Test your basic knowledge |

Family Medicine/ambulatory 2

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. Baby blues resolves by ______
Fiber (e.g. psyllium)
10th postpartum day
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
3rd month postpartum

2. MCC HTN in child
Meningitis - brain abscess - metastasis
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Renal parenchymal disease

3. contraindications to thrombolytic therapy
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
ACEI - ARB - B-blocker - diuretic - Spironolactone
1st line: TZD

4. Mastitis tx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Cephalexin OR dicloxacillin

5. Test to best determine source of lower GI bleed
1st line: TZD
Colonoscopy
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
5-HT blockers: tegasorad - alosetron

6. DASH diet plan
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
High K - high Ca - low Na
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

7. DDx Limp w/o pain in children - orthopedic
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
470ms+ in men - 480ms+ in women
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

8. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

9. 1st line tx in IBS constipation
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Fiber (e.g. psyllium)

10. Empiric CAP tx in hospitalized patient
H. flu - S. pneumo - S. aureus - Strep A/B/C
Dicyclomine - hyoscyamine (antispasmodics)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

11. rtPA should be used within ____ of stroke
Fasting blood glucose - LFTs - renal function - TSH
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
3 hours
Lumbar puncture

12. Headaches increasing in severity + intensity DDx
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Mass lesion - subdural hematoma - medication overuse
PCP pneumonia
Fasting blood glucose - LFTs - renal function - TSH

13. Cholesterol absorption blocker (ezetimibe)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

14. Papilledema DDx
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Fasting blood glucose - LFTs - renal function - TSH
Uterine atony
Mass lesion - pseudotumor cerebri - meningitis

15. DDx dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
= QT / sqrt(RR interval)
Venlafaxine - duloxetine - mirtazapine

16. QTc
Meningitis - brain abscess - metastasis
= QT / sqrt(RR interval)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Renal parenchymal disease

17. Afib - Aflutter tx
Foot/leg deficits - cognitive + personality changes
Digoxin (B-blockers as needed)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

18. Tx HTN + CKD
Meningitis - brain abscess - metastasis
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - ARB
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

19. CXR of CHF
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
SCFE (slipped capital femoral epiphysis)
B-blocker - Ca-channel blocker

20. Refer to cardiologist post-sports physical if ____
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fiber (e.g. psyllium)
8%

21. Chance of pregnancy after a single act of coitus
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
8%
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

22. New-onset headache in patient with HIV/cancer DDx
Amiodarone/lidocaine
High K - high Ca - low Na
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Meningitis - brain abscess - metastasis

23. 'Alarm' sx for upper GI endoscopy
Barium enema
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

24. Bilateral 'ground glass' infiltrate on CXR
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
PCP pneumonia

25. Sudden-onset headache DDx
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Mass lesion - subdural hematoma - medication overuse
Cephalexin OR dicloxacillin
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

26. Donepezil use/sfx
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
470ms+ in men - 480ms+ in women

27. MCC infxn in closed-fist injuries
Quinolone + metronidazole
Obesity; NE-uptake inhibition
Eikenella species
Furosemide - nitroglycerin - IV morphine sulphate

28. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Legionella
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

29. Peritonsillar abscess Sx
Bupriopion - amoxipine - trazodone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Mass lesion - pseudotumor cerebri - meningitis
Fever - sore throat - muffled voice - drooling - trismus - neck pain

30. MCC non-traumatic hip pathology in adolescents
Fever - sore throat - muffled voice - drooling - trismus - neck pain
SCFE (slipped capital femoral epiphysis)
Meningitis - brain abscess - metastasis
Eikenella species

31. Outpatient tx CHF
1st line: IV oxytocin - bimanual uterine massage - 2nd line: methylergonovine IM (CI in HTN) - 3rd line: PGF2a (Hemabate) IM (CI in asthma) - 4th line: Misoprostol
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

32. 4 T's of postpartum hemorrhage
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Eikenella species
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

33. Phendimetrazine
100% O2 6L/min - dihydroergotamine - triptans
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity; increased NE release
'thumb sign' (protrusion of into anterior wall of hypopharynx)

34. Headache post-head trauma DDx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Moderate/severe alzheimer dementia
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

35. Galantamine use/sfx
Meningitis - brain abscess - metastasis
Barium enema
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

36. Headache with sx systemic illness DDx
PCP pneumonia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Bacterial infxn of supraglottic tissue and surrounding areas
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

37. Sx Lewy Body Dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Neonate - infants - bilious vomiting - abdominal pain
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
5-HT blockers: tegasorad - alosetron

38. Orlistat
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Fiber (e.g. psyllium)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

39. Lubiprostone
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

40. Nicotinic acids
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - ARB - B-blocker - diuretic - Spironolactone
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

41. Organism that causes pneumonia with diarrhea
Legionella
100% O2 6L/min - dihydroergotamine - triptans
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Lumbar puncture

42. Prolonged QT interval (QTc)
ACEI - diuretic
Bupriopion - amoxipine - trazodone
High K - high Ca - low Na
470ms+ in men - 480ms+ in women

43. Sx normal-pressure hydrocephalus
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Dementia - incontinence - gait disturbance

44. Tx HTN + CHF
Venlafaxine - duloxetine - mirtazapine
Bacterial infxn of supraglottic tissue and surrounding areas
ACEI - ARB - B-blocker - diuretic - Spironolactone
Flat disk - button - batteries

45. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Amiodarone/lidocaine
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

46. Croup pathogens
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Quinolone + metronidazole

47. Cluster headache pflx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
3 hours
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

48. Tx HTN + CAD
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
470ms+ in men - 480ms+ in women
Legionella
ACEI - B-blocker - diuretic - Ca-blocker

49. Intussusception sx
ACEI - ARB - B-blocker - diuretic - Spironolactone
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Viral infxn of the subglottis
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

50. causes of malignant hyperthernia
Bupriopion - amoxipine - trazodone
1st line: TZD
Halothane - succinylcholine
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing