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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. 1st line tx in IBS constipation
Phenelzine - tranylcypramine
Fiber (e.g. psyllium)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

2. Dextroamphetamine
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
1st line: TZD
Fasting blood glucose - LFTs - renal function - TSH

3. Fibrates
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
Venlafaxine - duloxetine - mirtazapine
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

4. Bronchiolitis sx
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Mass lesion - subdural hematoma - medication overuse
8%
Flat disk - button - batteries

5. Tx HTN + CKD
ACEI - ARB
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Fiber (e.g. psyllium)

6. Tx HTN
1st line: TZD
Obesity; increased NE release
ACEI - diuretic
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

7. Croup pathogens
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
8%
ACEI - ARB
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

8. Focal neurologic sx (other than aura) DDx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
IV labetalol - nicardipine - sodium nitroprusside
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - vascular malformation - stroke - collagen vascular disease

9. Croup X-ray

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10. Chance of pregnancy after a single act of coitus
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
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
8%

11. Croup sx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
ACEI - ARB
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

12. vertebrobasilar stroke sx
ACEI - ARB
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
ACEI - B-blocker - diuretic - Ca-blocker

13. Empiric CAP tx in hospitalized patient
'steeple-sign' (subglottic narrowing)
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
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Quinolone + metronidazole

14. Tx HTN + DM
'steeple-sign' (subglottic narrowing)
Neonate - infants - bilious vomiting - abdominal pain
Flat disk - button - batteries
ACEI - ARB - diuretic - Ca-blocker - B-blocker

15. MCC HTN in child
Renal parenchymal disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Foot/leg deficits - cognitive + personality changes

16. Tx HTN + CHF
ACEI - B-blocker - diuretic - Ca-blocker
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Moderate/severe alzheimer dementia
ACEI - ARB - B-blocker - diuretic - Spironolactone

17. NMDA-R antagonist (memantine)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Moderate/severe alzheimer dementia
Postpartum fever - uterine tenderness - foul-smelling lochia
Mass lesion - subdural hematoma - medication overuse

18. Retropharyngeal abscess Sx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Phenelzine - tranylcypramine
ACEI - B-blocker - spironolactone

19. QTc
Dementia - incontinence - gait disturbance
= QT / sqrt(RR interval)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Fever - sore throat - muffled voice - drooling - trismus - neck pain

20. Statins
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Amitriptyline - propanolol - timolol - divalproex sodium
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

21. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Colonoscopy
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

22. epiglottitis
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Bacterial infxn of supraglottic tissue and surrounding areas
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

23. Dx and Tx of intussception
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Barium enema
Mass lesion - pseudotumor cerebri - meningitis
Foot/leg deficits - cognitive + personality changes

24. MCC infxn in closed-fist injuries
Eikenella species
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Amiodarone/lidocaine

25. IBS pain tx
Viral infxn of the subglottis
5-HT blockers: tegasorad - alosetron
470ms+ in men - 480ms+ in women
Mass lesion - subdural hematoma - medication overuse

26. Tx migraine
Legionella
Oral prednisone
Dantrolene IV - antipyretics - O2 - cooling blankets
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

27. Standard workup for dyslipidemia
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Fasting blood glucose - LFTs - renal function - TSH
Cephalexin OR dicloxacillin

28. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
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
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

29. MCC non-traumatic hip pathology in adolescents
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
SCFE (slipped capital femoral epiphysis)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

30. most common valvular heart defect in USA
Temporal arteritis - mass lesion
Dicyclomine - hyoscyamine (antispasmodics)
MVP
Furosemide - nitroglycerin - IV morphine sulphate

31. Lubiprostone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
SCFE (slipped capital femoral epiphysis)
'steeple-sign' (subglottic narrowing)

32. Tx HTN + CVA
100% O2 6L/min - dihydroergotamine - triptans
ACEI - diuretic
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
H. flu - S. pneumo - S. aureus - Strep A/B/C

33. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Phenelzine - tranylcypramine
Fiber (e.g. psyllium)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

34. Lochia
3rd month postpartum
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACEI - ARB
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

35. Metabolic syndrome
Dantrolene IV - antipyretics - O2 - cooling blankets
Venlafaxine - duloxetine - mirtazapine
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

36. New-onset headache in patient with HIV/cancer DDx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Meningitis - brain abscess - metastasis
Oral prednisone
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

37. Tx HTN + CAD
5-HT blockers: tegasorad - alosetron
ACEI - B-blocker - diuretic - Ca-blocker
Septic arthritis - fractures - congenital hip dysplasia
Renal parenchymal disease

38. Phendimetrazine
Obesity; increased NE release
TCA's
Furosemide - nitroglycerin - IV morphine sulphate
470ms+ in men - 480ms+ in women

39. Malrotation sx
Phenelzine - tranylcypramine
Neonate - infants - bilious vomiting - abdominal pain
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Renal parenchymal disease

40. Nicotinic acids
Mass lesion - pseudotumor cerebri - meningitis
Septic arthritis - fractures - congenital hip dysplasia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

41. malignant hyperthermia
Viral infxn of the subglottis
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

42. Refer to cardiologist post-sports physical if ____
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

43. Galantamine use/sfx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fiber (e.g. psyllium)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

44. DDx pediatric intestinal obsutrction
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Quinolone + metronidazole
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

45. Tx frequent/severe abd pain

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46. Drugs causing fever
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Phenelzine - tranylcypramine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

47. Diethylpropion
Obesity; increased NE release
Fiber (e.g. psyllium)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

48. Cluster headache acute tx
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
100% O2 6L/min - dihydroergotamine - triptans
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

49. X-ray epiglottitis

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50. Papilledema DDx
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mass lesion - pseudotumor cerebri - meningitis
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
8%