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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
DTaP - hepB - Hib - rotavirus - inactivated polio
4 yo - copies triangle - catches ball - dresses self
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Oxygen intervention 15h/d

2. Oral tx for PID
Alpha-1 antitrypsin deficiency
5 yo - draws person - ties shoes - skips
(ofloxacin OR levofloxacin) +/- metronidazole
MTX

3. Improve short-term outcomes in acute exacerbations of COPD - asthma
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
After delivery until delivery of placenta and membranes <30 mins
Clindamycin AND gentamicin
Steroids + bronchodilators

4. Tx acute gout
Colchicine
MCC melanoma in Africans/Asians. Under nails - soles - palms.
DTaP - hepB - Hib - rotavirus - inactivated polio
Fluoroquinolones

5. Dx PID
Urinary calcium. Hyper PTH (high) >> FHH (normal)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

6. Pregnancy class C smoking cessation drugs
Patch - bupropion - varenicline
4mo - sits unsupported - hand transfer - babbles
Ofloxacin OR levofloxacin +/- metronidazole
Monosodium urate crystals (gout)

7. Tx for thyroid storm
Bathing - dressing - eating - transferring - continence - toileting
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Hypomagnesemia
4 yo - copies triangle - catches ball - dresses self

8. IUPC (intrauterine pressure catheter)
Normal mental status; no other injuries; seen within 10 days of injury
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Cataracts
Measures strength of contractions

9. Tocodynamometer
Cataracts
Conrtaction monitoring along with fetal heart rate assessment
After delivery until delivery of placenta and membranes <30 mins
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

10. variable deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Prostatitis
Diabetes - HTN - GN
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

11. Sx of hypercalcemia
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ear pain - itching - inflammation/swollen canal - exudates/discharge

12. identifies left - right
6 yo
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

13. stranger/separation anxiety
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Anaphylaxis
5+ rads
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

14. bipyramidal - strongly positive birefringent
Starts at contraction. caused by increased vagal tone from fetal head compression.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals

15. parallel play
Calcium hydroxyapatite crystals
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Patch - bupropion - varenicline
Bathing - dressing - eating - transferring - continence - toileting

16. First stage of labor
Onset of labor until cervix dilation
Anterior shoulder cannot readily pass below the pubic symphysis.
Cataracts
Fe deficient anemia

17. Electrolyte abnormality that increases the incidence of torsades de pointes
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Hypomagnesemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
Most aggressive melanoma.

18. Dx criteria for RA
Oxygen intervention 15h/d
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ceftriaxone 125mg IM
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

19. Unstable angina vs MI Dx tests
3 yo - identify body part - copies square - hops - throws - past tense - story telling
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
(ofloxacin OR levofloxacin) +/- metronidazole
Calcium hydroxyapatite crystals

20. complications of otitis media
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Onset of labor until cervix dilation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ask - Advise - Assess - Assist - Arrange

21. The five A's of smoking cessation
Ask - Advise - Assess - Assist - Arrange
Starts at contraction. caused by increased vagal tone from fetal head compression.
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

22. writes name - counts 10 objects
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Diphenhydramine - chlorpheniramine - hydroxyzine
5 yo - draws person - ties shoes - skips
Steroids + bronchodilators

23. Early deceleration
4 yo - copies triangle - catches ball - dresses self
4mo - sits unsupported - hand transfer - babbles
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ofloxacin OR levofloxacin +/- metronidazole

24. Augments contractions
5+ rads
5 yo - draws person - ties shoes - skips
Fe deficient anemia
Oxytocin (IV)

25. Tx GAS ifxn
NAC or IV NaHCO3
Bupropion - varenicline - nicotine replacement
110-160bpm
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide

26. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ofloxacin OR levofloxacin +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
<20lb - <1YO - Reacts to pain - Responds to noise

27. IV tx for PID
Ofloxacin OR levofloxacin +/- metronidazole
MTX
9 mo - walks - throws - 1-3 words - 1-step commands
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

28. Tx otitis media
Aortic aneurysm
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Esophagitis - gastritis - dysphagia

29. Tx for anaphylaxis
9 mo - walks - throws - 1-3 words - 1-step commands
0.2-0.5mg aqueous EPI IM/SubQ
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance

30. social interaction
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
4 yo - copies triangle - catches ball - dresses self
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

31. Late deceleration
MCC melanoma. Radial growth.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Loratadine - fexofenadine - cetirizine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

32. IADL
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

33. Sx epiglottitis
Stridor - drooling - toxic appearance
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Tuberculosis; sarcoidosis; hodgkin disease

34. Other causes of hypercalcemia
Monosodium urate crystals (gout)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
1 mo - eyes follow object to midline - vocalizes
4mo - sits unsupported - hand transfer - babbles

35. Superficial spreading melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
MCC melanoma. Radial growth.

36. Cockcroft-Gault equation
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Short-acting + 40mg prednisone x 10-14days
Diabetes - HTN - GN
Fluoroquinolones

37. Sx otitis media
Pneumovax - influenza
Lung; SCC head & neck; RCC; breast; MM; prostate
0.2-0.5mg aqueous EPI IM/SubQ
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

38. causes of acute bronchitis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ferrous sulfate 325mg tid
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)
Ofloxacin OR levofloxacin +/- metronidazole

39. Immunizations for adult 65YO+
Tdap - influenza - pneumovax
Bathing - dressing - eating - transferring - continence - toileting
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

40. MONA therapy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ofloxacin OR levofloxacin +/- metronidazole

41. group play - gender - knows name
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
3 yo - identify body part - copies square - hops - throws - past tense - story telling

42. X-ray on knee?
Ofloxacin OR levofloxacin +/- metronidazole
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
5+ rads
Diabetes - HTN - GN

43. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

44. Dx bacterial rhinosinusitis
6-9MO
(ofloxacin OR levofloxacin) +/- metronidazole
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
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)

45. Age by which child says 'mama' and 'dada'
MCC melanoma. Radial growth.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Oxytocin (IV)
6-9MO

46. painless - deep - subQ swelling (periorbital - circumoral - facial)
Bupropion - varenicline - nicotine replacement
Clindamycin AND gentamicin
IV penicillin (or ampicillin)
Angioedema

47. Fetal heart rate range
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
6-9MO
110-160bpm
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

48. recognizes strangers
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
6 mo - pincer - crawls - cruises - mamma - dada - byebye
6 yo

49. medications causing hypercalcemia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Thiazdes; lithium
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Tdap - influenza - pneumovax

50. Tx acute exacerbation COPD
Urticaria
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Short-acting + 40mg prednisone x 10-14days