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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. Fe deficient anemia tx
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
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)
4 yo - copies triangle - catches ball - dresses self
Ferrous sulfate 325mg tid

2. needles - strong negative birefringent (yellow crystals parallel light)
Diabetes - HTN - GN
Monosodium urate crystals (gout)
Bupropion - varenicline - nicotine replacement
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

3. Augments contractions
Calcium oxalate crystals
Oxytocin (IV)
Diabetes - HTN - GN
Fluoroquinolones

4. Low serum iron - low MCV - low ferritin - +stool guaiac
Prostatitis
Fe deficient anemia
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

5. Oral tx for PID
Anaphylaxis
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Aortic aneurysm

6. Tx hyperkalemia in CKD
Nicotine inhaler - nasal spray - gum
Steroids + bronchodilators
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

7. Cockcroft-Gault equation
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
0.2-0.5mg aqueous EPI IM/SubQ
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

8. Smoking cessation agents
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Nuchal translucency - serum hCG - PAPP-A
Bupropion - varenicline - nicotine replacement

9. bacteria causing pharyngitis
Tdap - influenza - pneumovax
Ampicillin/sulbactam AND doxycycline
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

10. Pflx for traveler's diarrhea
Fluoroquinolones
Thiazides
Normal mental status; no other injuries; seen within 10 days of injury
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

11. Recommendations for rear-facing car seat
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
<20lb - <1YO - Reacts to pain - Responds to noise
110-160bpm
Thiazdes; lithium

12. complications of otitis media
Oxygen intervention 15h/d
9 mo - walks - throws - 1-3 words - 1-step commands
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

13. DDX for geriatric hearing impairment
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
6 yo
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

14. Tender - boggy prostate. Dx?
Long axis of fetus to long axis of mother (longitudinal or transverse)
1 mo - eyes follow object to midline - vocalizes
Prostatitis
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

15. MCC blindness worldwide
Stridor - drooling - toxic appearance
Biopsy
Cataracts
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

16. writes name - counts 10 objects
Bupropion - varenicline - nicotine replacement
0.2-0.5mg aqueous EPI IM/SubQ
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
5 yo - draws person - ties shoes - skips

17. Tx bacterial vaginosis
Steroids + bronchodilators
0.2-0.5mg aqueous EPI IM/SubQ
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Metronidazole or clindamycin

18. Granulomatous causes of hypercalcemia
Metronidazole or clindamycin
Colchicine
Thiazides
Tuberculosis; sarcoidosis; hodgkin disease

19. How much radiation is associated with fetal harm?
5+ rads
(cefotetan OR cefoxitin) AND doxycycline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Starts at contraction. caused by increased vagal tone from fetal head compression.

20. Dx criteria for RA
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Normal mental status; no other injuries; seen within 10 days of injury
Steroids + bronchodilators
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

21. dyspnea - visceral edema - hypotension
Patch - bupropion - varenicline
Anaphylaxis
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)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

22. Recommended folic acid daily dose
Cataracts
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

23. Acral lentinous melanoma
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Bathing - dressing - eating - transferring - continence - toileting
MCC melanoma in Africans/Asians. Under nails - soles - palms.
2 mo - eyes follow object past midline - rolls over - laughs - squeals

24. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Biopsy
0.2-0.5mg aqueous EPI IM/SubQ
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
NAC or IV NaHCO3

25. IV tx for PID
Normal mental status; no other injuries; seen within 10 days of injury
Clindamycin AND gentamicin
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

26. Causes of CKD
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Alpha-1 antitrypsin deficiency
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Diabetes - HTN - GN

27. recognizes strangers
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
6 mo - pincer - crawls - cruises - mamma - dada - byebye
9 mo - walks - throws - 1-3 words - 1-step commands
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

28. Tx otitis media
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Conrtaction monitoring along with fetal heart rate assessment
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

29. Estimated delivery date (Naegele's rule)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
= LMP + 7 days - 3 months
6-9MO
Loratadine - fexofenadine - cetirizine

30. medications causing hypercalcemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Anemia
Stridor - drooling - toxic appearance
Thiazdes; lithium

31. DOC for HTN in elderly
Onset of labor until cervix dilation
Thiazides
Cataracts
Short-acting + 40mg prednisone x 10-14days

32. bipyramidal - strongly positive birefringent
(cefotetan OR cefoxitin) AND doxycycline
Clindamycin AND gentamicin
Calcium oxalate crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

33. group play - gender - knows name
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
IV penicillin (or ampicillin)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
3 yo - identify body part - copies square - hops - throws - past tense - story telling

34. 2nd generation antihistamines
Lung; SCC head & neck; RCC; breast; MM; prostate
Loratadine - fexofenadine - cetirizine
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

35. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
5 yo - draws person - ties shoes - skips
IV penicillin (or ampicillin)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

36. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Tuberculosis; sarcoidosis; hodgkin disease
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

37. X-ray of ankle?
Conrtaction monitoring along with fetal heart rate assessment
Normal mental status; no other injuries; seen within 10 days of injury
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Cataracts

38. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Urticaria
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
9 mo - walks - throws - 1-3 words - 1-step commands

39. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
9 mo - walks - throws - 1-3 words - 1-step commands
Tuberculosis; sarcoidosis; hodgkin disease
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

40. Tx for anaphylaxis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
0.2-0.5mg aqueous EPI IM/SubQ
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Bupropion - varenicline - nicotine replacement

41. Large - irregularly shaped - prutitic - erythematous wheals
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
4 yo - copies triangle - catches ball - dresses self
Urticaria
5 yo - draws person - ties shoes - skips

42. Dx bacterial rhinosinusitis
Diphenhydramine - chlorpheniramine - hydroxyzine
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
Steroids + bronchodilators

43. Tocodynamometer
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Esophagitis - gastritis - dysphagia
Hypomagnesemia
Conrtaction monitoring along with fetal heart rate assessment

44. tx shoulder dystocia

45. 1st generation antihistamines
Flexion - internal rotation - extension - external rotation
Diphenhydramine - chlorpheniramine - hydroxyzine
Tuberculosis; sarcoidosis; hodgkin disease
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

46. Sx epiglottitis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Stridor - drooling - toxic appearance
Alpha-1 antitrypsin deficiency
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

47. The five A's of smoking cessation
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Loratadine - fexofenadine - cetirizine
Ask - Advise - Assess - Assist - Arrange
Anemia

48. Sx otitis media
Angioedema
1 mo - eyes follow object to midline - vocalizes
(ofloxacin OR levofloxacin) +/- metronidazole
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

49. Screened at 16-20 weeks GA for trisomy
Diphenhydramine - chlorpheniramine - hydroxyzine
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Urinary calcium. Hyper PTH (high) >> FHH (normal)

50. social smile - parent recognition
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thiazdes; lithium
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Urinary calcium. Hyper PTH (high) >> FHH (normal)