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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. Only therapy to decrease mortality in stage IV COPD
Oxygen intervention 15h/d
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

2. presbycusis
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Oxygen intervention 15h/d

3. Oral tx for PID
6 mo - pincer - crawls - cruises - mamma - dada - byebye
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Nicotine inhaler - nasal spray - gum
Ceftriaxone 125mg IM

4. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
Ceftriaxone 125mg IM
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

5. Low serum iron - low MCV - low ferritin - +stool guaiac
= LMP + 7 days - 3 months
6 yo
Prostatitis
Fe deficient anemia

6. Complications of GAS infxn
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Colchicine
Urticaria
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

7. GBS tx
IV penicillin (or ampicillin)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Conrtaction monitoring along with fetal heart rate assessment
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

8. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Age-related sensorineural hearing loss (high frequency and speech discrimination)
NAC or IV NaHCO3
Onset of labor until cervix dilation
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)

9. Optimal time for trisomy screen
16-18 weeks GA
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ofloxacin OR levofloxacin +/- metronidazole
Metronidazole or clindamycin

10. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
(ofloxacin OR levofloxacin) +/- metronidazole
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

11. Tx acute exacerbation COPD
Short-acting + 40mg prednisone x 10-14days
= LMP + 7 days - 3 months
Colchicine
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

12. Bisphospohonates sfx
Colchicine
1 mo - eyes follow object to midline - vocalizes
Ask - Advise - Assess - Assist - Arrange
Esophagitis - gastritis - dysphagia

13. causes of acute bronchitis
4mo - sits unsupported - hand transfer - babbles
Anterior shoulder cannot readily pass below the pubic symphysis.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

14. Dx bacterial rhinosinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
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)
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

15. MCC blindness worldwide
Metronidazole or clindamycin
4 yo - copies triangle - catches ball - dresses self
Patch - bupropion - varenicline
Cataracts

16. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Measures strength of contractions
Diabetes - HTN - GN
4 yo - copies triangle - catches ball - dresses self

17. Third stage of labor
Fe deficient anemia
After delivery until delivery of placenta and membranes <30 mins
Ampicillin/sulbactam AND doxycycline
Ferrous sulfate 325mg tid

18. Sx otitis media
Metronidazole or clindamycin
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

19. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Bathing - dressing - eating - transferring - continence - toileting
Thiazides
MCC melanoma in Africans/Asians. Under nails - soles - palms.

20. 2nd generation antihistamines
DTaP - hepB - Hib - rotavirus - inactivated polio
Starts at contraction. caused by increased vagal tone from fetal head compression.
Loratadine - fexofenadine - cetirizine
Clindamycin AND gentamicin

21. social interaction
Starts at contraction. caused by increased vagal tone from fetal head compression.
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
4 yo - copies triangle - catches ball - dresses self
Lung; SCC head & neck; RCC; breast; MM; prostate

22. X-ray of ankle?
Ceftriaxone 125mg IM
Esophagitis - gastritis - dysphagia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Normal mental status; no other injuries; seen within 10 days of injury

23. Tx of traveler's diarrhea
Thiazides
Anterior shoulder cannot readily pass below the pubic symphysis.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Oxygen intervention 15h/d

24. IADL
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
1 mo - eyes follow object to midline - vocalizes
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

25. needles - strong negative birefringent (yellow crystals parallel light)
6 yo
5+ rads
Monosodium urate crystals (gout)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

26. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Monosodium urate crystals (gout)
Anemia
Ampicillin/sulbactam AND doxycycline

27. Superficial spreading melanoma
Steroids + bronchodilators
MCC melanoma. Radial growth.
1 mo - eyes follow object to midline - vocalizes
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

28. Pregnancy class D smoking cessation drugs
NAC or IV NaHCO3
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Nicotine inhaler - nasal spray - gum

29. Corrected serum calcium =

30. Complications of PID
= LMP + 7 days - 3 months
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
(ofloxacin OR levofloxacin) +/- metronidazole
Measures strength of contractions

31. Bacteria causing chronic sinusitis
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Patch - bupropion - varenicline
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

32. Early deceleration
(cefotetan OR cefoxitin) AND doxycycline
Calcium oxalate crystals
Diabetes - HTN - GN
Starts at contraction. caused by increased vagal tone from fetal head compression.

33. parallel play
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
(cefotetan OR cefoxitin) AND doxycycline
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

34. Acral lentinous melanoma
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Aortic aneurysm
110-160bpm

35. Pflx for traveler's diarrhea
Oxytocin (IV)
Fluoroquinolones
Diabetes - HTN - GN
6 mo - pincer - crawls - cruises - mamma - dada - byebye

36. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
5+ rads
Esophagitis - gastritis - dysphagia
Biopsy

37. Emphysema - <45YO - nonsmoker
Tuberculosis; sarcoidosis; hodgkin disease
Urinary calcium. Hyper PTH (high) >> FHH (normal)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Alpha-1 antitrypsin deficiency

38. Sx peritonsillar abscess
Anterior shoulder cannot readily pass below the pubic symphysis.
Metronidazole or clindamycin
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ampicillin/sulbactam AND doxycycline

39. Mediators released in response to allergen
Diphenhydramine - chlorpheniramine - hydroxyzine
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
MTX
Hypomagnesemia

40. stranger/separation anxiety
1 mo - eyes follow object to midline - vocalizes
Thiazides
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Steroids + bronchodilators

41. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Metronidazole or clindamycin
Pneumovax - influenza
(ofloxacin OR levofloxacin) +/- metronidazole

42. Tocodynamometer
6-9MO
Conrtaction monitoring along with fetal heart rate assessment
DTaP - hepB - Hib - rotavirus - inactivated polio
MCC melanoma in Africans/Asians. Under nails - soles - palms.

43. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
9 mo - walks - throws - 1-3 words - 1-step commands
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

44. Causes of CKD
Diabetes - HTN - GN
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Cataracts
6 yo

45. Estimated delivery date (Naegele's rule)
After delivery until delivery of placenta and membranes <30 mins
= LMP + 7 days - 3 months
Nuchal translucency - serum hCG - PAPP-A
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)

46. Dx bacterial vaginosis
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

47. Fe deficient anemia tx
Ferrous sulfate 325mg tid
Tuberculosis; sarcoidosis; hodgkin disease
Urticaria
Bathing - dressing - eating - transferring - continence - toileting

48. Granulomatous causes of hypercalcemia
Nicotine inhaler - nasal spray - gum
4 yo - copies triangle - catches ball - dresses self
Clindamycin AND gentamicin
Tuberculosis; sarcoidosis; hodgkin disease

49. social smile - parent recognition
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Nuchal translucency - serum hCG - PAPP-A
2 mo - eyes follow object past midline - rolls over - laughs - squeals

50. group play - gender - knows name
Hypomagnesemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Esophagitis - gastritis - dysphagia
3 yo - identify body part - copies square - hops - throws - past tense - story telling