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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. Sx otitis externa
Ampicillin/sulbactam AND doxycycline
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Diphenhydramine - chlorpheniramine - hydroxyzine
Diabetes - HTN - GN

2. dyspnea - visceral edema - hypotension
Alpha-1 antitrypsin deficiency
Anaphylaxis
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Patch - bupropion - varenicline

3. Pflx for traveler's diarrhea
Biopsy
9 mo - walks - throws - 1-3 words - 1-step commands
Stridor - drooling - toxic appearance
Fluoroquinolones

4. Large - irregularly shaped - prutitic - erythematous wheals
Urticaria
Angioedema
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Calcium oxalate crystals

5. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Nicotine inhaler - nasal spray - gum

6. presbycusis
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

7. Recommended folic acid daily dose
MTX
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Metronidazole or clindamycin

8. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
MCC melanoma. Radial growth.
Colchicine
Anaphylaxis
NAC or IV NaHCO3

9. Tx otitis media
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
Anemia
(cefotetan OR cefoxitin) AND doxycycline

10. 1st generation antihistamines
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Diphenhydramine - chlorpheniramine - hydroxyzine
= LMP + 7 days - 3 months

11. writes name - counts 10 objects
Bupropion - varenicline - nicotine replacement
Pneumovax - influenza
5 yo - draws person - ties shoes - skips
Most aggressive melanoma.

12. Tocodynamometer
Conrtaction monitoring along with fetal heart rate assessment
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Loratadine - fexofenadine - cetirizine
Aortic aneurysm

13. Superficial spreading melanoma
MCC melanoma. Radial growth.
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Ceftriaxone 125mg IM

14. Second stage of labor
Flexion - internal rotation - extension - external rotation
Most aggressive melanoma.
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

15. Tx bacterial vaginosis
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
IV penicillin (or ampicillin)
NAC or IV NaHCO3
Metronidazole or clindamycin

16. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Ferrous sulfate 325mg tid
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)

17. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Anemia
Diphenhydramine - chlorpheniramine - hydroxyzine

18. How much radiation is associated with fetal harm?
5+ rads
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Most aggressive melanoma.
0.2-0.5mg aqueous EPI IM/SubQ

19. Late deceleration
Bathing - dressing - eating - transferring - continence - toileting
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Bupropion - varenicline - nicotine replacement
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

20. Tx chlamydia
Most aggressive melanoma.
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Steroids + bronchodilators
5+ rads

21. stranger/separation anxiety
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
4 yo - copies triangle - catches ball - dresses self
IV penicillin (or ampicillin)
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

22. Sx otitis media
Long axis of fetus to long axis of mother (longitudinal or transverse)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Ofloxacin OR levofloxacin +/- metronidazole
1 mo - eyes follow object to midline - vocalizes

23. IV tx for PID
Onset of labor until cervix dilation
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Ofloxacin OR levofloxacin +/- metronidazole
Clindamycin AND gentamicin

24. Dx PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Stridor - drooling - toxic appearance
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

25. painless - deep - subQ swelling (periorbital - circumoral - facial)
Angioedema
MCC melanoma. Radial growth.
9 mo - walks - throws - 1-3 words - 1-step commands
Ofloxacin OR levofloxacin +/- metronidazole

26. Lentigo Maligna
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Flexion - internal rotation - extension - external rotation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Onset of labor until cervix dilation

27. bacteria causing pharyngitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Calcium oxalate crystals
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

28. Fe deficient anemia tx
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Ferrous sulfate 325mg tid
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

29. Mediators released in response to allergen
110-160bpm
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Urticaria
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

30. IV tx for PID
Nuchal translucency - serum hCG - PAPP-A
MTX
(cefotetan OR cefoxitin) AND doxycycline
Ampicillin/sulbactam AND doxycycline

31. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Fluoroquinolones
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

32. Augments contractions
Ofloxacin OR levofloxacin +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)
Oxytocin (IV)
Esophagitis - gastritis - dysphagia

33. Tx RA (best long-term outcome)
MTX
Clindamycin AND gentamicin
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Ear pain - itching - inflammation/swollen canal - exudates/discharge

34. X-ray on knee?
(ofloxacin OR levofloxacin) +/- metronidazole
5 yo - draws person - ties shoes - skips
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

35. IV tx for PID
= LMP + 7 days - 3 months
Anemia
Ampicillin/sulbactam AND doxycycline
Patch - bupropion - varenicline

36. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Biopsy
Tdap - influenza - pneumovax

37. social interaction
Urticaria
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Fe deficient anemia
4 yo - copies triangle - catches ball - dresses self

38. Unstable angina vs MI Dx tests
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
Measures strength of contractions
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

39. Fetal lie
Flexion - internal rotation - extension - external rotation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Long axis of fetus to long axis of mother (longitudinal or transverse)
Hypomagnesemia

40. Only therapy to decrease mortality in stage IV COPD
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Measures strength of contractions
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Oxygen intervention 15h/d

41. Bacteria causing chronic sinusitis
Ceftriaxone 125mg IM
Loratadine - fexofenadine - cetirizine
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Colchicine

42. Tx acute gout
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Tuberculosis; sarcoidosis; hodgkin disease
Colchicine

43. Four cardinal fetal movements
Ferrous sulfate 325mg tid
Bathing - dressing - eating - transferring - continence - toileting
Colchicine
Flexion - internal rotation - extension - external rotation

44. IUPC (intrauterine pressure catheter)
Measures strength of contractions
DTaP - hepB - Hib - rotavirus - inactivated polio
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Urticaria

45. Sx of hypercalcemia
Monosodium urate crystals (gout)
Ofloxacin OR levofloxacin +/- metronidazole
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

46. Pregnancy class D smoking cessation drugs
Esophagitis - gastritis - dysphagia
= LMP + 7 days - 3 months
Nicotine inhaler - nasal spray - gum
Aortic aneurysm

47. Immunizations for adult 65YO+
Fluoroquinolones
Tdap - influenza - pneumovax
Tuberculosis; sarcoidosis; hodgkin disease
(ofloxacin OR levofloxacin) +/- metronidazole

48. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Biopsy
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

49. causes of acute bronchitis
(cefotetan OR cefoxitin) AND doxycycline
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

50. Optimal time for trisomy screen
16-18 weeks GA
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
(cefotetan OR cefoxitin) AND doxycycline
Loratadine - fexofenadine - cetirizine