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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. 4 T's of postpartum hemorrhage
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Furosemide - nitroglycerin - IV morphine sulphate
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
IV labetalol - nicardipine - sodium nitroprusside

2. Tx HTN + CAD
Mass lesion - vascular malformation - stroke - collagen vascular disease
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
ACEI - B-blocker - diuretic - Ca-blocker

3. 'Alarm' sx for upper GI endoscopy
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
ACEI - ARB
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

4. Lochia
Fiber (e.g. psyllium)
Moderate/severe alzheimer dementia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

5. MCA stroke sx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACEI - ARB - B-blocker - diuretic - Spironolactone
470ms+ in men - 480ms+ in women

6. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
10th postpartum day
= QT / sqrt(RR interval)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

7. atypical
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Eikenella species
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Bupriopion - amoxipine - trazodone

8. Stable vtach tx
Amiodarone/lidocaine
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Mass lesion - subdural hematoma - medication overuse

9. X-ray epiglottitis

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10. Organism that causes pneumonia with diarrhea
Uterine atony
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Legionella
Barium enema

11. Diethylpropion
ACEI - B-blocker - spironolactone
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
Moderate/severe alzheimer dementia
Obesity; increased NE release

12. DDx postoperative fever
Barium enema
Bacterial infxn of supraglottic tissue and surrounding areas
H. flu - S. pneumo - S. aureus - Strep A/B/C
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

13. Donepezil use/sfx
1st line: TZD
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
'steeple-sign' (subglottic narrowing)
SCFE (slipped capital femoral epiphysis)

14. QTc
= QT / sqrt(RR interval)
Fiber (e.g. psyllium)
8%
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

15. rtPA should be used within ____ of stroke
3 hours
Renal parenchymal disease
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

16. Tx diverticulitis
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Quinolone + metronidazole
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
3 hours

17. SNRI
3 hours
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Venlafaxine - duloxetine - mirtazapine
Fiber (e.g. psyllium)

18. Tx HTN + CVA
ACEI - diuretic
Oral prednisone
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

19. Headache post-head trauma DDx
Mass lesion - pseudotumor cerebri - meningitis
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

20. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
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
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

21. Causes of diverticular bleeding
Phenelzine - tranylcypramine
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

22. Galantamine use/sfx
'thumb sign' (protrusion of into anterior wall of hypopharynx)
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Cephalexin OR dicloxacillin

23. Dx and Tx of intussception
Barium enema
Lumbar puncture
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Legionella

24. Retropharyngeal abscess Sx
Mass lesion - subdural hematoma - medication overuse
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Septic arthritis - fractures - congenital hip dysplasia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

25. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
IV labetalol - nicardipine - sodium nitroprusside
10th postpartum day
Renal parenchymal disease

26. CXR of CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity; NE-uptake inhibition

27. Tx local - acute rxn to bee sting
Oral prednisone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Bupriopion - amoxipine - trazodone
Flat disk - button - batteries

28. Malrotation sx
Furosemide - nitroglycerin - IV morphine sulphate
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Bacterial infxn of supraglottic tissue and surrounding areas

29. NMDA-R antagonist (memantine)
Lumbar puncture
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Moderate/severe alzheimer dementia
Oral prednisone

30. Chance of pregnancy after a single act of coitus
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Obesity; increased NE release
8%

31. GI 'alarm' features
Furosemide - nitroglycerin - IV morphine sulphate
Eikenella species
Dicyclomine - hyoscyamine (antispasmodics)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

32. MAOI
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Phenelzine - tranylcypramine
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
10th postpartum day

33. MCC non-traumatic hip pathology in adolescents
SCFE (slipped capital femoral epiphysis)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Venlafaxine - duloxetine - mirtazapine

34. Croup X-ray

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35. Croup pathogens
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - B-blocker - diuretic - Ca-blocker

36. Orlistat
Meningitis - brain abscess - metastasis
Foot/leg deficits - cognitive + personality changes
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Postpartum fever - uterine tenderness - foul-smelling lochia

37. Headaches increasing in severity + intensity DDx
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

38. Intussusception sx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

39. Refer to cardiologist post-sports physical if ____
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
B-blocker - Ca-channel blocker
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Amitriptyline - propanolol - timolol - divalproex sodium

40. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Renal parenchymal disease

41. Tx frequent/severe abd pain

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42. Tx HTN + CKD
Digoxin (B-blockers as needed)
ACEI - ARB
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Phenelzine - tranylcypramine

43. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
SCFE (slipped capital femoral epiphysis)
1st line: TZD

44. Dx subarachnoid hemorrhage with negative noncontrast CT
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
PCP pneumonia
Lumbar puncture
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

45. causes of malignant hyperthernia
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Halothane - succinylcholine

46. DDx Limp w/o pain in children - orthopedic
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Furosemide - nitroglycerin - IV morphine sulphate
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
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

47. most common valvular heart defect in USA
3 hours
MVP
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
ACEI - diuretic

48. MCC infxn in closed-fist injuries
H. flu - S. pneumo - S. aureus - Strep A/B/C
Eikenella species
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Viral infxn of the subglottis

49. CAGE questionnaire
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fasting blood glucose - LFTs - renal function - TSH
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - B-blocker - spironolactone

50. Pflx migraine
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Barium enema
Amitriptyline - propanolol - timolol - divalproex sodium
Foot/leg deficits - cognitive + personality changes