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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 HTN + CAD
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
SCFE (slipped capital femoral epiphysis)
ACEI - B-blocker - diuretic - Ca-blocker
100% O2 6L/min - dihydroergotamine - triptans

2. Empiric CAP tx in healthy person
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

3. IBS pain tx
5-HT blockers: tegasorad - alosetron
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

4. 'Alarm' sx for upper GI endoscopy
= QT / sqrt(RR interval)
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
High K - high Ca - low Na
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

5. Croup
Dicyclomine - hyoscyamine (antispasmodics)
Viral infxn of the subglottis
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
8%

6. New-onset headache in patient with HIV/cancer DDx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Meningitis - brain abscess - metastasis
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Obesity; increased NE release

7. Diethylpropion
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Obesity; increased NE release

8. Chronic afib tx
Halothane - succinylcholine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
S. aureus

9. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Bupriopion - amoxipine - trazodone
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

10. atypical
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Eikenella species
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Bupriopion - amoxipine - trazodone

11. NMDA-R antagonist (memantine)
Moderate/severe alzheimer dementia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

12. Tx HTN + CKD
Flat disk - button - batteries
Dementia - incontinence - gait disturbance
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
ACEI - ARB

13. Pflx migraine
Mass lesion - vascular malformation - stroke - collagen vascular disease
Amitriptyline - propanolol - timolol - divalproex sodium
Halothane - succinylcholine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

14. Bronchiolitis sx
TCA's
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Uterine atony

15. Statins
Flat disk - button - batteries
ACEI - B-blocker - spironolactone
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
1st line: TZD

16. X-ray epiglottitis

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17. Headache post-head trauma DDx
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Obesity; increased NE release
Legionella
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

18. Sx normal-pressure hydrocephalus
Dementia - incontinence - gait disturbance
ACEI - B-blocker - spironolactone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

19. MCA stroke sx
Lumbar puncture
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Temporal arteritis - mass lesion

20. Dx subarachnoid hemorrhage with negative noncontrast CT
Foot/leg deficits - cognitive + personality changes
Alzheimer dementia
Lumbar puncture
Dicyclomine - hyoscyamine (antispasmodics)

21. tx malignant hyperthermia
5-HT blockers: tegasorad - alosetron
TCA's
Dantrolene IV - antipyretics - O2 - cooling blankets
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

22. Primary SVT tx
Obesity; increased NE release
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Furosemide - nitroglycerin - IV morphine sulphate
B-blocker - Ca-channel blocker

23. Cluster headache acute tx
Bacterial infxn of supraglottic tissue and surrounding areas
100% O2 6L/min - dihydroergotamine - triptans
Dementia - incontinence - gait disturbance
Bupriopion - amoxipine - trazodone

24. Headache after 50 YO DDx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
8%
Temporal arteritis - mass lesion
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

25. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
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

26. Donepezil use/sfx
Phenelzine - tranylcypramine
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
MVP
Amitriptyline - propanolol - timolol - divalproex sodium

27. QTc
= QT / sqrt(RR interval)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Colonoscopy
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

28. DDx pediatric intestinal obsutrction
PCP pneumonia
3rd month postpartum
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

29. Mastitis tx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Cephalexin OR dicloxacillin
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

30. DDx limp in infant/toddler
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Colonoscopy
Septic arthritis - fractures - congenital hip dysplasia

31. GI 'alarm' features
B-blocker - Ca-channel blocker
Bupriopion - amoxipine - trazodone
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

32. DASH diet plan
Flat disk - button - batteries
High K - high Ca - low Na
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Obesity; increased NE release

33. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
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
8%
470ms+ in men - 480ms+ in women

34. Bite injury pflx
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

35. Empiric CAP tx in hospitalized patient
Obesity; increased NE release
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Obesity; increased NE release
Bupriopion - amoxipine - trazodone

36. epiglottitis
Barium enema
3 hours
Bacterial infxn of supraglottic tissue and surrounding areas
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

37. Tx diverticulitis
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
8%
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Quinolone + metronidazole

38. Headaches increasing in severity + intensity DDx
5-HT blockers: tegasorad - alosetron
Postpartum fever - uterine tenderness - foul-smelling lochia
Mass lesion - subdural hematoma - medication overuse
Digoxin (B-blockers as needed)

39. Afib - Aflutter tx
Flat disk - button - batteries
MVP
= QT / sqrt(RR interval)
Digoxin (B-blockers as needed)

40. rtPA should be used within ____ of stroke
3 hours
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Phenelzine - tranylcypramine
5-HT blockers: tegasorad - alosetron

41. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

42. Standard workup for dyslipidemia
= QT / sqrt(RR interval)
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Fasting blood glucose - LFTs - renal function - TSH
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

43. Causes of diverticular bleeding
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
= QT / sqrt(RR interval)
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

44. Antihypertensives in suspected stroke
IV labetalol - nicardipine - sodium nitroprusside
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
SCFE (slipped capital femoral epiphysis)

45. 1st line tx in IBS constipation
10th postpartum day
Fiber (e.g. psyllium)
Alzheimer dementia
Mass lesion - subdural hematoma - medication overuse

46. Test to best determine source of lower GI bleed
B-blocker - Ca-channel blocker
Uterine atony
Halothane - succinylcholine
Colonoscopy

47. Sx Lewy Body Dementia
Fasting blood glucose - LFTs - renal function - TSH
MVP
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

48. Lubiprostone
100% O2 6L/min - dihydroergotamine - triptans
Dementia - incontinence - gait disturbance
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
High K - high Ca - low Na

49. 4 T's of postpartum hemorrhage
ACEI - ARB - B-blocker - diuretic - Spironolactone
= QT / sqrt(RR interval)
Digoxin (B-blockers as needed)
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

50. Tx HTN + CVA
ACEI - diuretic
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Legionella
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease