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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. complications of otitis media
Masoiditis - bacterial meningitis - brain abscess - subdural empyema
Urinary calcium. Hyper PTH (high) >> FHH (normal)
Tdap - influenza - pneumovax
5+ rads

2. Corrected serum calcium =

3. MCC blindness worldwide
0.2-0.5mg aqueous EPI IM/SubQ
Diabetes - HTN - GN
Cataracts
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)

4. Tx GAS ifxn
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Measures strength of contractions
1st line: penicillin V (oral) - penicillin G (IM) - if allergy: cephalosporin - macrolide
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat

5. Fe deficient anemia tx
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Pneumovax - influenza
Nicotine inhaler - nasal spray - gum
Ferrous sulfate 325mg tid

6. X-ray of ankle?
Normal mental status; no other injuries; seen within 10 days of injury
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Onset of labor until cervix dilation

7. tx shoulder dystocia

8. MONA therapy
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Complete cervical dilation (10cm) until delivery <2 hrs (nulliparous) <1hr (parous)
Tdap - influenza - pneumovax
Ampicillin/sulbactam AND doxycycline

9. Age by which child says 'mama' and 'dada'
2 mo - eyes follow object past midline - rolls over - laughs - squeals
6-9MO
Metronidazole or clindamycin
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

10. identifies left - right
6 yo
Calcium pyrophosphate dehydrate crystals (pseudogout)
12 mo - walks up/down stairs - runs - kicks - 2-3w phrases - uses name
Nicotine inhaler - nasal spray - gum

11. 2nd generation antihistamines
Diphenhydramine - chlorpheniramine - hydroxyzine
Age-related sensorineural hearing loss (high frequency and speech discrimination)
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Loratadine - fexofenadine - cetirizine

12. How much radiation is associated with fetal harm?
Loratadine - fexofenadine - cetirizine
5+ rads
Normal mental status; no other injuries; seen within 10 days of injury
Biopsy

13. group play - gender - knows name
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Transport - shopping - cooking - telephone - money management - medications - housecleaning - laundry
Most aggressive melanoma.

14. Cockcroft-Gault equation
Steroids + bronchodilators
Influenza PIV - adenovirus - rhinovirus - mycoplasma - c. pneumoniae
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)

15. Tx chlamydia
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Morphine - Oxygen - Nitroglycerin - Aspirin (clopidogrel if allergic) + B-blocker - GPIIb/IIIa inhibitors
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

16. Sx otitis media
3 yo - identify body part - copies square - hops - throws - past tense - story telling
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Metronidazole or clindamycin
Calcium hydroxyapatite crystals

17. Emphysema - <45YO - nonsmoker
Diphenhydramine - chlorpheniramine - hydroxyzine
Cr Clearance = [(140-age) x weight/72 x SCr] x 0.85 (if female)
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Alpha-1 antitrypsin deficiency

18. Improve short-term outcomes in acute exacerbations of COPD - asthma
Ear pain - itching - inflammation/swollen canal - exudates/discharge
Steroids + bronchodilators
Anterior shoulder cannot readily pass below the pubic symphysis.
Measures strength of contractions

19. variable deceleration
Short-acting + 40mg prednisone x 10-14days
<20lb - <1YO - Reacts to pain - Responds to noise
Stones; bondes; psychic groans (poor concentration - supor coma - weakness - fatigue); abdominal moans (pancreatitis - anorexia - pain - constipation - nausea - vomiting)
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.

20. 1st generation antihistamines
Steroids + bronchodilators
Diphenhydramine - chlorpheniramine - hydroxyzine
16-18 weeks GA
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)

21. Progressive fatigue - weakness - dyspnea - conjunctival pallor in an elderly patient
5 yo - draws person - ties shoes - skips
Anemia
Urticaria
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins

22. Other causes of hypercalcemia
Ear pain - fever - diminished hearing - vertigo - tinnitus; decreased membrane mobility - fluid behind tympanic membrane
Normal mental status; no other injuries; seen within 10 days of injury
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency

23. Augments contractions
= LMP + 7 days - 3 months
Tuberculosis; sarcoidosis; hodgkin disease
Oxytocin (IV)
Cataracts

24. Recommended folic acid daily dose
Rheumatic fever - PSGN - TSS - peritonsillar abscess - meningitis - bacteremia
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Calcium pyrophosphate dehydrate crystals (pseudogout)
Thiazides

25. bacteria causing pharyngitis
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Mycoplasma - c. pneumoniae - arcanobacterium haemolyticus - GAS (strep pyogenes)
2 mo - eyes follow object past midline - rolls over - laughs - squeals
Urticaria

26. parallel play
High dose PTU - B-blocker - hydrocortisone (prevent adrenal crisis)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors
9 mo - walks - throws - 1-3 words - 1-step commands
Nuchal translucency - serum hCG - PAPP-A

27. Immunizations for COPD patients
Pneumovax - influenza
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Cataracts
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

28. Sx otitis externa
Tuberculosis; sarcoidosis; hodgkin disease
Ear pain - itching - inflammation/swollen canal - exudates/discharge
IV penicillin (or ampicillin)
Oxygen intervention 15h/d

29. Mediators released in response to allergen
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)
1 mo - eyes follow object to midline - vocalizes
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Conrtaction monitoring along with fetal heart rate assessment

30. Tender - boggy prostate. Dx?
Prostatitis
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Patch - bupropion - varenicline
MCC melanoma in Africans/Asians. Under nails - soles - palms.

31. presbycusis
1st line: amoxicillin - TMP-SMX 10-14d 2nd line: amoxicillin-clavulanic acid; 2nd-3rd gen cephalosporin; fluoroquinolone; 2nd gen macrolides (azithromycin - clarithromycin)
Urticaria
Age-related sensorineural hearing loss (high frequency and speech discrimination)
2 yo - copies circle - tricycle - 3 cubes - sentences - 3 colors

32. bipyramidal - strongly positive birefringent
Anterior shoulder cannot readily pass below the pubic symphysis.
Calcium oxalate crystals
MCC melanoma in Africans/Asians. Under nails - soles - palms.
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.

33. Tx bacterial vaginosis
Steroids + bronchodilators
6-9MO
Bathing - dressing - eating - transferring - continence - toileting
Metronidazole or clindamycin

34. Tx acute gout
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
Age-related sensorineural hearing loss (high frequency and speech discrimination)
Colchicine
Pneumovax - influenza

35. Optimal time for trisomy screen
16-18 weeks GA
400ug (low risk) - 4mg (high-risk: e.g. anticonvulsant therapy - previous defect)
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
MCC melanoma in Africans/Asians. Under nails - soles - palms.

36. Pregnancy class D smoking cessation drugs
<20lb - <1YO - Reacts to pain - Responds to noise
Nicotine inhaler - nasal spray - gum
1 = 90+ GFR - 2 = 60-89 - 3 = 30-59 - 4 = 15-29 - 5 = <15 or dialysis
Presbycusis - noise-induced - cerumen impaction - otosclerosis - central auditory processing disorder (CAPD)

37. Complications of PID
Lower abdominal tenderness - adnexal tenderness - CMT - febrile - discharge - elevated ESR - CRP - gonorrhea/chlamydia infxn
Tdap - influenza - pneumovax
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)
Recurrence - tuboovarian abscess - chronic abdominal pain - infertility - ectopic pregnancy

38. Sx peritonsillar abscess
Ampicillin/sulbactam AND doxycycline
(cefotetan OR cefoxitin) AND doxycycline
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Thin homogenous discharge; pH > 4.5; +KOH whiff test; clue cells on wet mount

39. Acral lentinous melanoma
LCC melanoma. MCC in Hawaii. Mostly elderly. Face - ears - arms - upper trunk.
5+ rads
Abrupt decrease in fetal heart rate - inconsistent timing. caused by umbilical cord compression during contractions.
MCC melanoma in Africans/Asians. Under nails - soles - palms.

40. IUPC (intrauterine pressure catheter)
Monosodium urate crystals (gout)
Measures strength of contractions
NAC or IV NaHCO3
Angioedema

41. X-ray on knee?
Hypomagnesemia
PH > 6.5 (Nitrazine) - 'ferning' on air-dried microscope slide
55+; patella tenderness; fibular head tenderness; inability to flex knee 90o; inability to bear weight for 4 steps
Ofloxacin OR levofloxacin +/- metronidazole

42. First stage of labor
Most aggressive melanoma.
MCC melanoma in Africans/Asians. Under nails - soles - palms.
Onset of labor until cervix dilation
Colchicine

43. Sx epiglottitis
Pneumovax - influenza
Stridor - drooling - toxic appearance
Initial: Amoxicillin - alternative: amoxicillin-clavulanic acid - TMP-SMX - 2nd-3rd gen cephalosporins
Diabetes - HTN - GN

44. Unstable angina vs MI Dx tests
Hypervitaminosis A; hypervitaminosis D; rhabdomyolysis; adrenal insufficiency
Diphenhydramine - chlorpheniramine - hydroxyzine
CBC - electrolytes - BUN - creatinine - PT - PTT - INR - glucose - ECG - CXR - Ck-MB - Troponin T and I - O2 sat
Doxycycline 100mg bid x 7days OR azithromycin 1000mg once

45. Bacteria causing chronic sinusitis
Anaerobic: bacteroides - peptostreptococcus - fusobacterium
Morning stiffness - 3+ joints - hands - symmetric - nodules - +anti-Ig (RF) - erosions/decalcifications on XR
McRobert's manuever (hyperflexion of hips); suprapubic pressure; episiotomy
MCC melanoma in Africans/Asians. Under nails - soles - palms.

46. ADL
Histamine - tryptase - chymase - kinase - leukotrienes - PGD2
Steroids + bronchodilators
0.2-0.5mg aqueous EPI IM/SubQ
Bathing - dressing - eating - transferring - continence - toileting

47. Tx RA (best long-term outcome)
MTX
Triple/quad screen (AFP - b-hCG - estriol +/- inhibin A)
Flexion - internal rotation - extension - external rotation
Measures strength of contractions

48. IV tx for PID
Ampicillin/sulbactam AND doxycycline
5 yo - draws person - ties shoes - skips
Peritonsillar swelling - tonsil pushed to midline with contralateral uvula deviation; sore throat - trismus (pain w/ chewing)
Lung; SCC head & neck; RCC; breast; MM; prostate

49. Fetal lie
Long axis of fetus to long axis of mother (longitudinal or transverse)
[ceftriaxone OR (cefoxitin + probenecid)] AND doxycycline +/- metronidazole
= LMP + 7 days - 3 months
[0.8 x (normal albumin - patient's albumin)] + serum Ca level

50. social smile - parent recognition
[0.8 x (normal albumin - patient's albumin)] + serum Ca level
2 mo - eyes follow object past midline - rolls over - laughs - squeals
<20lb - <1YO - Reacts to pain - Responds to noise
Normal mental status; no other injuries; seen within 10 days of injury