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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. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
Ampicillin/sulbactam AND doxycycline
Metronidazole or clindamycin
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

2. Tx acute gout
Patch - bupropion - varenicline
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Colchicine
Bathing - dressing - eating - transferring - continence - toileting

3. Screening for 65-76YO male smoker
Aortic aneurysm
Steroids + bronchodilators
DTaP - hepB - Hib - rotavirus - inactivated polio
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

4. Pregnancy class D smoking cessation drugs
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Nicotine inhaler - nasal spray - gum
Calcium hydroxyapatite crystals

5. parallel play
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Diphenhydramine - chlorpheniramine - hydroxyzine
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Calcium hydroxyapatite crystals

6. GBS tx
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
MTX
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
IV penicillin (or ampicillin)

7. IV tx for PID
6 yo
(cefotetan OR cefoxitin) AND doxycycline
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Urinary calcium. Hyper PTH (high) >> FHH (normal)

8. Large - irregularly shaped - prutitic - erythematous wheals
Flexion - internal rotation - extension - external rotation
Tuberculosis; sarcoidosis; hodgkin disease
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Urticaria

9. IV tx for PID
Anterior shoulder cannot readily pass below the pubic symphysis.
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
(cefotetan OR cefoxitin) AND doxycycline
Ampicillin/sulbactam AND doxycycline

10. social interaction
Conrtaction monitoring along with fetal heart rate assessment
4 yo - copies triangle - catches ball - dresses self
Angioedema
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

11. Dx bacterial vaginosis
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
(ofloxacin OR levofloxacin) +/- metronidazole
Hypomagnesemia
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

12. Smoking cessation agents
110-160bpm
Bupropion - varenicline - nicotine replacement
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
MCC melanoma. Radial growth.

13. Pregnancy class C smoking cessation drugs
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Short-acting + 40mg prednisone x 10-14days
Patch - bupropion - varenicline
After delivery until delivery of placenta and membranes <30 mins

14. Fe deficient anemia tx
Angioedema
Ferrous sulfate 325mg tid
Loratadine - fexofenadine - cetirizine
Measures strength of contractions

15. Third stage of labor
Urticaria
5+ rads
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
After delivery until delivery of placenta and membranes <30 mins

16. Dx criteria for RA
Monosodium urate crystals (gout)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Thiazides

17. Low serum iron - low MCV - low ferritin - +stool guaiac
6 yo
Ferrous sulfate 325mg tid
Fe deficient anemia
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

18. Tx for thyroid storm
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Tuberculosis; sarcoidosis; hodgkin disease
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

19. Four cardinal fetal movements
Patch - bupropion - varenicline
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Flexion - internal rotation - extension - external rotation
Ear pain - itching - inflammation/swollen canal - exudates/discharge

20. 2nd generation antihistamines
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Loratadine - fexofenadine - cetirizine
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

21. Early deceleration
Tdap - influenza - pneumovax
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Starts at contraction. caused by increased vagal tone from fetal head compression.
NAC or IV NaHCO3

22. Tx otitis media
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Patch - bupropion - varenicline
Anaphylaxis
9 mo - walks - throws - 1-3 words - 1-step commands

23. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Calcium pyrophosphate dehydrate crystals (pseudogout)

24. Tx of traveler's diarrhea
Monosodium urate crystals (gout)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Lung; SCC head & neck; RCC; breast; MM; prostate

25. Mediators released in response to allergen
Thiazides
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Metronidazole or clindamycin

26. Age by which child says 'mama' and 'dada'
Calcium oxalate crystals
Stridor - drooling - toxic appearance
Bupropion - varenicline - nicotine replacement
6-9MO

27. Oral tx for PID
Pneumovax - influenza
Ofloxacin OR levofloxacin +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
(ofloxacin OR levofloxacin) +/- metronidazole

28. X-ray on knee?
Nuchal translucency - serum hCG - PAPP-A
After delivery until delivery of placenta and membranes <30 mins
Ask - Advise - Assess - Assist - Arrange
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

29. X-ray of ankle?
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
6-9MO
Normal mental status; no other injuries; seen within 10 days of injury
After delivery until delivery of placenta and membranes <30 mins

30. Acral lentinous melanoma
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Long axis of fetus to long axis of mother (longitudinal or transverse)
4mo - sits unsupported - hand transfer - babbles

31. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Short-acting + 40mg prednisone x 10-14days
Prostatitis
NAC or IV NaHCO3
Stridor - drooling - toxic appearance

32. group play - gender - knows name
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
3 yo - identify body part - copies square - hops - throws - past tense - story telling

33. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
After delivery until delivery of placenta and membranes <30 mins
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Urticaria

34. cystoplasmic inclusions - not birefringent
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
IV penicillin (or ampicillin)
Lung; SCC head & neck; RCC; breast; MM; prostate
Calcium hydroxyapatite crystals

35. Second stage of labor
Oxygen intervention 15h/d
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Cataracts
Flexion - internal rotation - extension - external rotation

36. Immunizations for COPD patients
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Aortic aneurysm
Pneumovax - influenza
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

37. social smile - parent recognition
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
4mo - sits unsupported - hand transfer - babbles
6-9MO

38. Bacteria causing chronic sinusitis
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

39. Augments contractions
Oxytocin (IV)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Calcium oxalate crystals
Nuchal translucency - serum hCG - PAPP-A

40. Only therapy to decrease mortality in stage IV COPD
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
(ofloxacin OR levofloxacin) +/- metronidazole
Oxygen intervention 15h/d
Bathing - dressing - eating - transferring - continence - toileting

41. Electrolyte abnormality that increases the incidence of torsades de pointes
1 mo - eyes follow object to midline - vocalizes
Hypomagnesemia
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

42. Pflx for traveler's diarrhea
Fluoroquinolones
Urticaria
After delivery until delivery of placenta and membranes <30 mins
<20lb - <1YO - Reacts to pain - Responds to noise

43. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Ask - Advise - Assess - Assist - Arrange
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Stridor - drooling - toxic appearance

44. Sx otitis media
Tuberculosis; sarcoidosis; hodgkin disease
4mo - sits unsupported - hand transfer - babbles
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane

45. Tx gonorrhea
Ceftriaxone 125mg IM
Nuchal translucency - serum hCG - PAPP-A
Onset of labor until cervix dilation
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

46. Granulomatous causes of hypercalcemia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Anaphylaxis
Tuberculosis; sarcoidosis; hodgkin disease
Nuchal translucency - serum hCG - PAPP-A

47. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
4mo - sits unsupported - hand transfer - babbles
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

48. Tender - boggy prostate. Dx?
Prostatitis
Loratadine - fexofenadine - cetirizine
Bathing - dressing - eating - transferring - continence - toileting
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

49. Immunizations at visit for 6MO
Thiazdes; lithium
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
DTaP - hepB - Hib - rotavirus - inactivated polio

50. First stage of labor
(ofloxacin OR levofloxacin) +/- metronidazole
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Onset of labor until cervix dilation
Nicotine inhaler - nasal spray - gum