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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.
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1. Lochia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Obesity; increased NE release
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACEI - B-blocker - spironolactone

2. ACA stroke ssx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Foot/leg deficits - cognitive + personality changes

3. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

4. MAOI
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Phenelzine - tranylcypramine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

5. Malrotation sx
B-blocker - Ca-channel blocker
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Neonate - infants - bilious vomiting - abdominal pain
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

6. Sibutramine
3 hours
Eikenella species
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

7. Baby blues resolves by ______
100% O2 6L/min - dihydroergotamine - triptans
Neonate - infants - bilious vomiting - abdominal pain
10th postpartum day
Amiodarone/lidocaine

8. most common valvular heart defect in USA
Obesity; increased NE release
SCFE (slipped capital femoral epiphysis)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
MVP

9. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Mass lesion - subdural hematoma - medication overuse
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

10. MCC infxn in closed-fist injuries
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
= QT / sqrt(RR interval)
Eikenella species
Halothane - succinylcholine

11. Tx local - acute rxn to bee sting
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
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Oral prednisone
ACEI - diuretic

12. Drugs causing fever
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
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
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

13. Bite injury pflx
'steeple-sign' (subglottic narrowing)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

14. IBS pain tx
IV labetalol - nicardipine - sodium nitroprusside
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
5-HT blockers: tegasorad - alosetron

15. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - B-blocker - spironolactone
Foot/leg deficits - cognitive + personality changes
Digoxin (B-blockers as needed)

16. Papilledema DDx
TCA's
Mass lesion - pseudotumor cerebri - meningitis
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
ACEI - ARB

17. Pflx migraine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amitriptyline - propanolol - timolol - divalproex sodium
S. aureus
Dantrolene IV - antipyretics - O2 - cooling blankets

18. Epiglottitis pathogens
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
H. flu - S. pneumo - S. aureus - Strep A/B/C
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

19. Sx HoCM
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

20. Organism that causes pneumonia with diarrhea
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - ARB
Fasting blood glucose - LFTs - renal function - TSH
Legionella

21. Orlistat
470ms+ in men - 480ms+ in women
ACEI - diuretic
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

22. Antihypertensives in suspected stroke
470ms+ in men - 480ms+ in women
IV labetalol - nicardipine - sodium nitroprusside
Venlafaxine - duloxetine - mirtazapine
8%

23. Dx and Tx of intussception
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Barium enema
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Temporal arteritis - mass lesion

24. DDx Limp w/o pain in children - orthopedic
Bacterial infxn of supraglottic tissue and surrounding areas
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Amiodarone/lidocaine
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

25. SSRI's
Quinolone + metronidazole
ACEI - ARB
Postpartum fever - uterine tenderness - foul-smelling lochia
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

26. Retropharyngeal abscess Sx
Meningitis - brain abscess - metastasis
High K - high Ca - low Na
Amitriptyline - propanolol - timolol - divalproex sodium
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

27. Tx HTN
100% O2 6L/min - dihydroergotamine - triptans
Flat disk - button - batteries
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
1st line: TZD

28. Tx HTN + CKD
SCFE (slipped capital femoral epiphysis)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Viral infxn of the subglottis
ACEI - ARB

29. Cluster headache pflx
Barium enema
MVP
Fasting blood glucose - LFTs - renal function - TSH
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

30. Phendimetrazine
Obesity; increased NE release
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Furosemide - nitroglycerin - IV morphine sulphate
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

31. Mastitis tx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Cephalexin OR dicloxacillin
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

32. Croup pathogens
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
H. flu - S. pneumo - S. aureus - Strep A/B/C
= QT / sqrt(RR interval)
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

33. MCA stroke sx
SCFE (slipped capital femoral epiphysis)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Oral prednisone
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

34. DDx pediatric intestinal obsutrction
Obesity; NE-uptake inhibition
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

35. Tx frequent/severe abd pain

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36. epiglottitis
Phenelzine - tranylcypramine
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Bacterial infxn of supraglottic tissue and surrounding areas
8%

37. vertebrobasilar stroke sx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Halothane - succinylcholine
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

38. NMDA-R antagonist (memantine)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Dantrolene IV - antipyretics - O2 - cooling blankets
Moderate/severe alzheimer dementia
Obesity; increased NE release

39. Rivastigmine
Alzheimer dementia
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Mass lesion - pseudotumor cerebri - meningitis
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

40. Sx of pneumococcal pneumonia
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
S. aureus
Furosemide - nitroglycerin - IV morphine sulphate
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

41. SNRI
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Venlafaxine - duloxetine - mirtazapine
Amiodarone/lidocaine

42. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
'steeple-sign' (subglottic narrowing)

43. Cluster headache acute tx
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
100% O2 6L/min - dihydroergotamine - triptans
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

44. Headache with sx systemic illness DDx
Dicyclomine - hyoscyamine (antispasmodics)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

45. ROME IBS criteria
8%
MVP
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

46. Tx HTN + post-MI
Lumbar puncture
ACEI - B-blocker - spironolactone
Mass lesion - subdural hematoma - medication overuse
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

47. malignant hyperthermia
Phenelzine - tranylcypramine
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
5-HT blockers: tegasorad - alosetron
TCA's

48. causes of malignant hyperthernia
ACEI - diuretic
Venlafaxine - duloxetine - mirtazapine
Halothane - succinylcholine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

49. Tx HTN + CAD
Uterine atony
Barium enema
ACEI - B-blocker - diuretic - Ca-blocker
Bacterial infxn of supraglottic tissue and surrounding areas

50. Headache post-head trauma DDx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
MVP
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
'steeple-sign' (subglottic narrowing)

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Family Medicine/ambulatory 2

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