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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. Diethylpropion
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity; increased NE release
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

2. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Dementia - incontinence - gait disturbance
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

3. IBS pain tx
5-HT blockers: tegasorad - alosetron
Flat disk - button - batteries
Colonoscopy
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

4. Antihypertensives in suspected stroke
'steeple-sign' (subglottic narrowing)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Oral prednisone
IV labetalol - nicardipine - sodium nitroprusside

5. Cholesterol absorption blocker (ezetimibe)
'steeple-sign' (subglottic narrowing)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Mass lesion - vascular malformation - stroke - collagen vascular disease
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

6. ROME IBS criteria
ACEI - B-blocker - diuretic - Ca-blocker
ACEI - ARB - B-blocker - diuretic - Spironolactone
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

7. Tx HTN + post-MI
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
SCFE (slipped capital femoral epiphysis)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - B-blocker - spironolactone

8. MCC HTN in child
Foot/leg deficits - cognitive + personality changes
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Renal parenchymal disease

9. DASH diet plan
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
High K - high Ca - low Na
Fiber (e.g. psyllium)

10. Focal neurologic sx (other than aura) DDx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Amitriptyline - propanolol - timolol - divalproex sodium
Mass lesion - vascular malformation - stroke - collagen vascular disease
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

11. Metabolic syndrome
Fiber (e.g. psyllium)
Moderate/severe alzheimer dementia
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Viral infxn of the subglottis

12. Organism that causes pneumonia post-influenza
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Dantrolene IV - antipyretics - O2 - cooling blankets
S. aureus
Venlafaxine - duloxetine - mirtazapine

13. atypical
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Bupriopion - amoxipine - trazodone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

14. Organism that causes pneumonia with diarrhea
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Amitriptyline - propanolol - timolol - divalproex sodium
Legionella
ACEI - B-blocker - spironolactone

15. CXR of CHF
1st line: TZD
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

16. Test to best determine source of lower GI bleed
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Colonoscopy

17. Pyloric stenosis sx

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18. SNRI
Eikenella species
10th postpartum day
470ms+ in men - 480ms+ in women
Venlafaxine - duloxetine - mirtazapine

19. Bilateral 'ground glass' infiltrate on CXR
Moderate/severe alzheimer dementia
PCP pneumonia
Flat disk - button - batteries
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

20. Sx Lewy Body Dementia
ACEI - B-blocker - spironolactone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
B-blocker - Ca-channel blocker

21. Cardiac Resynchronization Therapy (CRT) is warranted when ___
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Fasting blood glucose - LFTs - renal function - TSH
Uterine atony

22. Standard workup for dyslipidemia
Alzheimer dementia
Renal parenchymal disease
Fasting blood glucose - LFTs - renal function - TSH
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

23. DDx dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Viral infxn of the subglottis
Venlafaxine - duloxetine - mirtazapine
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

24. Epiglottitis pathogens
H. flu - S. pneumo - S. aureus - Strep A/B/C
IV labetalol - nicardipine - sodium nitroprusside
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Neonate - infants - bilious vomiting - abdominal pain

25. Headache post-head trauma DDx
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
ACEI - B-blocker - spironolactone
Foot/leg deficits - cognitive + personality changes

26. Commonly ingested foreign bodies
Flat disk - button - batteries
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Colonoscopy
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

27. Headache with sx systemic illness DDx
10th postpartum day
Obesity; increased NE release
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Bacterial infxn of supraglottic tissue and surrounding areas

28. Tx HTN + CVA
Obesity; increased NE release
Renal parenchymal disease
ACEI - diuretic
100% O2 6L/min - dihydroergotamine - triptans

29. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
IV labetalol - nicardipine - sodium nitroprusside
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

30. MCA stroke sx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Bupriopion - amoxipine - trazodone
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

31. Croup sx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

32. Peritonsillar abscess Sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity; increased NE release
Fever - sore throat - muffled voice - drooling - trismus - neck pain

33. Sx HoCM
Postpartum fever - uterine tenderness - foul-smelling lochia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Temporal arteritis - mass lesion
Mass lesion - pseudotumor cerebri - meningitis

34. contraindications to thrombolytic therapy
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Lumbar puncture
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

35. 'Alarm' sx for upper GI endoscopy
H. flu - S. pneumo - S. aureus - Strep A/B/C
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

36. Chronic afib tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Mass lesion - pseudotumor cerebri - meningitis
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

37. causes of malignant hyperthernia
Obesity; NE-uptake inhibition
Halothane - succinylcholine
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
'steeple-sign' (subglottic narrowing)

38. Afib - Aflutter tx
ACEI - diuretic
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Cephalexin OR dicloxacillin
Digoxin (B-blockers as needed)

39. Phentermine
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity; NE-uptake inhibition

40. New-onset headache in patient with HIV/cancer DDx
ACEI - B-blocker - spironolactone
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Meningitis - brain abscess - metastasis
Phenelzine - tranylcypramine

41. Empiric CAP tx in hospitalized patient
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

42. MCC infxn in closed-fist injuries
Eikenella species
Temporal arteritis - mass lesion
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

43. Tx uterine atony
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
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Quinolone + metronidazole
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

44. Croup X-ray

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45. GI 'alarm' features
Amitriptyline - propanolol - timolol - divalproex sodium
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

46. DDx limp in infant/toddler
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Septic arthritis - fractures - congenital hip dysplasia
Dicyclomine - hyoscyamine (antispasmodics)
Obesity; increased NE release

47. Rivastigmine
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Alzheimer dementia

48. Empiric CAP tx in healthy person
ACEI - B-blocker - spironolactone
Obesity; increased NE release
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

49. malignant hyperthermia
PCP pneumonia
Obesity; increased NE release
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
ACEI - ARB

50. MAOI
Fasting blood glucose - LFTs - renal function - TSH
Phenelzine - tranylcypramine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze