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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.
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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. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Viral infxn of the subglottis
Postpartum fever - uterine tenderness - foul-smelling lochia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

2. Cluster headache pflx
Uterine atony
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
MVP
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

3. Tx HTN + DM
PCP pneumonia
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release
ACEI - ARB - diuretic - Ca-blocker - B-blocker

4. CAGE questionnaire
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
Colonoscopy
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

5. CXR of CHF
PCP pneumonia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

6. Outpatient tx CHF
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Viral infxn of the subglottis
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
ACEI - B-blocker - spironolactone

7. Phentermine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Obesity; NE-uptake inhibition

8. Organism that causes pneumonia with diarrhea
MVP
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Legionella

9. Stable vtach tx
Amiodarone/lidocaine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
470ms+ in men - 480ms+ in women
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

10. Chronic afib tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
IV labetalol - nicardipine - sodium nitroprusside

11. rtPA should be used within ____ of stroke
IV labetalol - nicardipine - sodium nitroprusside
Phenelzine - tranylcypramine
3 hours
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

12. MCC postpartum hemorrhage
Venlafaxine - duloxetine - mirtazapine
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Uterine atony

13. Tx frequent/severe abd pain

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14. MCC HTN in child
Bacterial infxn of supraglottic tissue and surrounding areas
Renal parenchymal disease
ACEI - ARB - B-blocker - diuretic - Spironolactone
Eikenella species

15. Pyloric stenosis sx

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16. Tx mild/infrequent abd pain
Obesity; increased NE release
Dicyclomine - hyoscyamine (antispasmodics)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

17. ACA stroke ssx
Amiodarone/lidocaine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Mass lesion - subdural hematoma - medication overuse
Foot/leg deficits - cognitive + personality changes

18. Bite injury pflx
Obesity; increased NE release
MVP
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Bacterial infxn of supraglottic tissue and surrounding areas

19. MAOI
Lumbar puncture
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Phenelzine - tranylcypramine
Dantrolene IV - antipyretics - O2 - cooling blankets

20. IBS pain tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
5-HT blockers: tegasorad - alosetron
Venlafaxine - duloxetine - mirtazapine

21. Tx HTN
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
TCA's
1st line: TZD
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

22. Drugs causing fever
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Venlafaxine - duloxetine - mirtazapine

23. Antihypertensives in suspected stroke
Obesity; NE-uptake inhibition
IV labetalol - nicardipine - sodium nitroprusside
Neonate - infants - bilious vomiting - abdominal pain
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

24. Headache with sx systemic illness DDx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Uterine atony

25. Sibutramine
Barium enema
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

26. Tx acute pulmonary edema 2ndary to CHF
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Furosemide - nitroglycerin - IV morphine sulphate
Postpartum fever - uterine tenderness - foul-smelling lochia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

27. Test to best determine source of lower GI bleed
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Colonoscopy
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

28. 4 T's of postpartum hemorrhage
Viral infxn of the subglottis
B-blocker - Ca-channel blocker
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
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

29. DDx Limp w/o pain in children - orthopedic
= QT / sqrt(RR interval)
ACEI - B-blocker - diuretic - Ca-blocker
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

30. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
H. flu - S. pneumo - S. aureus - Strep A/B/C
Oral prednisone

31. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Barium enema
Phenelzine - tranylcypramine

32. Phendimetrazine
100% O2 6L/min - dihydroergotamine - triptans
ACEI - ARB
Colonoscopy
Obesity; increased NE release

33. Tx local - acute rxn to bee sting
Oral prednisone
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
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
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

34. Evaluating limp w/o pain in children
Mass lesion - pseudotumor cerebri - meningitis
Venlafaxine - duloxetine - mirtazapine
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
= QT / sqrt(RR interval)

35. Pflx migraine
Oral prednisone
Amitriptyline - propanolol - timolol - divalproex sodium
'steeple-sign' (subglottic narrowing)
Postpartum fever - uterine tenderness - foul-smelling lochia

36. MCA stroke sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Flat disk - button - batteries
Bacterial infxn of supraglottic tissue and surrounding areas
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

37. Dextroamphetamine
Obesity; increased NE release
10th postpartum day
Mass lesion - pseudotumor cerebri - meningitis
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

38. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Halothane - succinylcholine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

39. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
TCA's
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

40. Prolonged QT interval (QTc)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
470ms+ in men - 480ms+ in women
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Dicyclomine - hyoscyamine (antispasmodics)

41. epiglottitis
Bacterial infxn of supraglottic tissue and surrounding areas
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Legionella
SCFE (slipped capital femoral epiphysis)

42. Diethylpropion
Colonoscopy
Obesity; increased NE release
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

43. Headache after 50 YO DDx
Bupriopion - amoxipine - trazodone
Temporal arteritis - mass lesion
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
100% O2 6L/min - dihydroergotamine - triptans

44. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
470ms+ in men - 480ms+ in women

45. 'Alarm' sx for upper GI endoscopy
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Dantrolene IV - antipyretics - O2 - cooling blankets
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

46. Lochia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
ACEI - ARB
Colonoscopy
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

47. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
10th postpartum day

48. atypical
Meningitis - brain abscess - metastasis
Bupriopion - amoxipine - trazodone
Moderate/severe alzheimer dementia
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

49. Focal neurologic sx (other than aura) DDx
Mass lesion - vascular malformation - stroke - collagen vascular disease
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

50. Metabolic syndrome
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
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
Mass lesion - pseudotumor cerebri - meningitis
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose