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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. Malignancies with hypercalcemia
<20lb - <1YO - Reacts to pain - Responds to noise
DTaP - hepB - Hib - rotavirus - inactivated polio
Hypomagnesemia
Lung; SCC head & neck; RCC; breast; MM; prostate

2. DDX for geriatric hearing impairment
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Short-acting + 40mg prednisone x 10-14days
9 mo - walks - throws - 1-3 words - 1-step commands
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

3. Signs of rupture of membranes

4. Second stage of labor
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Fluoroquinolones
(ofloxacin OR levofloxacin) +/- metronidazole

5. IUPC (intrauterine pressure catheter)
Calcium hydroxyapatite crystals
Measures strength of contractions
Bupropion - varenicline - nicotine replacement
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

6. identifies left - right
6 yo
Clindamycin AND gentamicin
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
9 mo - walks - throws - 1-3 words - 1-step commands

7. Lentigo Maligna
Tuberculosis; sarcoidosis; hodgkin disease
MTX
Biopsy
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

8. Improve short-term outcomes in acute exacerbations of COPD - asthma
6-9MO
Steroids + bronchodilators
Fluoroquinolones
Ampicillin/sulbactam AND doxycycline

9. Augments contractions
6-9MO
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Oxytocin (IV)
NAC or IV NaHCO3

10. Fe deficient anemia tx
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Ferrous sulfate 325mg tid
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Clindamycin AND gentamicin

11. Tx chlamydia
Hypomagnesemia
Bupropion - varenicline - nicotine replacement
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)
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

12. social smile - parent recognition
Conrtaction monitoring along with fetal heart rate assessment
Oxytocin (IV)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
3 yo - identify body part - copies square - hops - throws - past tense - story telling

13. bipyramidal - strongly positive birefringent
4mo - sits unsupported - hand transfer - babbles
Anemia
Calcium oxalate crystals
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole

14. Dx PID
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Biopsy
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn

15. social interaction
DTaP - hepB - Hib - rotavirus - inactivated polio
Angioedema
Flexion - internal rotation - extension - external rotation
4 yo - copies triangle - catches ball - dresses self

16. CKD Stages
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
IV penicillin (or ampicillin)
Angioedema

17. Tx hyperkalemia in CKD
MTX
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
Ampicillin/sulbactam AND doxycycline

18. Regards human face - eye contact
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
MTX
6 mo - pincer - crawls - cruises - mamma - dada - byebye
1 mo - eyes follow object to midline - vocalizes

19. Sx epiglottitis
Tdap - influenza - pneumovax
Monosodium urate crystals (gout)
Flexion - internal rotation - extension - external rotation
Stridor - drooling - toxic appearance

20. Sx peritonsillar abscess
Thiazides
Most aggressive melanoma.
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

21. Unstable angina vs MI Dx tests
4mo - sits unsupported - hand transfer - babbles
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

22. Late deceleration
Ask - Advise - Assess - Assist - Arrange
9 mo - walks - throws - 1-3 words - 1-step commands
Starts at peak of contraction. caused by uteroplacental insufficiency: maternal hypotension; diabetes; prolonged pregnancy; placental abruption
Thiazdes; lithium

23. medications causing hypercalcemia
Flexion - internal rotation - extension - external rotation
6-9MO
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Thiazdes; lithium

24. Acral lentinous melanoma
Measures strength of contractions
Most aggressive melanoma.
Sodium polystyrene sulfonate (kayexalate) - insulin + glucose - retention enema
MCC melanoma in Africans/Asians. Under nails - soles - palms.

25. Four cardinal fetal movements
Cataracts
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Flexion - internal rotation - extension - external rotation
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

26. Only therapy to decrease mortality in stage IV COPD
Anterior shoulder cannot readily pass below the pubic symphysis.
Ampicillin/sulbactam AND doxycycline
Oxygen intervention 15h/d
Age-related sensorineural hearing loss (high frequency and speech discrimination)

27. Oral tx for PID
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Biopsy
Ampicillin/sulbactam AND doxycycline
Steroids + bronchodilators

28. Tender - boggy prostate. Dx?
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
Prostatitis
= LMP + 7 days - 3 months
3 yo - identify body part - copies square - hops - throws - past tense - story telling

29. Immunizations for adult 65YO+
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Stridor - drooling - toxic appearance
Tdap - influenza - pneumovax

30. Complications of PID
Short-acting + 40mg prednisone x 10-14days
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy
DTaP - hepB - Hib - rotavirus - inactivated polio
9 mo - walks - throws - 1-3 words - 1-step commands

31. How much radiation is associated with fetal harm?
5+ rads
Aortic aneurysm
Oxygen intervention 15h/d
Biopsy

32. Recommended folic acid daily dose
Diphenhydramine - chlorpheniramine - hydroxyzine
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Metronidazole or clindamycin
Thiazides

33. Sx otitis media
(cefotetan OR cefoxitin) AND doxycycline
Cataracts
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

34. cystoplasmic inclusions - not birefringent
Most aggressive melanoma.
Anaphylaxis
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Calcium hydroxyapatite crystals

35. Complications of GAS infxn
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Ampicillin/sulbactam AND doxycycline
Bathing - dressing - eating - transferring - continence - toileting
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia

36. Electrolyte abnormality that increases the incidence of torsades de pointes
Alpha-1 antitrypsin deficiency
Hypomagnesemia
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
1 mo - eyes follow object to midline - vocalizes

37. First stage of labor
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Onset of labor until cervix dilation
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Anemia

38. complications of otitis media
Starts at contraction. caused by increased vagal tone from fetal head compression.
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
NAC or IV NaHCO3
6 mo - pincer - crawls - cruises - mamma - dada - byebye

39. Immunizations at visit for 6MO
DTaP - hepB - Hib - rotavirus - inactivated polio
3 yo - identify body part - copies square - hops - throws - past tense - story telling
1 mo - eyes follow object to midline - vocalizes
9 mo - walks - throws - 1-3 words - 1-step commands

40. Emphysema - <45YO - nonsmoker
Alpha-1 antitrypsin deficiency
Anaphylaxis
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
MCC melanoma. Radial growth.

41. 1st generation antihistamines
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Diphenhydramine - chlorpheniramine - hydroxyzine
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
Urticaria

42. Screening for 65-76YO male smoker
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
6 yo
Calcium pyrophosphate dehydrate crystals (pseudogout)
Aortic aneurysm

43. variable deceleration
2 mo - eyes follow object past midline - rolls over - laughs - squeals
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
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.

44. Smoking cessation agents
Bupropion - varenicline - nicotine replacement
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
After delivery until delivery of placenta and membranes <30 mins
4 yo - copies triangle - catches ball - dresses self

45. causes of acute bronchitis
<20lb - <1YO - Reacts to pain - Responds to noise
Lung; SCC head & neck; RCC; breast; MM; prostate
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae

46. The five A's of smoking cessation
Urticaria
Ask - Advise - Assess - Assist - Arrange
Ciprofloxacin 500mg bid x 1-2days - azithromycin 1000mg or 10mg/kg daily x 3d (children) - Rifaximin (noninvasive E. coli)
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

47. Low serum iron - low MCV - low ferritin - +stool guaiac
Fe deficient anemia
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
Patch - bupropion - varenicline
Thiazdes; lithium

48. Third stage of labor
After delivery until delivery of placenta and membranes <30 mins
Ampicillin/sulbactam AND doxycycline
Normal mental status; no other injuries; seen within 10 days of injury
Onset of labor until cervix dilation

49. IV tx for PID
0.2-0.5mg aqueous EPI IM/SubQ
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
16-18 weeks GA
Ofloxacin OR levofloxacin +/- metronidazole

50. Dx bacterial vaginosis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
(ofloxacin OR levofloxacin) +/- metronidazole