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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. Galantamine use/sfx
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Moderate/severe alzheimer dementia
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)

2. Organism that causes pneumonia post-influenza
ACEI - ARB - B-blocker - diuretic - Spironolactone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
S. aureus
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

3. Donepezil use/sfx
Barium enema
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

4. Diethylpropion
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity; increased NE release
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

5. Tx HTN + post-MI
ACEI - B-blocker - spironolactone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Temporal arteritis - mass lesion

6. MCC non-traumatic hip pathology in adolescents
Alzheimer dementia
SCFE (slipped capital femoral epiphysis)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

7. 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
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
TCA's

8. Dx and Tx of intussception
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Barium enema
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

9. epiglottitis
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

10. Tx migraine
Eikenella species
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

11. contraindications to thrombolytic therapy
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

12. Tx HTN + CHF
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Alzheimer dementia
ACEI - ARB - B-blocker - diuretic - Spironolactone
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

13. Nicotinic acids
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

14. Chronic afib tx
ACEI - B-blocker - diuretic - Ca-blocker
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Neonate - infants - bilious vomiting - abdominal pain
= QT / sqrt(RR interval)

15. MCA stroke sx
ACEI - B-blocker - spironolactone
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

16. Croup
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Viral infxn of the subglottis
Foot/leg deficits - cognitive + personality changes

17. Tx acute pulmonary edema 2ndary to CHF
B-blocker - Ca-channel blocker
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Furosemide - nitroglycerin - IV morphine sulphate
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

18. SSRI's
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Phenelzine - tranylcypramine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

19. DDx dementia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Dementia - incontinence - gait disturbance
= QT / sqrt(RR interval)

20. Cluster headache pflx
Cephalexin OR dicloxacillin
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Digoxin (B-blockers as needed)

21. Phentermine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Obesity; NE-uptake inhibition
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

22. Standard workup for dyslipidemia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Fasting blood glucose - LFTs - renal function - TSH
Venlafaxine - duloxetine - mirtazapine
SCFE (slipped capital femoral epiphysis)

23. Headache after 50 YO DDx
Temporal arteritis - mass lesion
Mass lesion - vascular malformation - stroke - collagen vascular disease
3rd month postpartum
5-HT blockers: tegasorad - alosetron

24. Tx HTN
1st line: TZD
Neonate - infants - bilious vomiting - abdominal pain
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

25. TCA
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Halothane - succinylcholine
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

26. most common valvular heart defect in USA
MVP
Neonate - infants - bilious vomiting - abdominal pain
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

27. Tx mild/infrequent abd pain
Dicyclomine - hyoscyamine (antispasmodics)
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
IV labetalol - nicardipine - sodium nitroprusside

28. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
1st line: TZD
Foot/leg deficits - cognitive + personality changes
SCFE (slipped capital femoral epiphysis)

29. Empiric CAP tx in healthy person
Meningitis - brain abscess - metastasis
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

30. Pyloric stenosis sx

31. 4 T's of postpartum hemorrhage
Neonate - infants - bilious vomiting - abdominal pain
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Amitriptyline - propanolol - timolol - divalproex sodium
Lumbar puncture

32. rtPA should be used within ____ of stroke
3 hours
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Viral infxn of the subglottis
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

33. Cholesterol absorption blocker (ezetimibe)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Viral infxn of the subglottis
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

34. Lubiprostone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Uterine atony
Moderate/severe alzheimer dementia
5-HT blockers: tegasorad - alosetron

35. Bilateral 'ground glass' infiltrate on CXR
Halothane - succinylcholine
PCP pneumonia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Mass lesion - pseudotumor cerebri - meningitis

36. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

37. Malrotation sx
10th postpartum day
Neonate - infants - bilious vomiting - abdominal pain
Flat disk - button - batteries
High K - high Ca - low Na

38. Tx local - acute rxn to bee sting
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Oral prednisone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACEI - ARB - diuretic - Ca-blocker - B-blocker

39. vertebrobasilar stroke sx
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
High K - high Ca - low Na
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Foot/leg deficits - cognitive + personality changes

40. Headache with sx systemic illness DDx
Obesity; increased NE release
Bupriopion - amoxipine - trazodone
Legionella
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

41. Papilledema DDx
Obesity; NE-uptake inhibition
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
S. aureus
Mass lesion - pseudotumor cerebri - meningitis

42. Sx endometritis
Colonoscopy
Dementia - incontinence - gait disturbance
ACEI - B-blocker - spironolactone
Postpartum fever - uterine tenderness - foul-smelling lochia

43. Croup X-ray

44. Pflx migraine
470ms+ in men - 480ms+ in women
Amitriptyline - propanolol - timolol - divalproex sodium
Neonate - infants - bilious vomiting - abdominal pain
PCP pneumonia

45. Dextroamphetamine
Fiber (e.g. psyllium)
Obesity; increased NE release
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
IV labetalol - nicardipine - sodium nitroprusside

46. MAOI
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Phenelzine - tranylcypramine
TCA's
Fiber (e.g. psyllium)

47. Epiglottitis pathogens
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Fever - sore throat - muffled voice - drooling - trismus - neck pain
H. flu - S. pneumo - S. aureus - Strep A/B/C

48. Sx Lewy Body Dementia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

49. Tx uterine atony
Foot/leg deficits - cognitive + personality changes
ACEI - B-blocker - spironolactone
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
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

50. Empiric CAP tx in hospitalized patient
8%
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools