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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. Test to best determine source of lower GI bleed
Colonoscopy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Dicyclomine - hyoscyamine (antispasmodics)
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

2. rtPA should be used within ____ of stroke
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
3 hours
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

3. Headache after 50 YO DDx
Alzheimer dementia
470ms+ in men - 480ms+ in women
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Temporal arteritis - mass lesion

4. Tx HTN + DM
Obesity; increased NE release
Amiodarone/lidocaine
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - ARB - diuretic - Ca-blocker - B-blocker

5. X-ray epiglottitis

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6. Primary SVT tx
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
B-blocker - Ca-channel blocker
Flat disk - button - batteries

7. Croup pathogens
'steeple-sign' (subglottic narrowing)
ACEI - B-blocker - spironolactone
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Amitriptyline - propanolol - timolol - divalproex sodium

8. Refer to cardiologist post-sports physical if ____
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Foot/leg deficits - cognitive + personality changes

9. Dx subarachnoid hemorrhage with negative noncontrast CT
Lumbar puncture
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

10. Statins
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)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
3 hours

11. Sibutramine
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Amiodarone/lidocaine

12. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
High K - high Ca - low Na
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Fiber (e.g. psyllium)

13. Empiric CAP tx in hospitalized patient
470ms+ in men - 480ms+ in women
Dantrolene IV - antipyretics - O2 - cooling blankets
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Obesity; NE-uptake inhibition

14. causes of malignant hyperthernia
Legionella
Fasting blood glucose - LFTs - renal function - TSH
470ms+ in men - 480ms+ in women
Halothane - succinylcholine

15. Commonly ingested foreign bodies
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Flat disk - button - batteries
Bacterial infxn of supraglottic tissue and surrounding areas

16. Retropharyngeal abscess Sx
Septic arthritis - fractures - congenital hip dysplasia
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Uterine atony
ACEI - B-blocker - spironolactone

17. Tx HTN
Mass lesion - pseudotumor cerebri - meningitis
Dementia - incontinence - gait disturbance
1st line: TZD
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

18. Bronchiolitis sx
High K - high Ca - low Na
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - B-blocker - spironolactone
Dantrolene IV - antipyretics - O2 - cooling blankets

19. CXR of CHF
Mass lesion - pseudotumor cerebri - meningitis
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
H. flu - S. pneumo - S. aureus - Strep A/B/C
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

20. Outpatient tx CHF
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

21. MAOI
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Phenelzine - tranylcypramine
3 hours
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

22. Tx HTN + CVA
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - diuretic
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

23. Chronic afib tx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Postpartum fever - uterine tenderness - foul-smelling lochia
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

24. ACA stroke ssx
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Foot/leg deficits - cognitive + personality changes
Mass lesion - pseudotumor cerebri - meningitis

25. contraindications to thrombolytic therapy
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fever - sore throat - muffled voice - drooling - trismus - neck pain

26. Organism that causes pneumonia post-influenza
S. aureus
Barium enema
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

27. Pyloric stenosis sx

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28. MCC HTN in child
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Dantrolene IV - antipyretics - O2 - cooling blankets
Renal parenchymal disease
100% O2 6L/min - dihydroergotamine - triptans

29. Lochia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Dantrolene IV - antipyretics - O2 - cooling blankets
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

30. DASH diet plan
Furosemide - nitroglycerin - IV morphine sulphate
ACEI - ARB - B-blocker - diuretic - Spironolactone
High K - high Ca - low Na
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

31. SSRI's
ACEI - ARB
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Mass lesion - pseudotumor cerebri - meningitis

32. 1st line tx in IBS constipation
1st line: TZD
Uterine atony
Fiber (e.g. psyllium)
Oral prednisone

33. Sx of pneumococcal pneumonia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Eikenella species
Fasting blood glucose - LFTs - renal function - TSH
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

34. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
'steeple-sign' (subglottic narrowing)
Moderate/severe alzheimer dementia
Postpartum fever - uterine tenderness - foul-smelling lochia

35. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
Colonoscopy
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Fever - sore throat - muffled voice - drooling - trismus - neck pain

36. IBS pain tx
PCP pneumonia
5-HT blockers: tegasorad - alosetron
Foot/leg deficits - cognitive + personality changes
TCA's

37. most common valvular heart defect in USA
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
MVP
ACEI - ARB - B-blocker - diuretic - Spironolactone

38. MCC non-traumatic hip pathology in adolescents
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Renal parenchymal disease
SCFE (slipped capital femoral epiphysis)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

39. Sx HoCM
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
High K - high Ca - low Na
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

40. Tx uterine atony
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
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

41. ROME IBS criteria
Bacterial infxn of supraglottic tissue and surrounding areas
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Renal parenchymal disease
Lumbar puncture

42. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

43. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - ARB - diuretic - Ca-blocker - B-blocker
PCP pneumonia

44. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Obesity; increased NE release
Barium enema
Dantrolene IV - antipyretics - O2 - cooling blankets

45. Mastitis tx
Cephalexin OR dicloxacillin
H. flu - S. pneumo - S. aureus - Strep A/B/C
PCP pneumonia
10th postpartum day

46. vertebrobasilar stroke sx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Quinolone + metronidazole
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

47. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Moderate/severe alzheimer dementia
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
Amiodarone/lidocaine

48. Sudden-onset headache DDx
8%
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Oral prednisone

49. tx malignant hyperthermia
Meningitis - brain abscess - metastasis
SCFE (slipped capital femoral epiphysis)
Dantrolene IV - antipyretics - O2 - cooling blankets
ACEI - ARB - B-blocker - diuretic - Spironolactone

50. Fibrates
Flat disk - button - batteries
3rd month postpartum
'steeple-sign' (subglottic narrowing)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease