vaginosis
MCC melanoma. Radial growth.
<20lb - <1YO - Reacts to pain - Responds to noise
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

28. Sx epiglottitis
Short-acting + 40mg prednisone x 10-14days
MCC melanoma in Africans/Asians. Under nails - soles - palms.
IV penicillin (or ampicillin)
Stridor - drooling - toxic appearance

29. Causes of CKD
Normal mental status; no other injuries; seen within 10 days of injury
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1 mo - eyes follow object to midline - vocalizes
Diabetes - HTN - GN

30. Mediators released in response to allergen
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Flexion - internal rotation - extension - external rotation
4mo - sits unsupported - hand transfer - babbles
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

31. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
110-160bpm
NAC or IV NaHCO3
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

32. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
Nicotine inhaler - nasal spray - gum
6-9MO
Clindamycin AND gentamicin

33. social interaction
4 yo - copies triangle - catches ball - dresses self
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Oxytocin (IV)

34. Lentigo Maligna
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Lung; SCC head & neck; RCC; breast; MM; prostate
Hypomagnesemia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

35. Immunizations for adult 65YO+
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Tdap - influenza - pneumovax
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

36. IV tx for PID
Calcium pyrophosphate dehydrate crystals (pseudogout)
Aortic aneurysm
(cefotetan OR cefoxitin) AND doxycycline
1 mo - eyes follow object to midline - vocalizes

37. IV tx for PID
Oxytocin (IV)
Ofloxacin OR levofloxacin +/- metronidazole
Clindamycin AND gentamicin
Onset of labor until cervix dilation

38. Estimated delivery date (Naegele's rule)
Conrtaction monitoring along with fetal heart rate assessment
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
= LMP + 7 days - 3 months

39. Fetal lie
Flexion - internal rotation - extension - external rotation
Long axis of fetus to long axis of mother (longitudinal or transverse)
Stridor - drooling - toxic appearance
Aortic aneurysm

40. Immunizations at visit for 6MO
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
DTaP - hepB - Hib - rotavirus - inactivated polio
Anemia
After delivery until delivery of placenta and membranes <30 mins

41. Signs of rupture of membranes

42. The five A's of smoking cessation
Clindamycin AND gentamicin
Ask - Advise - Assess - Assist - Arrange
Ceftriaxone 125mg IM
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

43. variable deceleration
Ampicillin/sulbactam AND doxycycline
Ofloxacin OR levofloxacin +/- metronidazole
4mo - sits unsupported - hand transfer - babbles
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

44. identifies left - right
Calcium hydroxyapatite crystals
6 yo
Biopsy
Colchicine

45. Oral tx for PID
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
4mo - sits unsupported - hand transfer - babbles
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
(ofloxacin OR levofloxacin) +/- metronidazole

46. Granulomatous causes of hypercalcemia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Tuberculosis; sarcoidosis; hodgkin disease
Ceftriaxone 125mg IM
Fluoroquinolones

47. dyspnea - visceral edema - hypotension
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Anaphylaxis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

48. Complications of GAS infxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fe deficient anemia
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

49. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Tuberculosis; sarcoidosis; hodgkin disease
(cefotetan OR cefoxitin) AND doxycycline
6-9MO

50. shoulder dystocia
Loratadine - fexofenadine - cetirizine
Anterior shoulder cannot readily pass below the pubic symphysis.
Fluoroquinolones
Diphenhydramine - chlorpheniramine - hydroxyzine