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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 migraine
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Amitriptyline - propanolol - timolol - divalproex sodium
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
'thumb sign' (protrusion of into anterior wall of hypopharynx)

2. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
ACEI - B-blocker - spironolactone
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

3. ROME IBS criteria
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
'steeple-sign' (subglottic narrowing)
Halothane - succinylcholine

4. Causes of diverticular bleeding
Septic arthritis - fractures - congenital hip dysplasia
Colonoscopy
Mass lesion - vascular malformation - stroke - collagen vascular disease
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

5. Refer to cardiologist post-sports physical if ____
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Moderate/severe alzheimer dementia
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Uterine atony

6. Outpatient tx CHF
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
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

7. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Eikenella species
Barium enema
ACEI - B-blocker - diuretic - Ca-blocker

8. most common valvular heart defect in USA
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
MVP
'thumb sign' (protrusion of into anterior wall of hypopharynx)

9. Chance of pregnancy after a single act of coitus
8%
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Mass lesion - pseudotumor cerebri - meningitis
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

10. DASH diet plan
High K - high Ca - low Na
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - ARB
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

11. Orlistat
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Fasting blood glucose - LFTs - renal function - TSH
Barium enema
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

12. Diethylpropion
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Obesity; increased NE release

13. Tx diverticulitis
Quinolone + metronidazole
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Postpartum fever - uterine tenderness - foul-smelling lochia
Flat disk - button - batteries

14. Galantamine use/sfx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

15. DDx limp in infant/toddler
Barium enema
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
SCFE (slipped capital femoral epiphysis)
Septic arthritis - fractures - congenital hip dysplasia

16. Drugs causing fever
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Dementia - incontinence - gait disturbance

17. Focal neurologic sx (other than aura) DDx
Venlafaxine - duloxetine - mirtazapine
High K - high Ca - low Na
Mass lesion - vascular malformation - stroke - collagen vascular disease
Colonoscopy

18. Tx frequent/severe abd pain

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19. causes of malignant hyperthernia
Colonoscopy
Halothane - succinylcholine
1st line: TZD
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

20. atypical
Postpartum fever - uterine tenderness - foul-smelling lochia
Lumbar puncture
= QT / sqrt(RR interval)
Bupriopion - amoxipine - trazodone

21. Sx endometritis
H. flu - S. pneumo - S. aureus - Strep A/B/C
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Postpartum fever - uterine tenderness - foul-smelling lochia

22. Test to best determine source of lower GI bleed
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Colonoscopy
Temporal arteritis - mass lesion

23. Bilateral 'ground glass' infiltrate on CXR
Renal parenchymal disease
PCP pneumonia
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
B-blocker - Ca-channel blocker

24. Malrotation sx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Neonate - infants - bilious vomiting - abdominal pain
Legionella
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

25. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
MVP
1st line: TZD
Mass lesion - subdural hematoma - medication overuse

26. QTc
= QT / sqrt(RR interval)
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
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

27. Tacrine use/sfx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
3 hours
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

28. Sx normal-pressure hydrocephalus
3 hours
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Dementia - incontinence - gait disturbance

29. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
= QT / sqrt(RR interval)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

30. Antihypertensives in suspected stroke
Postpartum fever - uterine tenderness - foul-smelling lochia
IV labetalol - nicardipine - sodium nitroprusside
SCFE (slipped capital femoral epiphysis)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

31. Cluster headache pflx
100% O2 6L/min - dihydroergotamine - triptans
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

32. Sx Lewy Body Dementia
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

33. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Venlafaxine - duloxetine - mirtazapine
Amiodarone/lidocaine

34. Organism that causes pneumonia with diarrhea
Legionella
Alzheimer dementia
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Quinolone + metronidazole

35. malignant hyperthermia
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
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Fasting blood glucose - LFTs - renal function - TSH

36. Tx HTN
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Quinolone + metronidazole
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
1st line: TZD

37. Lubiprostone
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Flat disk - button - batteries
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

38. Pflx migraine
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
H. flu - S. pneumo - S. aureus - Strep A/B/C
Amitriptyline - propanolol - timolol - divalproex sodium
B-blocker - Ca-channel blocker

39. Pyloric stenosis sx

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40. MCC postpartum hemorrhage
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Uterine atony
Barium enema
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

41. SSRI's
ACEI - ARB
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Dicyclomine - hyoscyamine (antispasmodics)

42. Baby blues resolves by ______
S. aureus
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
10th postpartum day

43. Headache after 50 YO DDx
Temporal arteritis - mass lesion
3rd month postpartum
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
= QT / sqrt(RR interval)

44. X-ray epiglottitis

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45. Cardiac Resynchronization Therapy (CRT) is warranted when ___
ACEI - ARB - B-blocker - diuretic - Spironolactone
Neonate - infants - bilious vomiting - abdominal pain
Flat disk - button - batteries
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

46. Commonly ingested foreign bodies
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Lumbar puncture
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Flat disk - button - batteries

47. Empiric CAP tx in healthy person
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Phenelzine - tranylcypramine
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Fiber (e.g. psyllium)

48. 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
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
TCA's
Obesity; increased NE release

49. DDx postoperative fever
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Uterine atony
Amiodarone/lidocaine

50. Croup pathogens
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
ACEI - B-blocker - spironolactone
Mass lesion - vascular malformation - stroke - collagen vascular disease
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo