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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. Croup
Viral infxn of the subglottis
ACEI - B-blocker - spironolactone
5-HT blockers: tegasorad - alosetron
470ms+ in men - 480ms+ in women

2. Tx mild/infrequent abd pain
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
H. flu - S. pneumo - S. aureus - Strep A/B/C
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Dicyclomine - hyoscyamine (antispasmodics)

3. Dx and Tx of intussception
Amiodarone/lidocaine
Barium enema
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

4. Antihypertensives in suspected stroke
Fasting blood glucose - LFTs - renal function - TSH
IV labetalol - nicardipine - sodium nitroprusside
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Phenelzine - tranylcypramine

5. Chance of pregnancy after a single act of coitus
100% O2 6L/min - dihydroergotamine - triptans
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
8%
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

6. tx malignant hyperthermia
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
Dantrolene IV - antipyretics - O2 - cooling blankets
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Renal parenchymal disease

7. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
ACEI - B-blocker - spironolactone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

8. Sx HoCM
PCP pneumonia
Barium enema
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

9. MCC HTN in child
Venlafaxine - duloxetine - mirtazapine
Renal parenchymal disease
ACEI - B-blocker - spironolactone
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

10. ROME IBS criteria
Mass lesion - subdural hematoma - medication overuse
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

11. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
Barium enema
3rd month postpartum
TCA's

12. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
IV labetalol - nicardipine - sodium nitroprusside
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Mass lesion - pseudotumor cerebri - meningitis

13. Prolonged QT interval (QTc)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
470ms+ in men - 480ms+ in women
B-blocker - Ca-channel blocker
Uterine atony

14. Mastitis tx
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Viral infxn of the subglottis
Cephalexin OR dicloxacillin
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

15. Commonly ingested foreign bodies
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Mass lesion - vascular malformation - stroke - collagen vascular disease
Flat disk - button - batteries
Mass lesion - pseudotumor cerebri - meningitis

16. Sx of pneumococcal pneumonia
ACEI - ARB
Halothane - succinylcholine
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

17. Phendimetrazine
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Obesity; increased NE release
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Flat disk - button - batteries

18. Cluster headache pflx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Obesity; NE-uptake inhibition
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

19. DDx Limp w/o pain in children - orthopedic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
'thumb sign' (protrusion of into anterior wall of hypopharynx)
ACEI - B-blocker - spironolactone

20. TCA
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
5-HT blockers: tegasorad - alosetron
Alzheimer dementia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

21. Phentermine
S. aureus
Phenelzine - tranylcypramine
Obesity; NE-uptake inhibition
Bupriopion - amoxipine - trazodone

22. causes of malignant hyperthernia
Halothane - succinylcholine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Septic arthritis - fractures - congenital hip dysplasia

23. Tacrine use/sfx
Lumbar puncture
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

24. Refer to cardiologist post-sports physical if ____
Bacterial infxn of supraglottic tissue and surrounding areas
'steeple-sign' (subglottic narrowing)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

25. Primary SVT tx
100% O2 6L/min - dihydroergotamine - triptans
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
B-blocker - Ca-channel blocker
Lumbar puncture

26. 1st line tx in IBS constipation
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Fiber (e.g. psyllium)
Renal parenchymal disease
Quinolone + metronidazole

27. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Amitriptyline - propanolol - timolol - divalproex sodium
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

28. Bite injury pflx
1st line: TZD
Legionella
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

29. Bilateral 'ground glass' infiltrate on CXR
High K - high Ca - low Na
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
PCP pneumonia

30. most common valvular heart defect in USA
MVP
Moderate/severe alzheimer dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

31. Lochia
100% O2 6L/min - dihydroergotamine - triptans
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

32. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Cephalexin OR dicloxacillin
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

33. Tx HTN + CKD
ACEI - ARB
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Moderate/severe alzheimer dementia
PCP pneumonia

34. Stable vtach tx
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Amiodarone/lidocaine
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release

35. Empiric CAP tx in healthy person
SCFE (slipped capital femoral epiphysis)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

36. Headache after 50 YO DDx
Temporal arteritis - mass lesion
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
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
Fasting blood glucose - LFTs - renal function - TSH

37. malignant hyperthermia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
IV labetalol - nicardipine - sodium nitroprusside
Halothane - succinylcholine
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

38. Outpatient tx CHF
Cephalexin OR dicloxacillin
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Dantrolene IV - antipyretics - O2 - cooling blankets
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

39. vertebrobasilar stroke sx
1st line: TZD
Venlafaxine - duloxetine - mirtazapine
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
High K - high Ca - low Na

40. MCC postpartum hemorrhage
Alzheimer dementia
Uterine atony
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Mass lesion - vascular malformation - stroke - collagen vascular disease

41. Tx local - acute rxn to bee sting
Eikenella species
Postpartum fever - uterine tenderness - foul-smelling lochia
Oral prednisone
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

42. 4 T's of postpartum hemorrhage
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
High K - high Ca - low Na

43. New-onset headache in patient with HIV/cancer DDx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Meningitis - brain abscess - metastasis
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

44. Diethylpropion
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
Eikenella species
Amitriptyline - propanolol - timolol - divalproex sodium

45. Headache post-head trauma DDx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Bupriopion - amoxipine - trazodone

46. Galantamine use/sfx
3 hours
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

47. Pyloric stenosis sx

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48. X-ray epiglottitis

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49. Tx HTN
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
1st line: TZD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

50. Cardiac Resynchronization Therapy (CRT) is warranted when ___
'steeple-sign' (subglottic narrowing)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Barium enema
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion