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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. Croup
Viral infxn of the subglottis
ACEI - ARB - B-blocker - diuretic - Spironolactone
S. aureus
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

2. Malrotation sx
ACEI - B-blocker - spironolactone
Neonate - infants - bilious vomiting - abdominal pain
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

3. Sx Lewy Body Dementia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
B-blocker - Ca-channel blocker
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

4. rtPA should be used within ____ of stroke
3 hours
Bacterial infxn of supraglottic tissue and surrounding areas
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

5. DDx pediatric intestinal obsutrction
Temporal arteritis - mass lesion
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
TCA's

6. SSRI's
'steeple-sign' (subglottic narrowing)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
10th postpartum day

7. DASH diet plan
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
High K - high Ca - low Na
Meningitis - brain abscess - metastasis
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

8. Sudden-onset headache DDx
Colonoscopy
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

9. tx malignant hyperthermia
Legionella
3rd month postpartum
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Dantrolene IV - antipyretics - O2 - cooling blankets

10. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
8%
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

11. X-ray epiglottitis

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12. Focal neurologic sx (other than aura) DDx
Foot/leg deficits - cognitive + personality changes
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Mass lesion - vascular malformation - stroke - collagen vascular disease

13. ACA stroke ssx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Fasting blood glucose - LFTs - renal function - TSH
Foot/leg deficits - cognitive + personality changes

14. If not breast-feeding - when does menstruation restart?
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
MVP
Lumbar puncture
3rd month postpartum

15. Mastitis tx
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Cephalexin OR dicloxacillin

16. MCC postpartum hemorrhage
ACEI - B-blocker - diuretic - Ca-blocker
Uterine atony
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

17. Tx migraine
Barium enema
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

18. IBS pain tx
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
5-HT blockers: tegasorad - alosetron

19. QTc
Postpartum fever - uterine tenderness - foul-smelling lochia
Furosemide - nitroglycerin - IV morphine sulphate
= QT / sqrt(RR interval)
Mass lesion - pseudotumor cerebri - meningitis

20. Headache post-head trauma DDx
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Obesity; increased NE release
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

21. Sx normal-pressure hydrocephalus
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Oral prednisone
Dementia - incontinence - gait disturbance
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

22. Tx acute pulmonary edema 2ndary to CHF
ACEI - B-blocker - diuretic - Ca-blocker
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
Furosemide - nitroglycerin - IV morphine sulphate
Uterine atony

23. DDx postoperative fever
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Dantrolene IV - antipyretics - O2 - cooling blankets
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

24. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - B-blocker - diuretic - Ca-blocker
Furosemide - nitroglycerin - IV morphine sulphate
Viral infxn of the subglottis

25. Pflx migraine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amitriptyline - propanolol - timolol - divalproex sodium
Mass lesion - pseudotumor cerebri - meningitis
Temporal arteritis - mass lesion

26. Organism that causes pneumonia post-influenza
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
S. aureus
Quinolone + metronidazole
ACEI - ARB

27. Drugs causing fever
= QT / sqrt(RR interval)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

28. Tx mild/infrequent abd pain
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - propanolol - timolol - divalproex sodium
SCFE (slipped capital femoral epiphysis)

29. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
'thumb sign' (protrusion of into anterior wall of hypopharynx)

30. Cholesterol absorption blocker (ezetimibe)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

31. Croup pathogens
10th postpartum day
ACEI - ARB
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

32. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Quinolone + metronidazole
Phenelzine - tranylcypramine

33. Causes of diverticular bleeding
Temporal arteritis - mass lesion
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
100% O2 6L/min - dihydroergotamine - triptans

34. ROME IBS criteria
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Dementia - incontinence - gait disturbance
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

35. DDx dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
470ms+ in men - 480ms+ in women
Obesity; increased NE release
Uterine atony

36. Cluster headache pflx
3rd month postpartum
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
3 hours

37. Evaluating limp w/o pain in children
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Lumbar puncture
Obesity; NE-uptake inhibition
Foot/leg deficits - cognitive + personality changes

38. Diethylpropion
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Legionella
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release

39. Cardiac Resynchronization Therapy (CRT) is warranted when ___
3rd month postpartum
Foot/leg deficits - cognitive + personality changes
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Renal parenchymal disease

40. Galantamine use/sfx
Venlafaxine - duloxetine - mirtazapine
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

41. MAOI
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Phenelzine - tranylcypramine
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

42. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Digoxin (B-blockers as needed)
Cephalexin OR dicloxacillin
Barium enema

43. most common valvular heart defect in USA
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
MVP
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Moderate/severe alzheimer dementia

44. Outpatient tx CHF
Uterine atony
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Bupriopion - amoxipine - trazodone

45. atypical
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Bupriopion - amoxipine - trazodone
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dementia - incontinence - gait disturbance

46. MCC non-traumatic hip pathology in adolescents
B-blocker - Ca-channel blocker
Meningitis - brain abscess - metastasis
S. aureus
SCFE (slipped capital femoral epiphysis)

47. Headaches increasing in severity + intensity DDx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
= QT / sqrt(RR interval)
Uterine atony
Mass lesion - subdural hematoma - medication overuse

48. Tx HTN + post-MI
Amitriptyline - propanolol - timolol - divalproex sodium
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - B-blocker - spironolactone

49. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
'steeple-sign' (subglottic narrowing)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
3rd month postpartum

50. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Moderate/severe alzheimer dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Alzheimer dementia