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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. Tx HTN
B-blocker - Ca-channel blocker
Dementia - incontinence - gait disturbance
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
1st line: TZD

2. Sx Lewy Body Dementia
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
MVP
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

3. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - diuretic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

4. IBS pain tx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Lumbar puncture
5-HT blockers: tegasorad - alosetron
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

5. tx malignant hyperthermia
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Dantrolene IV - antipyretics - O2 - cooling blankets
3rd month postpartum
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

6. Focal neurologic sx (other than aura) DDx
Mass lesion - vascular malformation - stroke - collagen vascular disease
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Neonate - infants - bilious vomiting - abdominal pain
Dantrolene IV - antipyretics - O2 - cooling blankets

7. Tx HTN + CHF
Dicyclomine - hyoscyamine (antispasmodics)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
10th postpartum day
ACEI - ARB - B-blocker - diuretic - Spironolactone

8. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Flat disk - button - batteries
Viral infxn of the subglottis
Mass lesion - subdural hematoma - medication overuse

9. Statins
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - ARB - B-blocker - diuretic - Spironolactone
100% O2 6L/min - dihydroergotamine - triptans
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

10. Intussusception sx
Oral prednisone
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Phenelzine - tranylcypramine

11. Afib - Aflutter tx
Uterine atony
ACEI - ARB - B-blocker - diuretic - Spironolactone
Venlafaxine - duloxetine - mirtazapine
Digoxin (B-blockers as needed)

12. If not breast-feeding - when does menstruation restart?
Legionella
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
3rd month postpartum

13. CAGE questionnaire
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Mass lesion - subdural hematoma - medication overuse
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

14. Tx acute pulmonary edema 2ndary to CHF
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - propanolol - timolol - divalproex sodium
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Furosemide - nitroglycerin - IV morphine sulphate

15. Diethylpropion
Dantrolene IV - antipyretics - O2 - cooling blankets
Obesity; increased NE release
Renal parenchymal disease
Obesity; NE-uptake inhibition

16. QTc
S. aureus
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
= QT / sqrt(RR interval)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

17. X-ray epiglottitis

18. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

19. Phendimetrazine
Obesity; increased NE release
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Dementia - incontinence - gait disturbance

20. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
'steeple-sign' (subglottic narrowing)
Temporal arteritis - mass lesion

21. MCC infxn in closed-fist injuries
Eikenella species
= QT / sqrt(RR interval)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

22. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
3rd month postpartum
Postpartum fever - uterine tenderness - foul-smelling lochia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

23. 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
High K - high Ca - low Na
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

24. atypical
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Mass lesion - pseudotumor cerebri - meningitis
Bupriopion - amoxipine - trazodone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

25. 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
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
Temporal arteritis - mass lesion

26. MCC non-traumatic hip pathology in adolescents
SCFE (slipped capital femoral epiphysis)
Septic arthritis - fractures - congenital hip dysplasia
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
H. flu - S. pneumo - S. aureus - Strep A/B/C

27. DDx dementia
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

28. Dextroamphetamine
Foot/leg deficits - cognitive + personality changes
Obesity; increased NE release
470ms+ in men - 480ms+ in women
MVP

29. ACA stroke ssx
Flat disk - button - batteries
Foot/leg deficits - cognitive + personality changes
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Bupriopion - amoxipine - trazodone

30. Croup pathogens
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

31. Chance of pregnancy after a single act of coitus
Obesity; increased NE release
'thumb sign' (protrusion of into anterior wall of hypopharynx)
8%
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

32. MCC HTN in child
Cephalexin OR dicloxacillin
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Phenelzine - tranylcypramine
Renal parenchymal disease

33. Baby blues resolves by ______
Obesity; increased NE release
10th postpartum day
ACEI - ARB - B-blocker - diuretic - Spironolactone
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

34. TCA
H. flu - S. pneumo - S. aureus - Strep A/B/C
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fever - sore throat - muffled voice - drooling - trismus - neck pain
3rd month postpartum

35. Tx HTN + DM
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
100% O2 6L/min - dihydroergotamine - triptans

36. Tx HTN + post-MI
ACEI - ARB - B-blocker - diuretic - Spironolactone
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACEI - B-blocker - spironolactone
Digoxin (B-blockers as needed)

37. Sx normal-pressure hydrocephalus
Bupriopion - amoxipine - trazodone
Dementia - incontinence - gait disturbance
Lumbar puncture
Quinolone + metronidazole

38. Mastitis tx
Viral infxn of the subglottis
Cephalexin OR dicloxacillin
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Mass lesion - subdural hematoma - medication overuse

39. Evaluating limp w/o pain in children
Foot/leg deficits - cognitive + personality changes
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

40. Tx mild/infrequent abd pain
Fasting blood glucose - LFTs - renal function - TSH
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Dicyclomine - hyoscyamine (antispasmodics)

41. Peritonsillar abscess Sx
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Colonoscopy
Fever - sore throat - muffled voice - drooling - trismus - neck pain

42. Sx endometritis
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
High K - high Ca - low Na
Postpartum fever - uterine tenderness - foul-smelling lochia

43. Lochia
SCFE (slipped capital femoral epiphysis)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
= QT / sqrt(RR interval)
Furosemide - nitroglycerin - IV morphine sulphate

44. 'Alarm' sx for upper GI endoscopy
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Fasting blood glucose - LFTs - renal function - TSH

45. Donepezil use/sfx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Obesity; NE-uptake inhibition
Mass lesion - subdural hematoma - medication overuse
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

46. Organism that causes pneumonia post-influenza
High K - high Ca - low Na
S. aureus
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Fever - sore throat - muffled voice - drooling - trismus - neck pain

47. contraindications to thrombolytic therapy
Neonate - infants - bilious vomiting - abdominal pain
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
3rd month postpartum

48. Nicotinic acids
Dicyclomine - hyoscyamine (antispasmodics)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

49. Tx migraine
Dicyclomine - hyoscyamine (antispasmodics)
Temporal arteritis - mass lesion
Mass lesion - pseudotumor cerebri - meningitis
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

50. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - B-blocker - diuretic - Ca-blocker
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Cephalexin OR dicloxacillin