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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. GBS tx
Lung; SCC head & neck; RCC; breast; MM; prostate
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)
IV penicillin (or ampicillin)

2. Screening for 65-76YO male smoker
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
4 yo - copies triangle - catches ball - dresses self
1 mo - eyes follow object to midline - vocalizes
Aortic aneurysm

3. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Angioedema
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Diphenhydramine - chlorpheniramine - hydroxyzine

4. Pflx for traveler's diarrhea
Long axis of fetus to long axis of mother (longitudinal or transverse)
Fluoroquinolones
Onset of labor until cervix dilation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis

5. Immunizations for COPD patients
Pneumovax - influenza
6 yo
Oxygen intervention 15h/d
Long axis of fetus to long axis of mother (longitudinal or transverse)

6. painless - deep - subQ swelling (periorbital - circumoral - facial)
Clindamycin AND gentamicin
Age-related sensorineural hearing loss (high frequency and speech discrimination)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Angioedema

7. presbycusis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Metronidazole or clindamycin
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)

8. dyspnea - visceral edema - hypotension
Anaphylaxis
Clindamycin AND gentamicin
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Lung; SCC head & neck; RCC; breast; MM; prostate

9. DOC for HTN in elderly
Thiazides
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Most aggressive melanoma.

10. needles - strong negative birefringent (yellow crystals parallel light)
Monosodium urate crystals (gout)
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

11. Tx RA (best long-term outcome)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
MTX
Clindamycin AND gentamicin
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

12. Tx gonorrhea
Ceftriaxone 125mg IM
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Biopsy
IV penicillin (or ampicillin)

13. causes of acute bronchitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
MTX
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Anaphylaxis

14. Dx bacterial rhinosinusitis
Clindamycin AND gentamicin
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)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Urinary calcium. Hyper PTH (high) >> FHH (normal)

15. Bisphospohonates sfx
Ampicillin/sulbactam AND doxycycline
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Esophagitis - gastritis - dysphagia

16. Screened at 11-13 weeks GA for trisomy
Calcium hydroxyapatite crystals
Pneumovax - influenza
Lung; SCC head & neck; RCC; breast; MM; prostate
Nuchal translucency - serum hCG - PAPP-A

17. Acral lentinous melanoma
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Nuchal translucency - serum hCG - PAPP-A
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Prostatitis

18. Nodular melanoma
Most aggressive melanoma.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
1 mo - eyes follow object to midline - vocalizes
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

19. Tender - boggy prostate. Dx?
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Conrtaction monitoring along with fetal heart rate assessment
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Prostatitis

20. IV tx for PID
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Ampicillin/sulbactam AND doxycycline

21. Tx for anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Calcium hydroxyapatite crystals
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
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)

22. social smile - parent recognition
After delivery until delivery of placenta and membranes <30 mins
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

23. shoulder dystocia
5+ rads
Diabetes - HTN - GN
Starts at contraction. caused by increased vagal tone from fetal head compression.
Anterior shoulder cannot readily pass below the pubic symphysis.

24. Rod shaped - rhomboid - weakly positive birefringent
Calcium pyrophosphate dehydrate crystals (pseudogout)
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Short-acting + 40mg prednisone x 10-14days
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

25. Tx acute exacerbation COPD
Fe deficient anemia
Thiazdes; lithium
NAC or IV NaHCO3
Short-acting + 40mg prednisone x 10-14days

26. Oral tx for PID
Flexion - internal rotation - extension - external rotation
Short-acting + 40mg prednisone x 10-14days
MCC melanoma. Radial growth.
(ofloxacin OR levofloxacin) +/- metronidazole

27. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
NAC or IV NaHCO3
Calcium oxalate crystals

28. Pregnancy class C smoking cessation drugs
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ceftriaxone 125mg IM
Patch - bupropion - varenicline

29. Oral tx for PID
<20lb - <1YO - Reacts to pain - Responds to noise
Calcium hydroxyapatite crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

30. IADL
Lung; SCC head & neck; RCC; breast; MM; prostate
Calcium pyrophosphate dehydrate crystals (pseudogout)
Normal mental status; no other injuries; seen within 10 days of injury
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

31. bipyramidal - strongly positive birefringent
MCC melanoma. Radial growth.
Nuchal translucency - serum hCG - PAPP-A
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Calcium oxalate crystals

32. Tx acute gout
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Fe deficient anemia
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Colchicine

33. Corrected serum calcium =

34. Tx of traveler's diarrhea
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
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)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

35. Bacteria causing chronic sinusitis
DTaP - hepB - Hib - rotavirus - inactivated polio
Normal mental status; no other injuries; seen within 10 days of injury
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Urticaria

36. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cataracts
MTX

37. Only therapy to decrease mortality in stage IV COPD
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
NAC or IV NaHCO3
Oxygen intervention 15h/d

38. Complications of PID
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

39. IV tx for PID
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
1 mo - eyes follow object to midline - vocalizes
Ofloxacin OR levofloxacin +/- metronidazole
Esophagitis - gastritis - dysphagia

40. Third stage of labor
Anemia
After delivery until delivery of placenta and membranes <30 mins
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Flexion - internal rotation - extension - external rotation

41. Second stage of labor
Steroids + bronchodilators
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Long axis of fetus to long axis of mother (longitudinal or transverse)
Tuberculosis; sarcoidosis; hodgkin disease

42. Complications of GAS infxn
Calcium pyrophosphate dehydrate crystals (pseudogout)
16-18 weeks GA
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
MCC melanoma in Africans/Asians. Under nails - soles - palms.

43. 2nd generation antihistamines
Metronidazole or clindamycin
Loratadine - fexofenadine - cetirizine
Alpha-1 antitrypsin deficiency
Pneumovax - influenza

44. Tx bacterial vaginosis
Metronidazole or clindamycin
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
(cefotetan OR cefoxitin) AND doxycycline
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

45. variable deceleration
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Thiazdes; lithium
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

46. writes name - counts 10 objects
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
(cefotetan OR cefoxitin) AND doxycycline
5 yo - draws person - ties shoes - skips
5+ rads

47. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
Normal mental status; no other injuries; seen within 10 days of injury
3 yo - identify body part - copies square - hops - throws - past tense - story telling
NAC or IV NaHCO3
Colchicine

48. Malignancies with hypercalcemia
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Lung; SCC head & neck; RCC; breast; MM; prostate
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Stridor - drooling - toxic appearance

49. identifies left - right
Stridor - drooling - toxic appearance
Patch - bupropion - varenicline
6 yo
Oxytocin (IV)

50. Cockcroft-Gault equation
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium hydroxyapatite crystals
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Fe deficient anemia