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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. MCC non-traumatic hip pathology in adolescents
Dementia - incontinence - gait disturbance
SCFE (slipped capital femoral epiphysis)
5-HT blockers: tegasorad - alosetron
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

2. SSRI's
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Fasting blood glucose - LFTs - renal function - TSH

3. Commonly ingested foreign bodies
Flat disk - button - batteries
TCA's
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

4. Refer to cardiologist post-sports physical if ____
Moderate/severe alzheimer dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Amiodarone/lidocaine

5. Tx frequent/severe abd pain

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6. Epiglottitis pathogens
Obesity; NE-uptake inhibition
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
H. flu - S. pneumo - S. aureus - Strep A/B/C
Phenelzine - tranylcypramine

7. Baby blues resolves by ______
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Fasting blood glucose - LFTs - renal function - TSH
10th postpartum day

8. Cluster headache pflx
Phenelzine - tranylcypramine
Obesity; NE-uptake inhibition
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

9. Tx HTN + CVA
Septic arthritis - fractures - congenital hip dysplasia
ACEI - diuretic
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Flat disk - button - batteries

10. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Furosemide - nitroglycerin - IV morphine sulphate
High K - high Ca - low Na
Amiodarone/lidocaine

11. CAGE questionnaire
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
MVP
Dantrolene IV - antipyretics - O2 - cooling blankets
3rd month postpartum

12. Tx HTN + DM
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
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
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Digoxin (B-blockers as needed)

13. MCC infxn in closed-fist injuries
Fiber (e.g. psyllium)
ACEI - ARB - B-blocker - diuretic - Spironolactone
Eikenella species
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

14. vertebrobasilar stroke sx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
TCA's
Dicyclomine - hyoscyamine (antispasmodics)

15. Test to best determine source of lower GI bleed
Colonoscopy
= QT / sqrt(RR interval)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Fever - sore throat - muffled voice - drooling - trismus - neck pain

16. Tx mild/infrequent abd pain
Amitriptyline - propanolol - timolol - divalproex sodium
Dicyclomine - hyoscyamine (antispasmodics)
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Viral infxn of the subglottis

17. Tx HTN + CAD
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - B-blocker - diuretic - Ca-blocker

18. TCA
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Mass lesion - pseudotumor cerebri - meningitis
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
TCA's

19. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Dicyclomine - hyoscyamine (antispasmodics)

20. Metabolic syndrome
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
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

21. Organism that causes pneumonia with diarrhea
Legionella
Halothane - succinylcholine
MVP
Mass lesion - subdural hematoma - medication overuse

22. Sudden-onset headache DDx
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
8%
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

23. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Fasting blood glucose - LFTs - renal function - TSH
Oral prednisone

24. Antihypertensives in suspected stroke
3 hours
Dementia - incontinence - gait disturbance
IV labetalol - nicardipine - sodium nitroprusside
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

25. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

26. Tx acute pulmonary edema 2ndary to CHF
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Furosemide - nitroglycerin - IV morphine sulphate
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Halothane - succinylcholine

27. NMDA-R antagonist (memantine)
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Septic arthritis - fractures - congenital hip dysplasia
Moderate/severe alzheimer dementia

28. SNRI
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Venlafaxine - duloxetine - mirtazapine
Colonoscopy

29. most common valvular heart defect in USA
Uterine atony
Mass lesion - pseudotumor cerebri - meningitis
MVP
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

30. atypical
Bupriopion - amoxipine - trazodone
Neonate - infants - bilious vomiting - abdominal pain
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

31. CXR of CHF
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Alzheimer dementia
Legionella
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

32. GI 'alarm' features
Digoxin (B-blockers as needed)
Mass lesion - subdural hematoma - medication overuse
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Legionella

33. Pyloric stenosis sx

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34. Headaches increasing in severity + intensity DDx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Mass lesion - subdural hematoma - medication overuse
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Amitriptyline - propanolol - timolol - divalproex sodium

35. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Bupriopion - amoxipine - trazodone
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

36. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fiber (e.g. psyllium)
Uterine atony
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

37. epiglottitis
ACEI - diuretic
Furosemide - nitroglycerin - IV morphine sulphate
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Bacterial infxn of supraglottic tissue and surrounding areas

38. Tx HTN + post-MI
Obesity; increased NE release
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - B-blocker - spironolactone

39. tx malignant hyperthermia
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
ACEI - B-blocker - spironolactone
Dantrolene IV - antipyretics - O2 - cooling blankets
'thumb sign' (protrusion of into anterior wall of hypopharynx)

40. Headache post-head trauma DDx
3rd month postpartum
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Bacterial infxn of supraglottic tissue and surrounding areas

41. Orlistat
PCP pneumonia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
High K - high Ca - low Na
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

42. Tx local - acute rxn to bee sting
Halothane - succinylcholine
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Quinolone + metronidazole
Oral prednisone

43. Dextroamphetamine
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Obesity; increased NE release
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Foot/leg deficits - cognitive + personality changes

44. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Bacterial infxn of supraglottic tissue and surrounding areas
S. aureus

45. Tx uterine atony
ACEI - B-blocker - diuretic - Ca-blocker
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
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

46. Sx normal-pressure hydrocephalus
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Dementia - incontinence - gait disturbance
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
1st line: TZD

47. Statins
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Barium enema
ACEI - ARB

48. Papilledema DDx
S. aureus
Mass lesion - pseudotumor cerebri - meningitis
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Temporal arteritis - mass lesion

49. Tx diverticulitis
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Quinolone + metronidazole
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
IV labetalol - nicardipine - sodium nitroprusside

50. malignant hyperthermia
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Eikenella species
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity