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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
Ceftriaxone 125mg IM
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
4mo - sits unsupported - hand transfer - babbles

2. DOC for HTN in elderly
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
5+ rads
Thiazides
Calcium pyrophosphate dehydrate crystals (pseudogout)

3. variable deceleration
Nuchal translucency - serum hCG - PAPP-A
Ask - Advise - Assess - Assist - Arrange
After delivery until delivery of placenta and membranes <30 mins
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

4. Causes of CKD
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Diabetes - HTN - GN
9 mo - walks - throws - 1-3 words - 1-step commands

5. Nodular melanoma
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Normal mental status; no other injuries; seen within 10 days of injury
Most aggressive melanoma.

6. Oral tx for PID
Ampicillin/sulbactam AND doxycycline
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Calcium hydroxyapatite crystals
Fe deficient anemia

7. cystoplasmic inclusions - not birefringent
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
IV penicillin (or ampicillin)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Calcium hydroxyapatite crystals

8. Dx PID
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
DTaP - hepB - Hib - rotavirus - inactivated polio
Onset of labor until cervix dilation
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

9. First stage of labor
Clindamycin AND gentamicin
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Diabetes - HTN - GN
Onset of labor until cervix dilation

10. IV tx for PID
Clindamycin AND gentamicin
Angioedema
6 yo
3 yo - identify body part - copies square - hops - throws - past tense - story telling

11. Corrected serum calcium =

12. Fetal heart rate range
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
110-160bpm
Starts at contraction. caused by increased vagal tone from fetal head compression.
Ear pain - itching - inflammation/swollen canal - exudates/discharge

13. Tx chlamydia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Angioedema
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

14. IV tx for PID
Angioedema
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Tuberculosis; sarcoidosis; hodgkin disease
Ampicillin/sulbactam AND doxycycline

15. How much radiation is associated with fetal harm?
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
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)
5+ rads

16. Tx of traveler's diarrhea
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Calcium pyrophosphate dehydrate crystals (pseudogout)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
0.2-0.5mg aqueous EPI IM/SubQ

17. regards hand
3 yo - identify body part - copies square - hops - throws - past tense - story telling
4mo - sits unsupported - hand transfer - babbles
IV penicillin (or ampicillin)
Flexion - internal rotation - extension - external rotation

18. Sx of hypercalcemia
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
6-9MO
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

19. presbycusis
Conrtaction monitoring along with fetal heart rate assessment
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Thiazdes; lithium
= LMP + 7 days - 3 months

20. Screened at 11-13 weeks GA for trisomy
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Ceftriaxone 125mg IM
Nuchal translucency - serum hCG - PAPP-A
Short-acting + 40mg prednisone x 10-14days

21. Premedication with ___ or ___ reduces risk of contrast-induced nephropathy
NAC or IV NaHCO3
4mo - sits unsupported - hand transfer - babbles
0.2-0.5mg aqueous EPI IM/SubQ
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)

22. IUPC (intrauterine pressure catheter)
Measures strength of contractions
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Tuberculosis; sarcoidosis; hodgkin disease
Fluoroquinolones

23. MCC blindness worldwide
Cataracts
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Onset of labor until cervix dilation

24. Improve short-term outcomes in acute exacerbations of COPD - asthma
Steroids + bronchodilators
DTaP - hepB - Hib - rotavirus - inactivated polio
Onset of labor until cervix dilation
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

25. Granulomatous causes of hypercalcemia
Tuberculosis; sarcoidosis; hodgkin disease
Ampicillin/sulbactam AND doxycycline
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Metronidazole or clindamycin

26. Emphysema - <45YO - nonsmoker
Fe deficient anemia
Loratadine - fexofenadine - cetirizine
Most aggressive melanoma.
Alpha-1 antitrypsin deficiency

27. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
Ceftriaxone 125mg IM
Biopsy
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

28. Superficial spreading melanoma
MCC melanoma. Radial growth.
Onset of labor until cervix dilation
16-18 weeks GA
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

29. Early deceleration
Oxygen intervention 15h/d
Stridor - drooling - toxic appearance
Starts at contraction. caused by increased vagal tone from fetal head compression.
Thiazdes; lithium

30. Signs of rupture of membranes

31. CKD Stages
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Steroids + bronchodilators

32. IADL
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Monosodium urate crystals (gout)
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

33. X-ray on knee?
Fluoroquinolones
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps

34. stranger/separation anxiety
Lung; SCC head & neck; RCC; breast; MM; prostate
Diphenhydramine - chlorpheniramine - hydroxyzine
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name

35. Pflx for traveler's diarrhea
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Fluoroquinolones
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

36. Tx acute sinusitis
Aortic aneurysm
Tdap - influenza - pneumovax
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Steroids + bronchodilators

37. Tx bacterial vaginosis
Oxygen intervention 15h/d
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Fe deficient anemia
Metronidazole or clindamycin

38. Tx GAS ifxn
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Cataracts
Metronidazole or clindamycin
Calcium pyrophosphate dehydrate crystals (pseudogout)

39. medications causing hypercalcemia
9 mo - walks - throws - 1-3 words - 1-step commands
Thiazdes; lithium
Fluoroquinolones
Flexion - internal rotation - extension - external rotation

40. MONA therapy
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
5+ rads
4mo - sits unsupported - hand transfer - babbles
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors

41. Complications of GAS infxn
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy

42. Fe deficient anemia tx
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ferrous sulfate 325mg tid
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Metronidazole or clindamycin

43. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Anemia
Steroids + bronchodilators

44. social interaction
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
(cefotetan OR cefoxitin) AND doxycycline
4 yo - copies triangle - catches ball - dresses self
6 mo - pincer - crawls - cruises - mamma - dada - byebye

45. Tx hyperkalemia in CKD
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
5 yo - draws person - ties shoes - skips
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema

46. writes name - counts 10 objects
5+ rads
Anterior shoulder cannot readily pass below the pubic symphysis.
Nuchal translucency - serum hCG - PAPP-A
5 yo - draws person - ties shoes - skips

47. GBS tx
Esophagitis - gastritis - dysphagia
Starts at contraction. caused by increased vagal tone from fetal head compression.
6-9MO
IV penicillin (or ampicillin)

48. Tocodynamometer
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Conrtaction monitoring along with fetal heart rate assessment
Tuberculosis; sarcoidosis; hodgkin disease
Stridor - drooling - toxic appearance

49. 2nd generation antihistamines
Starts at contraction. caused by increased vagal tone from fetal head compression.
Loratadine - fexofenadine - cetirizine
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Nicotine inhaler - nasal spray - gum

50. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
Anemia
Thiazdes; lithium
Urinary calcium. Hyper PTH (high) >> FHH (normal)
4 yo - copies triangle - catches ball - dresses self