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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. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Dicyclomine - hyoscyamine (antispasmodics)
Neonate - infants - bilious vomiting - abdominal pain
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

2. Tx HTN + DM
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
'steeple-sign' (subglottic narrowing)
ACEI - ARB - diuretic - Ca-blocker - B-blocker

3. Statins
1st line: TZD
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

4. Phentermine
Obesity; NE-uptake inhibition
Lumbar puncture
Foot/leg deficits - cognitive + personality changes
Quinolone + metronidazole

5. CXR of CHF
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Lumbar puncture
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

6. Dx subarachnoid hemorrhage with negative noncontrast CT
5-HT blockers: tegasorad - alosetron
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Lumbar puncture

7. Commonly ingested foreign bodies
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Obesity; NE-uptake inhibition
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Flat disk - button - batteries

8. DDx limp in infant/toddler
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Septic arthritis - fractures - congenital hip dysplasia
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Uterine atony

9. 4 T's of postpartum hemorrhage
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
ACEI - ARB - B-blocker - diuretic - Spironolactone
10th postpartum day
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

10. Papilledema DDx
Mass lesion - pseudotumor cerebri - meningitis
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

11. Stable vtach tx
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
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Halothane - succinylcholine

12. Pyloric stenosis sx

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13. Headache with sx systemic illness DDx
3rd month postpartum
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Mass lesion - pseudotumor cerebri - meningitis
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

14. Diethylpropion
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Temporal arteritis - mass lesion
Obesity; increased NE release

15. GI 'alarm' features
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
10th postpartum day

16. Croup pathogens
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Eikenella species
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

17. DASH diet plan
High K - high Ca - low Na
Eikenella species
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Neonate - infants - bilious vomiting - abdominal pain

18. Croup X-ray

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19. Tx local - acute rxn to bee sting
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Oral prednisone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Alzheimer dementia

20. SSRI's
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Moderate/severe alzheimer dementia
S. aureus

21. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Legionella
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

22. contraindications to thrombolytic therapy
PCP pneumonia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Dicyclomine - hyoscyamine (antispasmodics)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

23. Sx of pneumococcal pneumonia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Neonate - infants - bilious vomiting - abdominal pain
Mass lesion - subdural hematoma - medication overuse
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

24. If not breast-feeding - when does menstruation restart?
3rd month postpartum
ACEI - diuretic
Amiodarone/lidocaine
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

25. Standard workup for dyslipidemia
= QT / sqrt(RR interval)
Fasting blood glucose - LFTs - renal function - TSH
Venlafaxine - duloxetine - mirtazapine
Phenelzine - tranylcypramine

26. DDx pediatric intestinal obsutrction
Furosemide - nitroglycerin - IV morphine sulphate
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACEI - B-blocker - spironolactone
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

27. Tx HTN + post-MI
3 hours
ACEI - B-blocker - spironolactone
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

28. IBS pain tx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
5-HT blockers: tegasorad - alosetron
Meningitis - brain abscess - metastasis
Septic arthritis - fractures - congenital hip dysplasia

29. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Flat disk - button - batteries
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

30. Cluster headache acute tx
Amiodarone/lidocaine
Venlafaxine - duloxetine - mirtazapine
100% O2 6L/min - dihydroergotamine - triptans
3 hours

31. Donepezil use/sfx
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
470ms+ in men - 480ms+ in women
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

32. Bilateral 'ground glass' infiltrate on CXR
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
PCP pneumonia
S. aureus

33. Organism that causes pneumonia post-influenza
Septic arthritis - fractures - congenital hip dysplasia
S. aureus
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Foot/leg deficits - cognitive + personality changes

34. vertebrobasilar stroke sx
ACEI - ARB - diuretic - Ca-blocker - B-blocker
High K - high Ca - low Na
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

35. Galantamine use/sfx
'steeple-sign' (subglottic narrowing)
ACEI - B-blocker - spironolactone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
H. flu - S. pneumo - S. aureus - Strep A/B/C

36. DDx dementia
Barium enema
Viral infxn of the subglottis
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Eikenella species

37. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Mass lesion - subdural hematoma - medication overuse
Digoxin (B-blockers as needed)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
3rd month postpartum

38. Chronic afib tx
Fiber (e.g. psyllium)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Temporal arteritis - mass lesion
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

39. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - ARB - B-blocker - diuretic - Spironolactone
Eikenella species
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

40. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Cephalexin OR dicloxacillin
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

41. Sx normal-pressure hydrocephalus
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Dementia - incontinence - gait disturbance
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Obesity; increased NE release

42. Primary SVT tx
Dementia - incontinence - gait disturbance
B-blocker - Ca-channel blocker
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

43. Lochia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

44. CAGE questionnaire
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

45. Retropharyngeal abscess Sx
Legionella
Moderate/severe alzheimer dementia
Eikenella species
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

46. Organism that causes pneumonia with diarrhea
Legionella
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Meningitis - brain abscess - metastasis

47. Tx acute pulmonary edema 2ndary to CHF
High K - high Ca - low Na
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Furosemide - nitroglycerin - IV morphine sulphate
PCP pneumonia

48. Test to best determine source of lower GI bleed
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Colonoscopy
PCP pneumonia

49. most common valvular heart defect in USA
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
MVP
470ms+ in men - 480ms+ in women
10th postpartum day

50. Bite injury pflx
Phenelzine - tranylcypramine
Postpartum fever - uterine tenderness - foul-smelling lochia
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD