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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 frequent/severe abd pain

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2. Stable vtach tx
Amiodarone/lidocaine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
'thumb sign' (protrusion of into anterior wall of hypopharynx)

3. Commonly ingested foreign bodies
H. flu - S. pneumo - S. aureus - Strep A/B/C
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Flat disk - button - batteries
Mass lesion - pseudotumor cerebri - meningitis

4. Tx acute pulmonary edema 2ndary to CHF
Obesity; increased NE release
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Oral prednisone
Furosemide - nitroglycerin - IV morphine sulphate

5. Phendimetrazine
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity; increased NE release
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
'steeple-sign' (subglottic narrowing)

6. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
5-HT blockers: tegasorad - alosetron

7. TCA
Renal parenchymal disease
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Fiber (e.g. psyllium)

8. Orlistat
Bupriopion - amoxipine - trazodone
Digoxin (B-blockers as needed)
Amitriptyline - propanolol - timolol - divalproex sodium
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

9. Headaches increasing in severity + intensity DDx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Mass lesion - subdural hematoma - medication overuse
ACEI - ARB

10. DDx pediatric intestinal obsutrction
Dantrolene IV - antipyretics - O2 - cooling blankets
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Septic arthritis - fractures - congenital hip dysplasia
H. flu - S. pneumo - S. aureus - Strep A/B/C

11. epiglottitis
100% O2 6L/min - dihydroergotamine - triptans
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Mass lesion - pseudotumor cerebri - meningitis
Bacterial infxn of supraglottic tissue and surrounding areas

12. Empiric CAP tx in hospitalized patient
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Cephalexin OR dicloxacillin
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
5-HT blockers: tegasorad - alosetron

13. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Postpartum fever - uterine tenderness - foul-smelling lochia
Fever - sore throat - muffled voice - drooling - trismus - neck pain
IV labetalol - nicardipine - sodium nitroprusside

14. Epiglottitis pathogens
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
H. flu - S. pneumo - S. aureus - Strep A/B/C
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
ACEI - B-blocker - spironolactone

15. Croup X-ray

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16. malignant hyperthermia
470ms+ in men - 480ms+ in women
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
IV labetalol - nicardipine - sodium nitroprusside

17. Empiric CAP tx in healthy person
Neonate - infants - bilious vomiting - abdominal pain
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Bacterial infxn of supraglottic tissue and surrounding areas
8%

18. 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
ACEI - diuretic
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

19. Organism that causes pneumonia with diarrhea
Legionella
Bupriopion - amoxipine - trazodone
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Dementia - incontinence - gait disturbance

20. ACA stroke ssx
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Foot/leg deficits - cognitive + personality changes
Mass lesion - vascular malformation - stroke - collagen vascular disease
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

21. 1st line tx in IBS constipation
Halothane - succinylcholine
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Fiber (e.g. psyllium)

22. Tacrine use/sfx
1st line: TZD
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
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 - subdural hematoma - medication overuse

23. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
3rd month postpartum
Flat disk - button - batteries
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

24. Croup pathogens
Moderate/severe alzheimer dementia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Temporal arteritis - mass lesion
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

25. Organism that causes pneumonia post-influenza
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
S. aureus
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACEI - ARB - diuretic - Ca-blocker - B-blocker

26. Prolonged QT interval (QTc)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
470ms+ in men - 480ms+ in women

27. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Septic arthritis - fractures - congenital hip dysplasia
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

28. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
ACEI - B-blocker - diuretic - Ca-blocker
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
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

29. MCA stroke sx
5-HT blockers: tegasorad - alosetron
Obesity; increased NE release
Barium enema
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

30. Bite injury pflx
ACEI - ARB
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Phenelzine - tranylcypramine

31. MAOI
Legionella
S. aureus
Phenelzine - tranylcypramine
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

32. Tx HTN + CKD
ACEI - ARB
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
ACEI - diuretic

33. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
3rd month postpartum

34. Sx HoCM
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Mass lesion - pseudotumor cerebri - meningitis
'steeple-sign' (subglottic narrowing)

35. NMDA-R antagonist (memantine)
Eikenella species
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Mass lesion - pseudotumor cerebri - meningitis
Moderate/severe alzheimer dementia

36. SNRI
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Flat disk - button - batteries
Venlafaxine - duloxetine - mirtazapine
IV labetalol - nicardipine - sodium nitroprusside

37. QTc
= QT / sqrt(RR interval)
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Obesity; increased NE release
Venlafaxine - duloxetine - mirtazapine

38. 4 T's of postpartum hemorrhage
Alzheimer dementia
8%
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Postpartum fever - uterine tenderness - foul-smelling lochia

39. Retropharyngeal abscess Sx
Oral prednisone
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
ACEI - diuretic

40. New-onset headache in patient with HIV/cancer DDx
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - vascular malformation - stroke - collagen vascular disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Meningitis - brain abscess - metastasis

41. MCC infxn in closed-fist injuries
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
PCP pneumonia
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Eikenella species

42. Bronchiolitis sx
Obesity; increased NE release
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Obesity; increased NE release
Obesity; increased NE release

43. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
H. flu - S. pneumo - S. aureus - Strep A/B/C
Bupriopion - amoxipine - trazodone

44. Tx HTN + CAD
Obesity; increased NE release
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
ACEI - B-blocker - diuretic - Ca-blocker
Obesity; NE-uptake inhibition

45. Statins
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

46. MCC HTN in child
Obesity; increased NE release
H. flu - S. pneumo - S. aureus - Strep A/B/C
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Renal parenchymal disease

47. DASH diet plan
Legionella
High K - high Ca - low Na
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
B-blocker - Ca-channel blocker

48. X-ray epiglottitis

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49. Tx migraine
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

50. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
Bupriopion - amoxipine - trazodone
Dementia - incontinence - gait disturbance
ACEI - ARB