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

2. Dx and Tx of intussception
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Barium enema
PCP pneumonia
Neonate - infants - bilious vomiting - abdominal pain

3. Tx acute pulmonary edema 2ndary to CHF
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Obesity; increased NE release
Furosemide - nitroglycerin - IV morphine sulphate

4. 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
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
ACEI - ARB
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

5. Tx HTN
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
1st line: TZD
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Halothane - succinylcholine

6. Stable vtach tx
Amiodarone/lidocaine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Temporal arteritis - mass lesion

7. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Digoxin (B-blockers as needed)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

8. Tx HTN + CKD
Amitriptyline - propanolol - timolol - divalproex sodium
Fasting blood glucose - LFTs - renal function - TSH
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
ACEI - ARB

9. Organism that causes pneumonia with diarrhea
Legionella
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
1st line: TZD
Fiber (e.g. psyllium)

10. Refer to cardiologist post-sports physical if ____
Legionella
Alzheimer dementia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

11. Cluster headache acute tx
'thumb sign' (protrusion of into anterior wall of hypopharynx)
100% O2 6L/min - dihydroergotamine - triptans
Fasting blood glucose - LFTs - renal function - TSH
Dicyclomine - hyoscyamine (antispasmodics)

12. Drugs causing fever
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

13. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Foot/leg deficits - cognitive + personality changes
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

14. Donepezil use/sfx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
ACEI - B-blocker - diuretic - Ca-blocker
Obesity; increased NE release
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

15. Orlistat
Temporal arteritis - mass lesion
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Viral infxn of the subglottis
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

16. Causes of diverticular bleeding
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

17. Tacrine use/sfx
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
TCA's
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

18. DDx dementia
Fasting blood glucose - LFTs - renal function - TSH
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

19. Dextroamphetamine
ACEI - B-blocker - spironolactone
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Obesity; increased NE release
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

20. 'Alarm' sx for upper GI endoscopy
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

21. Dx subarachnoid hemorrhage with negative noncontrast CT
Fiber (e.g. psyllium)
Fasting blood glucose - LFTs - renal function - TSH
Lumbar puncture
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

22. GI 'alarm' features
MVP
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

23. Bilateral 'ground glass' infiltrate on CXR
ACEI - ARB - B-blocker - diuretic - Spironolactone
PCP pneumonia
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

24. Statins
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
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
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

25. Chronic afib tx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Postpartum fever - uterine tenderness - foul-smelling lochia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

26. Tx HTN + DM
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Uterine atony
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Fiber (e.g. psyllium)

27. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Venlafaxine - duloxetine - mirtazapine
Cephalexin OR dicloxacillin
SCFE (slipped capital femoral epiphysis)

28. Mastitis tx
Cephalexin OR dicloxacillin
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Postpartum fever - uterine tenderness - foul-smelling lochia

29. contraindications to thrombolytic therapy
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Eikenella species
Moderate/severe alzheimer dementia
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

30. SSRI's
= QT / sqrt(RR interval)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
3rd month postpartum
Eikenella species

31. Cholesterol absorption blocker (ezetimibe)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Bupriopion - amoxipine - trazodone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

32. CAGE questionnaire
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amitriptyline - propanolol - timolol - divalproex sodium
'thumb sign' (protrusion of into anterior wall of hypopharynx)

33. Headache with sx systemic illness DDx
ACEI - ARB
Uterine atony
470ms+ in men - 480ms+ in women
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

34. ACA stroke ssx
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Temporal arteritis - mass lesion
Foot/leg deficits - cognitive + personality changes
PCP pneumonia

35. Standard workup for dyslipidemia
Uterine atony
Neonate - infants - bilious vomiting - abdominal pain
Fasting blood glucose - LFTs - renal function - TSH
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

36. Sx HoCM
Uterine atony
Flat disk - button - batteries
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

37. MCA stroke sx
ACEI - diuretic
Lumbar puncture
Temporal arteritis - mass lesion
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

38. Prolonged QT interval (QTc)
ACEI - B-blocker - diuretic - Ca-blocker
ACEI - diuretic
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
470ms+ in men - 480ms+ in women

39. Pyloric stenosis sx

40. Rivastigmine
PCP pneumonia
Mass lesion - subdural hematoma - medication overuse
Alzheimer dementia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

41. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fever - sore throat - muffled voice - drooling - trismus - neck pain
= QT / sqrt(RR interval)

42. Sudden-onset headache DDx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

43. causes of malignant hyperthernia
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Barium enema
Alzheimer dementia
Halothane - succinylcholine

44. Afib - Aflutter tx
Digoxin (B-blockers as needed)
High K - high Ca - low Na
5-HT blockers: tegasorad - alosetron
Mass lesion - vascular malformation - stroke - collagen vascular disease

45. Sx of pneumococcal pneumonia
Furosemide - nitroglycerin - IV morphine sulphate
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

46. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
Temporal arteritis - mass lesion
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Moderate/severe alzheimer dementia

47. Diethylpropion
Dementia - incontinence - gait disturbance
ACEI - ARB - B-blocker - diuretic - Spironolactone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity; increased NE release

48. If not breast-feeding - when does menstruation restart?
Venlafaxine - duloxetine - mirtazapine
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
3rd month postpartum

49. Sx Lewy Body Dementia
Temporal arteritis - mass lesion
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Fasting blood glucose - LFTs - renal function - TSH
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

50. Test to best determine source of lower GI bleed
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Colonoscopy
Bacterial infxn of supraglottic tissue and surrounding areas
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction