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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. medications causing hypercalcemia
Short-acting + 40mg prednisone x 10-14days
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Thiazdes; lithium
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

2. Screening for 65-76YO male smoker
Anterior shoulder cannot readily pass below the pubic symphysis.
6 yo
Aortic aneurysm
Anemia

3. First stage of labor
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ask - Advise - Assess - Assist - Arrange
Esophagitis - gastritis - dysphagia
Onset of labor until cervix dilation

4. X-ray of ankle?
Prostatitis
Steroids + bronchodilators
Hypomagnesemia
Normal mental status; no other injuries; seen within 10 days of injury

5. Age by which child says 'mama' and 'dada'
6-9MO
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
MTX
Pneumovax - influenza

6. Nonfunctioning nodules > 1cm require _____
Most aggressive melanoma.
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Biopsy
3 yo - identify body part - copies square - hops - throws - past tense - story telling

7. Pregnancy class D smoking cessation drugs
Ofloxacin OR levofloxacin +/- metronidazole
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Nicotine inhaler - nasal spray - gum

8. Fetal heart rate range
3 yo - identify body part - copies square - hops - throws - past tense - story telling
110-160bpm
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Tdap - influenza - pneumovax

9. bacteria causing pharyngitis
Angioedema
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ofloxacin OR levofloxacin +/- metronidazole
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

10. tx shoulder dystocia

11. Mediators released in response to allergen
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Fe deficient anemia

12. IADL
Tdap - influenza - pneumovax
Most aggressive melanoma.
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

13. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

14. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ceftriaxone 125mg IM
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

15. Dx PID
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Angioedema
MTX

16. How much radiation is associated with fetal harm?
Urticaria
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Calcium pyrophosphate dehydrate crystals (pseudogout)
5+ rads

17. Bacteria causing chronic sinusitis
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
9 mo - walks - throws - 1-3 words - 1-step commands
Angioedema
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

18. explorations
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
9 mo - walks - throws - 1-3 words - 1-step commands
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

19. Dx bacterial rhinosinusitis
Ask - Advise - Assess - Assist - Arrange
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)
Angioedema
5 yo - draws person - ties shoes - skips

20. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
0.2-0.5mg aqueous EPI IM/SubQ
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Onset of labor until cervix dilation

21. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
Starts at contraction. caused by increased vagal tone from fetal head compression.
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

22. IV tx for PID
Clindamycin AND gentamicin
6-9MO
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Diabetes - HTN - GN

23. 2nd generation antihistamines
Patch - bupropion - varenicline
Loratadine - fexofenadine - cetirizine
6 yo
Cataracts

24. parallel play
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Ear pain - itching - inflammation/swollen canal - exudates/discharge
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Bathing - dressing - eating - transferring - continence - toileting

25. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Loratadine - fexofenadine - cetirizine
Calcium oxalate crystals
DTaP - hepB - Hib - rotavirus - inactivated polio
Urinary calcium. Hyper PTH (high) >> FHH (normal)

26. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
4 yo - copies triangle - catches ball - dresses self
Most aggressive melanoma.
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Anemia

27. CKD Stages
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Angioedema
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

28. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Short-acting + 40mg prednisone x 10-14days
<20lb - <1YO - Reacts to pain - Responds to noise
Nicotine inhaler - nasal spray - gum

29. painless - deep - subQ swelling (periorbital - circumoral - facial)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Angioedema
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

30. X-ray on knee?
Calcium oxalate crystals
Onset of labor until cervix dilation
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Oxytocin (IV)

31. Cockcroft-Gault equation
Anaphylaxis
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
110-160bpm
4mo - sits unsupported - hand transfer - babbles

32. DOC for HTN in elderly
Ask - Advise - Assess - Assist - Arrange
4mo - sits unsupported - hand transfer - babbles
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Thiazides

33. Tx gonorrhea
Ferrous sulfate 325mg tid
Ceftriaxone 125mg IM
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

34. Tender - boggy prostate. Dx?
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Lung; SCC head & neck; RCC; breast; MM; prostate
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Prostatitis

35. MCC blindness worldwide
Cataracts
Most aggressive melanoma.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Tuberculosis; sarcoidosis; hodgkin disease

36. regards hand
4mo - sits unsupported - hand transfer - babbles
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tdap - influenza - pneumovax
Bupropion - varenicline - nicotine replacement

37. Superficial spreading melanoma
Cataracts
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
MCC melanoma. Radial growth.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

38. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Oxygen intervention 15h/d

39. dyspnea - visceral edema - hypotension
IV penicillin (or ampicillin)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anaphylaxis
Ampicillin/sulbactam AND doxycycline

40. Tx acute sinusitis
Anemia
Angioedema
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

41. shoulder dystocia
Diphenhydramine - chlorpheniramine - hydroxyzine
Anterior shoulder cannot readily pass below the pubic symphysis.
Fluoroquinolones
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

42. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Fluoroquinolones
Nicotine inhaler - nasal spray - gum

43. Tx RA (best long-term outcome)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
16-18 weeks GA
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
MTX

44. Recommended folic acid daily dose
Tuberculosis; sarcoidosis; hodgkin disease
Metronidazole or clindamycin
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Thiazides

45. Causes of CKD
Diabetes - HTN - GN
Stridor - drooling - toxic appearance
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

46. Early deceleration
Calcium oxalate crystals
Monosodium urate crystals (gout)
Starts at contraction. caused by increased vagal tone from fetal head compression.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

47. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Tuberculosis; sarcoidosis; hodgkin disease
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Fluoroquinolones

48. Emphysema - <45YO - nonsmoker
Starts at contraction. caused by increased vagal tone from fetal head compression.
Prostatitis
Alpha-1 antitrypsin deficiency
(ofloxacin OR levofloxacin) +/- metronidazole

49. Complications of PID
Nuchal translucency - serum hCG - PAPP-A
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Patch - bupropion - varenicline
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

50. ADL
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
<20lb - <1YO - Reacts to pain - Responds to noise
Long axis of fetus to long axis of mother (longitudinal or transverse)
Bathing - dressing - eating - transferring - continence - toileting