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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. Donepezil use/sfx
Eikenella species
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Obesity; increased NE release

2. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Viral infxn of the subglottis
Mass lesion - pseudotumor cerebri - meningitis
Renal parenchymal disease

3. Tx acute pulmonary edema 2ndary to CHF
Furosemide - nitroglycerin - IV morphine sulphate
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
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

4. Chronic afib tx
5-HT blockers: tegasorad - alosetron
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

5. Tx HTN + CAD
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Bupriopion - amoxipine - trazodone
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - B-blocker - diuretic - Ca-blocker

6. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

7. Primary SVT tx
B-blocker - Ca-channel blocker
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

8. DDx Limp w/o pain in children - orthopedic
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
ACEI - ARB - B-blocker - diuretic - Spironolactone
Uterine atony
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

9. 1st line tx in IBS constipation
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Fiber (e.g. psyllium)
Phenelzine - tranylcypramine

10. Mastitis tx
Foot/leg deficits - cognitive + personality changes
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
High K - high Ca - low Na
Cephalexin OR dicloxacillin

11. Cluster headache acute tx
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
100% O2 6L/min - dihydroergotamine - triptans
8%
SCFE (slipped capital femoral epiphysis)

12. atypical
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Bupriopion - amoxipine - trazodone
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
3 hours

13. Malrotation sx
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Neonate - infants - bilious vomiting - abdominal pain
'steeple-sign' (subglottic narrowing)
Phenelzine - tranylcypramine

14. MCC HTN in child
Obesity; increased NE release
Fever - sore throat - muffled voice - drooling - trismus - neck pain
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
Renal parenchymal disease

15. QTc
= QT / sqrt(RR interval)
B-blocker - Ca-channel blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Neonate - infants - bilious vomiting - abdominal pain

16. Tx HTN
ACEI - diuretic
Lumbar puncture
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: TZD

17. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Mass lesion - vascular malformation - stroke - collagen vascular disease

18. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Obesity; increased NE release
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

19. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
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
MVP

20. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
High K - high Ca - low Na
'steeple-sign' (subglottic narrowing)
Obesity; increased NE release

21. Dextroamphetamine
Barium enema
Obesity; increased NE release
Amiodarone/lidocaine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

22. MCC non-traumatic hip pathology in adolescents
Meningitis - brain abscess - metastasis
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
SCFE (slipped capital femoral epiphysis)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

23. SNRI
Septic arthritis - fractures - congenital hip dysplasia
Venlafaxine - duloxetine - mirtazapine
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

24. Tx diverticulitis
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Quinolone + metronidazole

25. Empiric CAP tx in hospitalized patient
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Fever - sore throat - muffled voice - drooling - trismus - neck pain

26. Prolonged QT interval (QTc)
Mass lesion - pseudotumor cerebri - meningitis
Obesity; increased NE release
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
470ms+ in men - 480ms+ in women

27. CXR of CHF
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
10th postpartum day
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

28. epiglottitis
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Bacterial infxn of supraglottic tissue and surrounding areas
470ms+ in men - 480ms+ in women
Mass lesion - subdural hematoma - medication overuse

29. Croup sx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
1st line: TZD

30. Orlistat
Dicyclomine - hyoscyamine (antispasmodics)
Septic arthritis - fractures - congenital hip dysplasia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

31. Fibrates
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
B-blocker - Ca-channel blocker

32. Lochia
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Bacterial infxn of supraglottic tissue and surrounding areas
Alzheimer dementia

33. Tx uterine atony
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
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Mass lesion - pseudotumor cerebri - meningitis
Halothane - succinylcholine

34. IBS pain tx
5-HT blockers: tegasorad - alosetron
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Bacterial infxn of supraglottic tissue and surrounding areas

35. 4 T's of postpartum hemorrhage
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
High K - high Ca - low Na
H. flu - S. pneumo - S. aureus - Strep A/B/C
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

36. 'Alarm' sx for upper GI endoscopy
Colonoscopy
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Uterine atony
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

37. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Neonate - infants - bilious vomiting - abdominal pain
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

38. Headaches increasing in severity + intensity DDx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Mass lesion - subdural hematoma - medication overuse
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

39. Outpatient tx CHF
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Cephalexin OR dicloxacillin

40. X-ray epiglottitis

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41. Headache after 50 YO DDx
Eikenella species
IV labetalol - nicardipine - sodium nitroprusside
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Temporal arteritis - mass lesion

42. Cluster headache pflx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

43. most common valvular heart defect in USA
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
ACEI - diuretic
Amitriptyline - propanolol - timolol - divalproex sodium
MVP

44. contraindications to thrombolytic therapy
TCA's
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Mass lesion - pseudotumor cerebri - meningitis
Eikenella species

45. Galantamine use/sfx
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity; increased NE release
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
MVP

46. Tx HTN + post-MI
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
ACEI - B-blocker - spironolactone
MVP
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

47. Metabolic syndrome
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Bupriopion - amoxipine - trazodone
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

48. Sudden-onset headache DDx
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
TCA's
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
3 hours

49. DASH diet plan
Digoxin (B-blockers as needed)
High K - high Ca - low Na
ACEI - ARB - diuretic - Ca-blocker - B-blocker
S. aureus

50. Statins
Temporal arteritis - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Dantrolene IV - antipyretics - O2 - cooling blankets
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo