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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. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
Tdap - influenza - pneumovax
Ampicillin/sulbactam AND doxycycline
Biopsy

2. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Conrtaction monitoring along with fetal heart rate assessment
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
1 mo - eyes follow object to midline - vocalizes

3. ADL
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Ceftriaxone 125mg IM
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Bathing - dressing - eating - transferring - continence - toileting

4. painless - deep - subQ swelling (periorbital - circumoral - facial)
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Angioedema
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

5. Dx bacterial rhinosinusitis
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
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)

6. Dx bacterial vaginosis
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Normal mental status; no other injuries; seen within 10 days of injury
Loratadine - fexofenadine - cetirizine
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

7. Unstable angina vs MI Dx tests
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Anemia
Loratadine - fexofenadine - cetirizine
NAC or IV NaHCO3

8. Four cardinal fetal movements
5+ rads
Flexion - internal rotation - extension - external rotation
Bupropion - varenicline - nicotine replacement
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

9. needles - strong negative birefringent (yellow crystals parallel light)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
DTaP - hepB - Hib - rotavirus - inactivated polio
NAC or IV NaHCO3
Monosodium urate crystals (gout)

10. Tocodynamometer
Loratadine - fexofenadine - cetirizine
Nicotine inhaler - nasal spray - gum
16-18 weeks GA
Conrtaction monitoring along with fetal heart rate assessment

11. Late deceleration
Calcium oxalate crystals
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Tdap - influenza - pneumovax
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

12. Oral tx for PID
(ofloxacin OR levofloxacin) +/- metronidazole
Measures strength of contractions
5+ rads
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

13. Estimated delivery date (Naegele's rule)
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
(cefotetan OR cefoxitin) AND doxycycline
Most aggressive melanoma.
= LMP + 7 days - 3 months

14. Sx otitis externa
Normal mental status; no other injuries; seen within 10 days of injury
Cataracts
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

15. Superficial spreading melanoma
Onset of labor until cervix dilation
110-160bpm
MCC melanoma. Radial growth.
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

16. Tx for thyroid storm
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
MCC melanoma in Africans/Asians. Under nails - soles - palms.
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry

17. Tx hyperkalemia in CKD
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Clindamycin AND gentamicin
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

18. causes of acute bronchitis
MCC melanoma. Radial growth.
Tdap - influenza - pneumovax
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

19. 2nd generation antihistamines
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
5 yo - draws person - ties shoes - skips
Thiazdes; lithium
Loratadine - fexofenadine - cetirizine

20. group play - gender - knows name
Monosodium urate crystals (gout)
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

21. complications of otitis media
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Anaphylaxis
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

22. Tx chlamydia
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Cataracts
Thiazides
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

23. dyspnea - visceral edema - hypotension
Calcium pyrophosphate dehydrate crystals (pseudogout)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once
MTX
Anaphylaxis

24. Sx otitis media
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Esophagitis - gastritis - dysphagia
Urinary calcium. Hyper PTH (high) >> FHH (normal)

25. DDX for geriatric hearing impairment
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Conrtaction monitoring along with fetal heart rate assessment
Nuchal translucency - serum hCG - PAPP-A
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

26. Recommendations for rear-facing car seat
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Cataracts
<20lb - <1YO - Reacts to pain - Responds to noise
Normal mental status; no other injuries; seen within 10 days of injury

27. IV tx for PID
Colchicine
Tdap - influenza - pneumovax
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Ofloxacin OR levofloxacin +/- metronidazole

28. Tx bacterial vaginosis
5+ rads
Metronidazole or clindamycin
Diabetes - HTN - GN
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

29. Mediators released in response to allergen
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

30. Tx RA (best long-term outcome)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
MTX

31. Tx acute sinusitis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Ferrous sulfate 325mg tid
(ofloxacin OR levofloxacin) +/- metronidazole
IV penicillin (or ampicillin)

32. presbycusis
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
IV penicillin (or ampicillin)
Age-related sensorineural hearing loss (high frequency and speech discrimination)
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)

33. IV tx for PID
Ampicillin/sulbactam AND doxycycline
Oxygen intervention 15h/d
Most aggressive melanoma.
Nuchal translucency - serum hCG - PAPP-A

34. Acral lentinous melanoma
MCC melanoma in Africans/Asians. Under nails - soles - palms.
4 yo - copies triangle - catches ball - dresses self
Long axis of fetus to long axis of mother (longitudinal or transverse)
NAC or IV NaHCO3

35. Pregnancy class D smoking cessation drugs
Conrtaction monitoring along with fetal heart rate assessment
Thiazdes; lithium
Nicotine inhaler - nasal spray - gum
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

36. Sx peritonsillar abscess
Anaphylaxis
0.2-0.5mg aqueous EPI IM/SubQ
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Fluoroquinolones

37. Electrolyte abnormality that increases the incidence of torsades de pointes
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
Hypomagnesemia
IV penicillin (or ampicillin)
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

38. How much radiation is associated with fetal harm?
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
Fe deficient anemia
DTaP - hepB - Hib - rotavirus - inactivated polio
5+ rads

39. recognizes strangers
110-160bpm
6 mo - pincer - crawls - cruises - mamma - dada - byebye
Ampicillin/sulbactam AND doxycycline
Prostatitis

40. explorations
9 mo - walks - throws - 1-3 words - 1-step commands
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
MTX
16-18 weeks GA

41. Screened at 11-13 weeks GA for trisomy
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Cataracts
Nicotine inhaler - nasal spray - gum
Nuchal translucency - serum hCG - PAPP-A

42. Nonfunctioning nodules > 1cm require _____
Anterior shoulder cannot readily pass below the pubic symphysis.
16-18 weeks GA
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Biopsy

43. X-ray on knee?
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Urticaria
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR

44. Corrected serum calcium =

45. Causes of CKD
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)
9 mo - walks - throws - 1-3 words - 1-step commands
Diabetes - HTN - GN
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)

46. Only therapy to decrease mortality in stage IV COPD
<20lb - <1YO - Reacts to pain - Responds to noise
Nicotine inhaler - nasal spray - gum
Oxygen intervention 15h/d
(ofloxacin OR levofloxacin) +/- metronidazole

47. Immunizations for COPD patients
Aortic aneurysm
Hypomagnesemia
Pneumovax - influenza
Long axis of fetus to long axis of mother (longitudinal or transverse)

48. tx shoulder dystocia

49. cystoplasmic inclusions - not birefringent
Calcium hydroxyapatite crystals
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Patch - bupropion - varenicline
6 yo

50. Tx GAS ifxn
Aortic aneurysm
Ofloxacin OR levofloxacin +/- metronidazole
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Colchicine