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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. Mediators released in response to allergen
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Diphenhydramine - chlorpheniramine - hydroxyzine
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anterior shoulder cannot readily pass below the pubic symphysis.

2. Tx otitis media
6 yo
Monosodium urate crystals (gout)
Urticaria
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

3. dyspnea - visceral edema - hypotension
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Anaphylaxis
Bupropion - varenicline - nicotine replacement
4 yo - copies triangle - catches ball - dresses self

4. Tx hyperkalemia in CKD
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Short-acting + 40mg prednisone x 10-14days
0.2-0.5mg aqueous EPI IM/SubQ
NAC or IV NaHCO3

5. Late deceleration
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

6. Tx of traveler's diarrhea
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
MCC melanoma in Africans/Asians. Under nails - soles - palms.
IV penicillin (or ampicillin)

7. Low serum iron - low MCV - low ferritin - +stool guaiac
Lung; SCC head & neck; RCC; breast; MM; prostate
Fe deficient anemia
DTaP - hepB - Hib - rotavirus - inactivated polio
Nicotine inhaler - nasal spray - gum

8. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
Ampicillin/sulbactam AND doxycycline
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
16-18 weeks GA

9. Pregnancy class C smoking cessation drugs
Urticaria
Nuchal translucency - serum hCG - PAPP-A
Starts at contraction. caused by increased vagal tone from fetal head compression.
Patch - bupropion - varenicline

10. Smoking cessation agents
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
5+ rads
Bupropion - varenicline - nicotine replacement
Normal mental status; no other injuries; seen within 10 days of injury

11. Large - irregularly shaped - prutitic - erythematous wheals
Anterior shoulder cannot readily pass below the pubic symphysis.
Hypomagnesemia
Urticaria
Calcium pyrophosphate dehydrate crystals (pseudogout)

12. Cockcroft-Gault equation
Calcium hydroxyapatite crystals
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Nuchal translucency - serum hCG - PAPP-A

13. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Anaphylaxis

14. Estimated delivery date (Naegele's rule)
= LMP + 7 days - 3 months
Diphenhydramine - chlorpheniramine - hydroxyzine
MTX
Anaphylaxis

15. bacteria causing pharyngitis
Thiazides
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)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

16. Sx peritonsillar abscess
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
1 mo - eyes follow object to midline - vocalizes
Patch - bupropion - varenicline
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)

17. IV tx for PID
Thiazdes; lithium
Clindamycin AND gentamicin
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
NAC or IV NaHCO3

18. social smile - parent recognition
Thiazides
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ear pain - itching - inflammation/swollen canal - exudates/discharge
2 mo - eyes follow object past midline - rolls over - laughs - squeals

19. Bacteria causing chronic sinusitis
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Anemia
Ferrous sulfate 325mg tid
Anaerobic: bacteroides - peptostreptococcus - fusobacterium

20. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Stridor - drooling - toxic appearance
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

21. Regards human face - eye contact
Angioedema
1 mo - eyes follow object to midline - vocalizes
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
MCC melanoma in Africans/Asians. Under nails - soles - palms.

22. DDX for geriatric hearing impairment
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Bupropion - varenicline - nicotine replacement

23. MONA therapy
Hypomagnesemia
Diabetes - HTN - GN
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

24. Tx for anaphylaxis
1 mo - eyes follow object to midline - vocalizes
Metronidazole or clindamycin
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
0.2-0.5mg aqueous EPI IM/SubQ

25. regards hand
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
2 mo - eyes follow object past midline - rolls over - laughs - squeals
4mo - sits unsupported - hand transfer - babbles

26. Complications of GAS infxn
Lung; SCC head & neck; RCC; breast; MM; prostate
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Starts at contraction. caused by increased vagal tone from fetal head compression.
Oxytocin (IV)

27. X-ray of ankle?
Ofloxacin OR levofloxacin +/- metronidazole
Long axis of fetus to long axis of mother (longitudinal or transverse)
Oxytocin (IV)
Normal mental status; no other injuries; seen within 10 days of injury

28. Screening for 65-76YO male smoker
Aortic aneurysm
Steroids + bronchodilators
6-9MO
Thiazdes; lithium

29. Fe deficient anemia tx
Fluoroquinolones
Conrtaction monitoring along with fetal heart rate assessment
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Ferrous sulfate 325mg tid

30. IV tx for PID
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ofloxacin OR levofloxacin +/- metronidazole
Biopsy
4 yo - copies triangle - catches ball - dresses self

31. painless - deep - subQ swelling (periorbital - circumoral - facial)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Anaphylaxis
Alpha-1 antitrypsin deficiency
Angioedema

32. Recommendations for rear-facing car seat
Patch - bupropion - varenicline
Ofloxacin OR levofloxacin +/- metronidazole
<20lb - <1YO - Reacts to pain - Responds to noise
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

33. Granulomatous causes of hypercalcemia
Calcium pyrophosphate dehydrate crystals (pseudogout)
Tuberculosis; sarcoidosis; hodgkin disease
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

34. DOC for HTN in elderly
4mo - sits unsupported - hand transfer - babbles
Thiazides
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

35. Other causes of hypercalcemia
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Oxytocin (IV)
Thiazides
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)

36. Bisphospohonates sfx
Esophagitis - gastritis - dysphagia
Ofloxacin OR levofloxacin +/- metronidazole
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)

37. Unstable angina vs MI Dx tests
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
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)

38. Acral lentinous melanoma
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
NAC or IV NaHCO3
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Long axis of fetus to long axis of mother (longitudinal or transverse)

39. Only therapy to decrease mortality in stage IV COPD
Clindamycin AND gentamicin
Alpha-1 antitrypsin deficiency
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Oxygen intervention 15h/d

40. presbycusis
DTaP - hepB - Hib - rotavirus - inactivated polio
Colchicine
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Age-related sensorineural hearing loss (high frequency and speech discrimination)

41. Screened at 11-13 weeks GA for trisomy
Nuchal translucency - serum hCG - PAPP-A
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium pyrophosphate dehydrate crystals (pseudogout)
Calcium oxalate crystals

42. Screened at 16-20 weeks GA for trisomy
5+ rads
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Thiazides
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)

43. Tx acute gout
Colchicine
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

44. Four cardinal fetal movements
Urticaria
4mo - sits unsupported - hand transfer - babbles
Flexion - internal rotation - extension - external rotation
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

45. Early deceleration
Starts at contraction. caused by increased vagal tone from fetal head compression.
(cefotetan OR cefoxitin) AND doxycycline
Clindamycin AND gentamicin
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)

46. Tx for thyroid storm
6 mo - pincer - crawls - cruises - mamma - dada - byebye
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Nuchal translucency - serum hCG - PAPP-A
Ofloxacin OR levofloxacin +/- metronidazole

47. Tx gonorrhea
Clindamycin AND gentamicin
Fe deficient anemia
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Ceftriaxone 125mg IM

48. bipyramidal - strongly positive birefringent
Anaphylaxis
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Metronidazole or clindamycin
Calcium oxalate crystals

49. tx shoulder dystocia

50. X-ray on knee?
Monosodium urate crystals (gout)
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps