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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 + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
TCA's
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

2. Dx and Tx of intussception
Barium enema
TCA's
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Oral prednisone

3. Sibutramine
S. aureus
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
IV labetalol - nicardipine - sodium nitroprusside

4. most common valvular heart defect in USA
B-blocker - Ca-channel blocker
Cephalexin OR dicloxacillin
MVP
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

5. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
ACEI - diuretic
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

6. DDx limp in infant/toddler
Phenelzine - tranylcypramine
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Cephalexin OR dicloxacillin
Septic arthritis - fractures - congenital hip dysplasia

7. Galantamine use/sfx
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
8%
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

8. DDx postoperative fever
SCFE (slipped capital femoral epiphysis)
8%
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

9. Chronic afib tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
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
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

10. Retropharyngeal abscess Sx
Mass lesion - subdural hematoma - medication overuse
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

11. Orlistat
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
470ms+ in men - 480ms+ in women
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

12. Phendimetrazine
1st line: TZD
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Obesity; increased NE release
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

13. Primary SVT tx
Fiber (e.g. psyllium)
B-blocker - Ca-channel blocker
Cephalexin OR dicloxacillin
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

14. Test to best determine source of lower GI bleed
Colonoscopy
5-HT blockers: tegasorad - alosetron
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

15. CAGE questionnaire
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fever - sore throat - muffled voice - drooling - trismus - neck pain
H. flu - S. pneumo - S. aureus - Strep A/B/C

16. causes of malignant hyperthernia
ACEI - ARB
Halothane - succinylcholine
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Postpartum fever - uterine tenderness - foul-smelling lochia

17. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Bacterial infxn of supraglottic tissue and surrounding areas
Cephalexin OR dicloxacillin
Venlafaxine - duloxetine - mirtazapine

18. Statins
Septic arthritis - fractures - congenital hip dysplasia
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Legionella

19. Antihypertensives in suspected stroke
Renal parenchymal disease
MVP
Meningitis - brain abscess - metastasis
IV labetalol - nicardipine - sodium nitroprusside

20. ACA stroke ssx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Meningitis - brain abscess - metastasis
Foot/leg deficits - cognitive + personality changes
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

21. rtPA should be used within ____ of stroke
Mass lesion - vascular malformation - stroke - collagen vascular disease
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
3 hours
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

22. Baby blues resolves by ______
10th postpartum day
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Septic arthritis - fractures - congenital hip dysplasia

23. 4 T's of postpartum hemorrhage
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

24. Malrotation sx
High K - high Ca - low Na
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Postpartum fever - uterine tenderness - foul-smelling lochia
Neonate - infants - bilious vomiting - abdominal pain

25. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
IV labetalol - nicardipine - sodium nitroprusside
10th postpartum day

26. 1st line tx in IBS constipation
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Fiber (e.g. psyllium)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACEI - B-blocker - diuretic - Ca-blocker

27. Croup
Venlafaxine - duloxetine - mirtazapine
Viral infxn of the subglottis
Oral prednisone
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

28. DDx dementia
B-blocker - Ca-channel blocker
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
Dantrolene IV - antipyretics - O2 - cooling blankets

29. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Lumbar puncture
100% O2 6L/min - dihydroergotamine - triptans

30. TCA
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Amitriptyline - propanolol - timolol - divalproex sodium
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Foot/leg deficits - cognitive + personality changes

31. Bronchiolitis sx
Septic arthritis - fractures - congenital hip dysplasia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

32. Tx HTN + CKD
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Alzheimer dementia
ACEI - ARB
B-blocker - Ca-channel blocker

33. DASH diet plan
High K - high Ca - low Na
Septic arthritis - fractures - congenital hip dysplasia
Venlafaxine - duloxetine - mirtazapine
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

34. Croup sx
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
10th postpartum day
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
PCP pneumonia

35. CXR of CHF
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
10th postpartum day
Digoxin (B-blockers as needed)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

36. Bite injury pflx
H. flu - S. pneumo - S. aureus - Strep A/B/C
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Dementia - incontinence - gait disturbance
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

37. 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
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

38. Headache post-head trauma DDx
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Mass lesion - subdural hematoma - medication overuse
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

39. MCC non-traumatic hip pathology in adolescents
SCFE (slipped capital femoral epiphysis)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
ACEI - diuretic

40. SNRI
Venlafaxine - duloxetine - mirtazapine
3 hours
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Obesity; increased NE release

41. Lubiprostone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Temporal arteritis - mass lesion

42. Sudden-onset headache DDx
8%
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

43. atypical
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Bupriopion - amoxipine - trazodone
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Fasting blood glucose - LFTs - renal function - TSH

44. QTc
= QT / sqrt(RR interval)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Bacterial infxn of supraglottic tissue and surrounding areas

45. Drugs causing fever
TCA's
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
S. aureus
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

46. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

47. Phentermine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Mass lesion - subdural hematoma - medication overuse
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity; NE-uptake inhibition

48. epiglottitis
Bacterial infxn of supraglottic tissue and surrounding areas
Halothane - succinylcholine
Amiodarone/lidocaine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

49. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
10th postpartum day
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

50. Papilledema DDx
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - pseudotumor cerebri - meningitis
Furosemide - nitroglycerin - IV morphine sulphate