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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. presbycusis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Age-related sensorineural hearing loss (high frequency and speech discrimination)

2. IV tx for PID
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Clindamycin AND gentamicin
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

3. MCC blindness worldwide
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cataracts
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
MTX

4. explorations
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)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Calcium oxalate crystals

5. 2nd generation antihistamines
Metronidazole or clindamycin
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
MCC melanoma. Radial growth.
Loratadine - fexofenadine - cetirizine

6. Complications of PID
DTaP - hepB - Hib - rotavirus - inactivated polio
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Tdap - influenza - pneumovax
MCC melanoma. Radial growth.

7. painless - deep - subQ swelling (periorbital - circumoral - facial)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Angioedema
Cataracts

8. Other causes of hypercalcemia
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Calcium hydroxyapatite crystals
Diabetes - HTN - GN

9. How much radiation is associated with fetal harm?
= LMP + 7 days - 3 months
5+ rads
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

10. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
Urticaria
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

11. Rod shaped - rhomboid - weakly positive birefringent
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ofloxacin OR levofloxacin +/- metronidazole

12. Tx acute sinusitis
After delivery until delivery of placenta and membranes <30 mins
Metronidazole or clindamycin
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Urticaria

13. DOC for HTN in elderly
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Stridor - drooling - toxic appearance
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Thiazides

14. bipyramidal - strongly positive birefringent
Calcium oxalate crystals
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Measures strength of contractions
Starts at contraction. caused by increased vagal tone from fetal head compression.

15. Superficial spreading melanoma
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Normal mental status; no other injuries; seen within 10 days of injury
MCC melanoma. Radial growth.

16. Malignancies with hypercalcemia
Colchicine
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Lung; SCC head & neck; RCC; breast; MM; prostate
Most aggressive melanoma.

17. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Fluoroquinolones

18. Tender - boggy prostate. Dx?
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Monosodium urate crystals (gout)
Prostatitis
Aortic aneurysm

19. complications of otitis media
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
NAC or IV NaHCO3
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Bathing - dressing - eating - transferring - continence - toileting

20. X-ray on knee?
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

21. Only therapy to decrease mortality in stage IV COPD
Starts at contraction. caused by increased vagal tone from fetal head compression.
Cataracts
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Oxygen intervention 15h/d

22. Third stage of labor
Monosodium urate crystals (gout)
5 yo - draws person - ties shoes - skips
After delivery until delivery of placenta and membranes <30 mins
Bupropion - varenicline - nicotine replacement

23. Pflx for traveler's diarrhea
Urticaria
After delivery until delivery of placenta and membranes <30 mins
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Fluoroquinolones

24. Pregnancy class C smoking cessation drugs
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Angioedema
Patch - bupropion - varenicline
Short-acting + 40mg prednisone x 10-14days

25. Nodular melanoma
5+ rads
Most aggressive melanoma.
Ampicillin/sulbactam AND doxycycline
6-9MO

26. Dx bacterial vaginosis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium pyrophosphate dehydrate crystals (pseudogout)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Fe deficient anemia

27. Causes of CKD
Diabetes - HTN - GN
Esophagitis - gastritis - dysphagia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium pyrophosphate dehydrate crystals (pseudogout)

28. Tx gonorrhea
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Fe deficient anemia
Ceftriaxone 125mg IM

29. variable deceleration
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

30. IV tx for PID
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
(cefotetan OR cefoxitin) AND doxycycline
4 yo - copies triangle - catches ball - dresses self
Ampicillin/sulbactam AND doxycycline

31. Pregnancy class D smoking cessation drugs
Calcium pyrophosphate dehydrate crystals (pseudogout)
Aortic aneurysm
Ferrous sulfate 325mg tid
Nicotine inhaler - nasal spray - gum

32. Tx of traveler's diarrhea
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
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)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

33. Four cardinal fetal movements
Fe deficient anemia
Calcium hydroxyapatite crystals
Flexion - internal rotation - extension - external rotation
1 mo - eyes follow object to midline - vocalizes

34. Tx acute gout
Short-acting + 40mg prednisone x 10-14days
= LMP + 7 days - 3 months
Nicotine inhaler - nasal spray - gum
Colchicine

35. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Cataracts
Anemia
Flexion - internal rotation - extension - external rotation
4mo - sits unsupported - hand transfer - babbles

36. cystoplasmic inclusions - not birefringent
Clindamycin AND gentamicin
MCC melanoma. Radial growth.
Calcium hydroxyapatite crystals
Biopsy

37. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Urticaria
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Most aggressive melanoma.

38. ADL
Prostatitis
Cataracts
Bathing - dressing - eating - transferring - continence - toileting
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

39. Dx bacterial rhinosinusitis
Lung; SCC head & neck; RCC; breast; MM; prostate
Flexion - internal rotation - extension - external rotation
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
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)

40. The five A's of smoking cessation
After delivery until delivery of placenta and membranes <30 mins
Ask - Advise - Assess - Assist - Arrange
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Short-acting + 40mg prednisone x 10-14days

41. shoulder dystocia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Anterior shoulder cannot readily pass below the pubic symphysis.
Steroids + bronchodilators
Normal mental status; no other injuries; seen within 10 days of injury

42. Age by which child says 'mama' and 'dada'
6-9MO
MCC melanoma in Africans/Asians. Under nails - soles - palms.
16-18 weeks GA
Thiazdes; lithium

43. Immunizations for COPD patients
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Pneumovax - influenza
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Calcium pyrophosphate dehydrate crystals (pseudogout)

44. identifies left - right
6 yo
1 mo - eyes follow object to midline - vocalizes
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Clindamycin AND gentamicin

45. Tx for thyroid storm
Thiazdes; lithium
Esophagitis - gastritis - dysphagia
MTX
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

46. stranger/separation anxiety
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
(cefotetan OR cefoxitin) AND doxycycline
Oxytocin (IV)

47. Nonfunctioning nodules > 1cm require _____
Biopsy
Anemia
Fe deficient anemia
Conrtaction monitoring along with fetal heart rate assessment

48. IV tx for PID
Cataracts
<20lb - <1YO - Reacts to pain - Responds to noise
Onset of labor until cervix dilation
Ampicillin/sulbactam AND doxycycline

49. Tx bacterial vaginosis
Metronidazole or clindamycin
Bathing - dressing - eating - transferring - continence - toileting
Loratadine - fexofenadine - cetirizine
Nuchal translucency - serum hCG - PAPP-A

50. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Thiazides
Long axis of fetus to long axis of mother (longitudinal or transverse)
Starts at contraction. caused by increased vagal tone from fetal head compression.