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Family Medicine/ambulatory 2

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. SNRI
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Venlafaxine - duloxetine - mirtazapine
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Fiber (e.g. psyllium)

2. Prolonged QT interval (QTc)
S. aureus
Mass lesion - vascular malformation - stroke - collagen vascular disease
PCP pneumonia
470ms+ in men - 480ms+ in women

3. Tx frequent/severe abd pain

4. DDx postoperative fever
Obesity; increased NE release
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

5. Cluster headache pflx
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

6. Statins
IV labetalol - nicardipine - sodium nitroprusside
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

7. Cluster headache acute tx
ACEI - B-blocker - diuretic - Ca-blocker
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
100% O2 6L/min - dihydroergotamine - triptans
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

8. vertebrobasilar stroke sx
Phenelzine - tranylcypramine
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Amiodarone/lidocaine
Meningitis - brain abscess - metastasis

9. Dx and Tx of intussception
3 hours
Barium enema
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

10. Tacrine use/sfx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

11. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Fasting blood glucose - LFTs - renal function - TSH
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

12. Tx diverticulitis
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
470ms+ in men - 480ms+ in women
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Quinolone + metronidazole

13. DDx Limp w/o pain in children - orthopedic
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Colonoscopy
1st line: TZD
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

14. Tx local - acute rxn to bee sting
S. aureus
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Meningitis - brain abscess - metastasis
Oral prednisone

15. Organism that causes pneumonia with diarrhea
Obesity; increased NE release
Temporal arteritis - mass lesion
Legionella
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

16. Outpatient tx CHF
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
ACEI - B-blocker - spironolactone

17. DDx pediatric intestinal obsutrction
Bacterial infxn of supraglottic tissue and surrounding areas
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Foot/leg deficits - cognitive + personality changes
MVP

18. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
ACEI - ARB
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

19. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Septic arthritis - fractures - congenital hip dysplasia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

20. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Dicyclomine - hyoscyamine (antispasmodics)
ACEI - ARB
Eikenella species

21. Headache after 50 YO DDx
S. aureus
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Temporal arteritis - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

22. tx malignant hyperthermia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Dantrolene IV - antipyretics - O2 - cooling blankets
Quinolone + metronidazole

23. New-onset headache in patient with HIV/cancer DDx
Amitriptyline - propanolol - timolol - divalproex sodium
Meningitis - brain abscess - metastasis
8%
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

24. Tx HTN + post-MI
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
ACEI - B-blocker - spironolactone
Colonoscopy

25. Commonly ingested foreign bodies
Flat disk - button - batteries
470ms+ in men - 480ms+ in women
ACEI - B-blocker - diuretic - Ca-blocker
Furosemide - nitroglycerin - IV morphine sulphate

26. Metabolic syndrome
Mass lesion - pseudotumor cerebri - meningitis
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

27. Tx uterine atony
Amiodarone/lidocaine
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
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
Fiber (e.g. psyllium)

28. Chance of pregnancy after a single act of coitus
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Halothane - succinylcholine
'thumb sign' (protrusion of into anterior wall of hypopharynx)
8%

29. Primary SVT tx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
B-blocker - Ca-channel blocker

30. Tx HTN + CAD
3 hours
Venlafaxine - duloxetine - mirtazapine
10th postpartum day
ACEI - B-blocker - diuretic - Ca-blocker

31. Baby blues resolves by ______
Uterine atony
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
10th postpartum day

32. Chronic afib tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Renal parenchymal disease

33. Tx HTN + CVA
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - diuretic

34. MCC non-traumatic hip pathology in adolescents
SCFE (slipped capital femoral epiphysis)
PCP pneumonia
1st line: TZD
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

35. Empiric CAP tx in healthy person
Furosemide - nitroglycerin - IV morphine sulphate
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Meningitis - brain abscess - metastasis
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

36. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
8%

37. IBS pain tx
Dicyclomine - hyoscyamine (antispasmodics)
5-HT blockers: tegasorad - alosetron
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

38. GI 'alarm' features
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
S. aureus
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

39. NMDA-R antagonist (memantine)
Septic arthritis - fractures - congenital hip dysplasia
Alzheimer dementia
Moderate/severe alzheimer dementia
Barium enema

40. rtPA should be used within ____ of stroke
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
3 hours
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

41. Nicotinic acids
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

42. Refer to cardiologist post-sports physical if ____
Colonoscopy
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fiber (e.g. psyllium)
Phenelzine - tranylcypramine

43. Lubiprostone
Renal parenchymal disease
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
TCA's
Oral prednisone

44. Headache post-head trauma DDx
Septic arthritis - fractures - congenital hip dysplasia
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Bacterial infxn of supraglottic tissue and surrounding areas
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

45. Phendimetrazine
Amitriptyline - propanolol - timolol - divalproex sodium
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Obesity; increased NE release

46. Bite injury pflx
Legionella
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

47. Epiglottitis pathogens
Colonoscopy
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Dantrolene IV - antipyretics - O2 - cooling blankets
H. flu - S. pneumo - S. aureus - Strep A/B/C

48. Peritonsillar abscess Sx
Halothane - succinylcholine
Fever - sore throat - muffled voice - drooling - trismus - neck pain
MVP
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

49. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Lumbar puncture
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

50. epiglottitis
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome