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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. MCA stroke sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
ACEI - diuretic
'steeple-sign' (subglottic narrowing)

2. Chance of pregnancy after a single act of coitus
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
8%
Temporal arteritis - mass lesion

3. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Legionella

4. MCC postpartum hemorrhage
Dantrolene IV - antipyretics - O2 - cooling blankets
Phenelzine - tranylcypramine
Uterine atony
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

5. Headache with sx systemic illness DDx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
TCA's
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
SCFE (slipped capital femoral epiphysis)

6. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Mass lesion - subdural hematoma - medication overuse
Obesity; NE-uptake inhibition
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

7. Lochia
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

8. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
B-blocker - Ca-channel blocker

9. contraindications to thrombolytic therapy
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Venlafaxine - duloxetine - mirtazapine
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

10. atypical
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Bupriopion - amoxipine - trazodone
Colonoscopy
Moderate/severe alzheimer dementia

11. Phentermine
Obesity; NE-uptake inhibition
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Viral infxn of the subglottis
Phenelzine - tranylcypramine

12. Pyloric stenosis sx

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13. Malrotation sx
Obesity; increased NE release
IV labetalol - nicardipine - sodium nitroprusside
Neonate - infants - bilious vomiting - abdominal pain
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

14. Rivastigmine
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Legionella
Alzheimer dementia
= QT / sqrt(RR interval)

15. Epiglottitis pathogens
Renal parenchymal disease
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
H. flu - S. pneumo - S. aureus - Strep A/B/C

16. Tacrine use/sfx
TCA's
Foot/leg deficits - cognitive + personality changes
Uterine atony
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

17. Orlistat
Legionella
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Obesity; NE-uptake inhibition

18. Metabolic syndrome
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fasting blood glucose - LFTs - renal function - TSH
Obesity; increased NE release
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

19. Diethylpropion
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Dementia - incontinence - gait disturbance

20. Sx of pneumococcal pneumonia
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
3rd month postpartum
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

21. Sx HoCM
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Obesity; increased NE release
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

22. Drugs causing fever
Oral prednisone
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Moderate/severe alzheimer dementia

23. Focal neurologic sx (other than aura) DDx
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Mass lesion - pseudotumor cerebri - meningitis
100% O2 6L/min - dihydroergotamine - triptans
Mass lesion - vascular malformation - stroke - collagen vascular disease

24. Croup sx
Alzheimer dementia
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Viral infxn of the subglottis

25. vertebrobasilar stroke sx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Fasting blood glucose - LFTs - renal function - TSH

26. Test to best determine source of lower GI bleed
High K - high Ca - low Na
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Colonoscopy

27. Tx HTN + CKD
Temporal arteritis - mass lesion
Mass lesion - pseudotumor cerebri - meningitis
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
ACEI - ARB

28. Organism that causes pneumonia with diarrhea
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Legionella
5-HT blockers: tegasorad - alosetron

29. Primary SVT tx
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
3rd month postpartum
B-blocker - Ca-channel blocker

30. NMDA-R antagonist (memantine)
Moderate/severe alzheimer dementia
10th postpartum day
ACEI - ARB
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

31. Tx HTN + post-MI
Fasting blood glucose - LFTs - renal function - TSH
ACEI - B-blocker - spironolactone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

32. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
8%
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Moderate/severe alzheimer dementia

33. Tx uterine atony
PCP pneumonia
= QT / sqrt(RR interval)
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
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

34. Tx HTN + CAD
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Lumbar puncture
Amiodarone/lidocaine
ACEI - B-blocker - diuretic - Ca-blocker

35. malignant hyperthermia
H. flu - S. pneumo - S. aureus - Strep A/B/C
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Mass lesion - subdural hematoma - medication overuse
1st line: TZD

36. Sudden-onset headache DDx
Fiber (e.g. psyllium)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
ACEI - B-blocker - diuretic - Ca-blocker
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

37. Dx and Tx of intussception
Mass lesion - pseudotumor cerebri - meningitis
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Barium enema
Mass lesion - vascular malformation - stroke - collagen vascular disease

38. Tx diverticulitis
MVP
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Quinolone + metronidazole
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

39. MAOI
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Phenelzine - tranylcypramine

40. Nicotinic acids
ACEI - ARB - B-blocker - diuretic - Spironolactone
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity; increased NE release

41. Statins
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Mass lesion - pseudotumor cerebri - meningitis
3rd month postpartum

42. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
IV labetalol - nicardipine - sodium nitroprusside
SCFE (slipped capital femoral epiphysis)
Meningitis - brain abscess - metastasis

43. Tx HTN + CVA
H. flu - S. pneumo - S. aureus - Strep A/B/C
ACEI - diuretic
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
100% O2 6L/min - dihydroergotamine - triptans

44. Tx local - acute rxn to bee sting
Oral prednisone
Obesity; increased NE release
ACEI - diuretic
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

45. Afib - Aflutter tx
Obesity; increased NE release
Digoxin (B-blockers as needed)
5-HT blockers: tegasorad - alosetron
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

46. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Postpartum fever - uterine tenderness - foul-smelling lochia
H. flu - S. pneumo - S. aureus - Strep A/B/C
Septic arthritis - fractures - congenital hip dysplasia

47. 4 T's of postpartum hemorrhage
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Temporal arteritis - mass lesion
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

48. GI 'alarm' features
Eikenella species
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Colonoscopy
Cephalexin OR dicloxacillin

49. DASH diet plan
100% O2 6L/min - dihydroergotamine - triptans
High K - high Ca - low Na
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Fasting blood glucose - LFTs - renal function - TSH

50. SSRI's
Mass lesion - vascular malformation - stroke - collagen vascular disease
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Quinolone + metronidazole