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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. Four cardinal fetal movements
Flexion - internal rotation - extension - external rotation
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Ampicillin/sulbactam AND doxycycline
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

2. Sx otitis media
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Oxygen intervention 15h/d
16-18 weeks GA
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

3. bacteria causing pharyngitis
Stridor - drooling - toxic appearance
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

4. group play - gender - knows name
110-160bpm
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

5. explorations
Ceftriaxone 125mg IM
Ferrous sulfate 325mg tid
9 mo - walks - throws - 1-3 words - 1-step commands
Steroids + bronchodilators

6. IV tx for PID
Stridor - drooling - toxic appearance
(cefotetan OR cefoxitin) AND doxycycline
MCC melanoma. Radial growth.
110-160bpm

7. Early deceleration
4mo - sits unsupported - hand transfer - babbles
Oxytocin (IV)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Starts at contraction. caused by increased vagal tone from fetal head compression.

8. Cockcroft-Gault equation
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Oxytocin (IV)
110-160bpm
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

9. recognizes strangers
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Biopsy
Angioedema
Anaphylaxis

10. IV tx for PID
Clindamycin AND gentamicin
110-160bpm
Pneumovax - influenza
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)

11. X-ray on knee?
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
16-18 weeks GA
(cefotetan OR cefoxitin) AND doxycycline

12. writes name - counts 10 objects
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
5 yo - draws person - ties shoes - skips
Thiazdes; lithium
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

13. Tx acute gout
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Ferrous sulfate 325mg tid
Colchicine
Monosodium urate crystals (gout)

14. Second stage of labor
Pneumovax - influenza
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Steroids + bronchodilators
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

15. Smoking cessation agents
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Bupropion - varenicline - nicotine replacement
5 yo - draws person - ties shoes - skips

16. Tx GAS ifxn
5 yo - draws person - ties shoes - skips
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Biopsy
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

17. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Metronidazole or clindamycin
MCC melanoma. Radial growth.

18. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Ofloxacin OR levofloxacin +/- metronidazole
Calcium pyrophosphate dehydrate crystals (pseudogout)

19. How much radiation is associated with fetal harm?
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
5+ rads
Anterior shoulder cannot readily pass below the pubic symphysis.
Thiazides

20. shoulder dystocia
Metronidazole or clindamycin
Anterior shoulder cannot readily pass below the pubic symphysis.
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Monosodium urate crystals (gout)

21. identifies left - right
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
6 yo
Ferrous sulfate 325mg tid
Tdap - influenza - pneumovax

22. IV tx for PID
6 yo
Esophagitis - gastritis - dysphagia
Ofloxacin OR levofloxacin +/- metronidazole
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

23. Screened at 11-13 weeks GA for trisomy
Short-acting + 40mg prednisone x 10-14days
Nuchal translucency - serum hCG - PAPP-A
Calcium hydroxyapatite crystals
Thiazdes; lithium

24. 1st generation antihistamines
Oxygen intervention 15h/d
Diphenhydramine - chlorpheniramine - hydroxyzine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
6-9MO

25. Improve short-term outcomes in acute exacerbations of COPD - asthma
Long axis of fetus to long axis of mother (longitudinal or transverse)
Steroids + bronchodilators
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
9 mo - walks - throws - 1-3 words - 1-step commands

26. presbycusis
Bupropion - varenicline - nicotine replacement
Nicotine inhaler - nasal spray - gum
Age-related sensorineural hearing loss (high frequency and speech discrimination)
MTX

27. Sx of hypercalcemia
Flexion - internal rotation - extension - external rotation
6-9MO
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Ofloxacin OR levofloxacin +/- metronidazole

28. Electrolyte abnormality that increases the incidence of torsades de pointes
Hypomagnesemia
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Fluoroquinolones
0.2-0.5mg aqueous EPI IM/SubQ

29. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
Loratadine - fexofenadine - cetirizine
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Masoiditis - bacterial meningitis - brain abscess - subdural empyema

30. Low serum iron - low MCV - low ferritin - +stool guaiac
Urticaria
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Fe deficient anemia

31. First stage of labor
Onset of labor until cervix dilation
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

32. Tx acute exacerbation COPD
Esophagitis - gastritis - dysphagia
Lung; SCC head & neck; RCC; breast; MM; prostate
Short-acting + 40mg prednisone x 10-14days
Metronidazole or clindamycin

33. Tender - boggy prostate. Dx?
6 yo
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
6-9MO
Prostatitis

34. GBS tx
1 mo - eyes follow object to midline - vocalizes
Thiazides
<20lb - <1YO - Reacts to pain - Responds to noise
IV penicillin (or ampicillin)

35. Tx for anaphylaxis
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
5+ rads
0.2-0.5mg aqueous EPI IM/SubQ

36. Fe deficient anemia tx
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ferrous sulfate 325mg tid
(ofloxacin OR levofloxacin) +/- metronidazole
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

37. causes of acute bronchitis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Tuberculosis; sarcoidosis; hodgkin disease
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Nicotine inhaler - nasal spray - gum

38. CKD Stages
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
MTX

39. social smile - parent recognition
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
2 mo - eyes follow object past midline - rolls over - laughs - squeals
4 yo - copies triangle - catches ball - dresses self
Diphenhydramine - chlorpheniramine - hydroxyzine

40. Sx epiglottitis
Stridor - drooling - toxic appearance
Ferrous sulfate 325mg tid
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Anterior shoulder cannot readily pass below the pubic symphysis.

41. Oral tx for PID
110-160bpm
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Nuchal translucency - serum hCG - PAPP-A
16-18 weeks GA

42. Unstable angina vs MI Dx tests
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

43. Nodular melanoma
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Most aggressive melanoma.
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

44. Superficial spreading melanoma
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
MTX
Alpha-1 antitrypsin deficiency
MCC melanoma. Radial growth.

45. painless - deep - subQ swelling (periorbital - circumoral - facial)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
NAC or IV NaHCO3
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Angioedema

46. Nonfunctioning nodules > 1cm require _____
Esophagitis - gastritis - dysphagia
Biopsy
Colchicine
Diabetes - HTN - GN

47. Tx otitis media
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)
Tdap - influenza - pneumovax
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

48. social interaction
Bathing - dressing - eating - transferring - continence - toileting
Oxytocin (IV)
4 yo - copies triangle - catches ball - dresses self
6-9MO

49. regards hand
16-18 weeks GA
Ofloxacin OR levofloxacin +/- metronidazole
4mo - sits unsupported - hand transfer - babbles
6 mo - pincer - crawls - cruises - mamma - dada - byebye

50. Fetal lie
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Biopsy
Long axis of fetus to long axis of mother (longitudinal or transverse)
9 mo - walks - throws - 1-3 words - 1-step commands