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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. Dx and Tx of intussception
Barium enema
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Obesity; NE-uptake inhibition
Colonoscopy

2. CAGE questionnaire
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

3. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Neonate - infants - bilious vomiting - abdominal pain
ACEI - B-blocker - diuretic - Ca-blocker
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

4. MCA stroke sx
5-HT blockers: tegasorad - alosetron
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
= QT / sqrt(RR interval)

5. Cluster headache acute tx
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
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
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
100% O2 6L/min - dihydroergotamine - triptans

6. DASH diet plan
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
High K - high Ca - low Na
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

7. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Viral infxn of the subglottis
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Dicyclomine - hyoscyamine (antispasmodics)

8. IBS pain tx
IV labetalol - nicardipine - sodium nitroprusside
Obesity; increased NE release
Venlafaxine - duloxetine - mirtazapine
5-HT blockers: tegasorad - alosetron

9. TCA
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

10. Croup pathogens
Alzheimer dementia
Dicyclomine - hyoscyamine (antispasmodics)
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
MVP

11. Diethylpropion
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Obesity; increased NE release
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

12. malignant hyperthermia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Fever - sore throat - muffled voice - drooling - trismus - neck pain
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
ACEI - diuretic

13. Rivastigmine
Fasting blood glucose - LFTs - renal function - TSH
Amiodarone/lidocaine
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Alzheimer dementia

14. Phendimetrazine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
10th postpartum day
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Obesity; increased NE release

15. Bite injury pflx
ACEI - ARB - B-blocker - diuretic - Spironolactone
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
ACEI - ARB

16. QTc
= QT / sqrt(RR interval)
Septic arthritis - fractures - congenital hip dysplasia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Lumbar puncture

17. Intussusception sx
Flat disk - button - batteries
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Quinolone + metronidazole

18. 'Alarm' sx for upper GI endoscopy
Mass lesion - pseudotumor cerebri - meningitis
Obesity; increased NE release
Cephalexin OR dicloxacillin
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

19. DDx Limp w/o pain in children - orthopedic
Foot/leg deficits - cognitive + personality changes
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

20. Organism that causes pneumonia with diarrhea
Dantrolene IV - antipyretics - O2 - cooling blankets
H. flu - S. pneumo - S. aureus - Strep A/B/C
TCA's
Legionella

21. Tx frequent/severe abd pain

22. contraindications to thrombolytic therapy
IV labetalol - nicardipine - sodium nitroprusside
Temporal arteritis - mass lesion
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Venlafaxine - duloxetine - mirtazapine

23. Tx diverticulitis
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Quinolone + metronidazole

24. Retropharyngeal abscess Sx
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Fever - sore throat - muffled voice - drooling - trismus - neck pain
= QT / sqrt(RR interval)
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

25. Causes of diverticular bleeding
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
ACEI - ARB

26. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
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; increased NE release

27. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
100% O2 6L/min - dihydroergotamine - triptans

28. SNRI
Venlafaxine - duloxetine - mirtazapine
100% O2 6L/min - dihydroergotamine - triptans
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
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

29. Standard workup for dyslipidemia
Neonate - infants - bilious vomiting - abdominal pain
Fasting blood glucose - LFTs - renal function - TSH
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Barium enema

30. Commonly ingested foreign bodies
Obesity; increased NE release
Postpartum fever - uterine tenderness - foul-smelling lochia
MVP
Flat disk - button - batteries

31. Tx HTN + post-MI
MVP
Obesity; increased NE release
ACEI - B-blocker - spironolactone
= QT / sqrt(RR interval)

32. Sx HoCM
Colonoscopy
= QT / sqrt(RR interval)
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Quinolone + metronidazole

33. Drugs causing fever
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Mass lesion - subdural hematoma - medication overuse
Cephalexin OR dicloxacillin
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

34. Stable vtach tx
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Amiodarone/lidocaine
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

35. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Amitriptyline - propanolol - timolol - divalproex sodium
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Obesity; NE-uptake inhibition

36. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Cephalexin OR dicloxacillin

37. Croup X-ray

38. Sx of pneumococcal pneumonia
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
H. flu - S. pneumo - S. aureus - Strep A/B/C
= QT / sqrt(RR interval)

39. Tx uterine atony
Mass lesion - subdural hematoma - medication overuse
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
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

40. ROME IBS criteria
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Obesity; increased NE release
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

41. Tx HTN + CVA
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
ACEI - diuretic
Amitriptyline - propanolol - timolol - divalproex sodium
8%

42. MAOI
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Phenelzine - tranylcypramine
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Foot/leg deficits - cognitive + personality changes

43. Sx endometritis
SCFE (slipped capital femoral epiphysis)
Venlafaxine - duloxetine - mirtazapine
Postpartum fever - uterine tenderness - foul-smelling lochia
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

44. epiglottitis
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Bacterial infxn of supraglottic tissue and surrounding areas
MVP
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

45. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Colonoscopy
B-blocker - Ca-channel blocker
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

46. rtPA should be used within ____ of stroke
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Obesity; increased NE release
ACEI - diuretic
3 hours

47. New-onset headache in patient with HIV/cancer DDx
Meningitis - brain abscess - metastasis
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Bacterial infxn of supraglottic tissue and surrounding areas
'thumb sign' (protrusion of into anterior wall of hypopharynx)

48. X-ray epiglottitis

49. Headache post-head trauma DDx
Bacterial infxn of supraglottic tissue and surrounding areas
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Dantrolene IV - antipyretics - O2 - cooling blankets
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

50. Statins
Neonate - infants - bilious vomiting - abdominal pain
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine