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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. Emphysema - <45YO - nonsmoker
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Bupropion - varenicline - nicotine replacement
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Alpha-1 antitrypsin deficiency

2. writes name - counts 10 objects
Anaphylaxis
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 yo - draws person - ties shoes - skips
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

3. X-ray of ankle?
1 mo - eyes follow object to midline - vocalizes
Normal mental status; no other injuries; seen within 10 days of injury
Lung; SCC head & neck; RCC; breast; MM; prostate
Clindamycin AND gentamicin

4. IV tx for PID
Thiazdes; lithium
Diabetes - HTN - GN
Ampicillin/sulbactam AND doxycycline
NAC or IV NaHCO3

5. Tx chlamydia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

6. social interaction
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
4 yo - copies triangle - catches ball - dresses self
After delivery until delivery of placenta and membranes <30 mins
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption

7. Dx bacterial vaginosis
Clindamycin AND gentamicin
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Nicotine inhaler - nasal spray - gum
Onset of labor until cervix dilation

8. First stage of labor
Monosodium urate crystals (gout)
Onset of labor until cervix dilation
Cataracts
Long axis of fetus to long axis of mother (longitudinal or transverse)

9. Immunizations for COPD patients
Pneumovax - influenza
Conrtaction monitoring along with fetal heart rate assessment
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Steroids + bronchodilators

10. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
MCC melanoma in Africans/Asians. Under nails - soles - palms.

11. Bacteria causing chronic sinusitis
6-9MO
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Stridor - drooling - toxic appearance

12. Tocodynamometer
Fluoroquinolones
Starts at contraction. caused by increased vagal tone from fetal head compression.
Conrtaction monitoring along with fetal heart rate assessment
MTX

13. bipyramidal - strongly positive birefringent
Oxygen intervention 15h/d
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Calcium oxalate crystals
Lung; SCC head & neck; RCC; breast; MM; prostate

14. IV tx for PID
Calcium oxalate crystals
Stridor - drooling - toxic appearance
Ofloxacin OR levofloxacin +/- metronidazole
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

15. Tx for anaphylaxis
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Calcium hydroxyapatite crystals
6 yo
0.2-0.5mg aqueous EPI IM/SubQ

16. shoulder dystocia
Colchicine
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Anterior shoulder cannot readily pass below the pubic symphysis.
Cataracts

17. Bisphospohonates sfx
Lung; SCC head & neck; RCC; breast; MM; prostate
Esophagitis - gastritis - dysphagia
Urticaria
Ask - Advise - Assess - Assist - Arrange

18. Rod shaped - rhomboid - weakly positive birefringent
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Calcium pyrophosphate dehydrate crystals (pseudogout)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Urinary calcium. Hyper PTH (high) >> FHH (normal)

19. Fe deficient anemia tx
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.
Ferrous sulfate 325mg tid
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

20. Augments contractions
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Anterior shoulder cannot readily pass below the pubic symphysis.
Oxytocin (IV)
Lung; SCC head & neck; RCC; breast; MM; prostate

21. Corrected serum calcium =

22. Recommendations for rear-facing car seat
6 yo
<20lb - <1YO - Reacts to pain - Responds to noise
Nuchal translucency - serum hCG - PAPP-A
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

23. Large - irregularly shaped - prutitic - erythematous wheals
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Lung; SCC head & neck; RCC; breast; MM; prostate
Urticaria
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

24. presbycusis
NAC or IV NaHCO3
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Alpha-1 antitrypsin deficiency

25. Pflx for traveler's diarrhea
Steroids + bronchodilators
Fluoroquinolones
16-18 weeks GA
6-9MO

26. Electrolyte abnormality that increases the incidence of torsades de pointes
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Hypomagnesemia
Urinary calcium. Hyper PTH (high) >> FHH (normal)

27. stranger/separation anxiety
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Nicotine inhaler - nasal spray - gum
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Anterior shoulder cannot readily pass below the pubic symphysis.

28. Mediators released in response to allergen
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
(ofloxacin OR levofloxacin) +/- metronidazole
Ampicillin/sulbactam AND doxycycline
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

29. Fetal heart rate range
Monosodium urate crystals (gout)
DTaP - hepB - Hib - rotavirus - inactivated polio
Ampicillin/sulbactam AND doxycycline
110-160bpm

30. Malignancies with hypercalcemia
Flexion - internal rotation - extension - external rotation
Lung; SCC head & neck; RCC; breast; MM; prostate
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2

31. Sx otitis media
Anterior shoulder cannot readily pass below the pubic symphysis.
Steroids + bronchodilators
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Bathing - dressing - eating - transferring - continence - toileting

32. Sx otitis externa
Tdap - influenza - pneumovax
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Loratadine - fexofenadine - cetirizine
Ear pain - itching - inflammation/swollen canal - exudates/discharge

33. Immunizations for adult 65YO+
Angioedema
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
Tdap - influenza - pneumovax

34. cystoplasmic inclusions - not birefringent
Oxytocin (IV)
Prostatitis
Oxygen intervention 15h/d
Calcium hydroxyapatite crystals

35. Acral lentinous melanoma
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
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)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

36. DDX for geriatric hearing impairment
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
DTaP - hepB - Hib - rotavirus - inactivated polio

37. Tx of traveler's diarrhea
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
Bathing - dressing - eating - transferring - continence - toileting
Ask - Advise - Assess - Assist - Arrange

38. Screened at 16-20 weeks GA for trisomy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

39. Immunizations at visit for 6MO
5+ rads
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Diphenhydramine - chlorpheniramine - hydroxyzine
DTaP - hepB - Hib - rotavirus - inactivated polio

40. Only therapy to decrease mortality in stage IV COPD
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Starts at contraction. caused by increased vagal tone from fetal head compression.
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Oxygen intervention 15h/d

41. Pregnancy class C smoking cessation drugs
Stridor - drooling - toxic appearance
Diphenhydramine - chlorpheniramine - hydroxyzine
Patch - bupropion - varenicline
Fe deficient anemia

42. How to differentiate primary hyperPTH from FHH (familial hypocalciuric hypercalcemia)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Monosodium urate crystals (gout)
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

43. Regards human face - eye contact
1 mo - eyes follow object to midline - vocalizes
IV penicillin (or ampicillin)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Ofloxacin OR levofloxacin +/- metronidazole

44. Signs of rupture of membranes

45. Cockcroft-Gault equation
Thiazdes; lithium
Colchicine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Most aggressive melanoma.

46. 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
Patch - bupropion - varenicline
Calcium pyrophosphate dehydrate crystals (pseudogout)

47. medications causing hypercalcemia
Oxytocin (IV)
Thiazdes; lithium
0.2-0.5mg aqueous EPI IM/SubQ
Ferrous sulfate 325mg tid

48. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at contraction. caused by increased vagal tone from fetal head compression.
4mo - sits unsupported - hand transfer - babbles
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

49. Pregnancy class D smoking cessation drugs
Lung; SCC head & neck; RCC; breast; MM; prostate
Nicotine inhaler - nasal spray - gum
(cefotetan OR cefoxitin) AND doxycycline
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

50. painless - deep - subQ swelling (periorbital - circumoral - facial)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Angioedema
Thiazides
NAC or IV NaHCO3