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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.
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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 frequent/severe abd pain

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2. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
SCFE (slipped capital femoral epiphysis)
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

3. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
High K - high Ca - low Na
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
'steeple-sign' (subglottic narrowing)

4. Tx local - acute rxn to bee sting
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Oral prednisone
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

5. Pyloric stenosis sx

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6. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
5-HT blockers: tegasorad - alosetron
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

7. Tacrine use/sfx
Digoxin (B-blockers as needed)
Moderate/severe alzheimer dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Cephalexin OR dicloxacillin

8. Tx uterine atony
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Mass lesion - subdural hematoma - medication overuse
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

9. Outpatient tx CHF
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Amiodarone/lidocaine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

10. NMDA-R antagonist (memantine)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Mass lesion - pseudotumor cerebri - meningitis
Moderate/severe alzheimer dementia
IV labetalol - nicardipine - sodium nitroprusside

11. If not breast-feeding - when does menstruation restart?
3rd month postpartum
Furosemide - nitroglycerin - IV morphine sulphate
Digoxin (B-blockers as needed)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

12. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
PCP pneumonia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
High K - high Ca - low Na

13. Baby blues resolves by ______
Alzheimer dementia
10th postpartum day
Obesity; increased NE release
Halothane - succinylcholine

14. epiglottitis
Legionella
Postpartum fever - uterine tenderness - foul-smelling lochia
Bacterial infxn of supraglottic tissue and surrounding areas
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

15. rtPA should be used within ____ of stroke
3 hours
Mass lesion - subdural hematoma - medication overuse
Obesity; NE-uptake inhibition
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

16. Primary SVT tx
B-blocker - Ca-channel blocker
Bacterial infxn of supraglottic tissue and surrounding areas
Viral infxn of the subglottis
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

17. Drugs causing fever
Legionella
Mass lesion - vascular malformation - stroke - collagen vascular disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

18. Tx HTN + DM
S. aureus
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Temporal arteritis - mass lesion
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

19. Croup pathogens
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Flat disk - button - batteries
Fiber (e.g. psyllium)

20. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker

21. Tx mild/infrequent abd pain
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Dicyclomine - hyoscyamine (antispasmodics)
Alzheimer dementia
Foot/leg deficits - cognitive + personality changes

22. Causes of diverticular bleeding
Quinolone + metronidazole
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
H. flu - S. pneumo - S. aureus - Strep A/B/C
Obesity; increased NE release

23. DDx dementia
8%
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Dicyclomine - hyoscyamine (antispasmodics)

24. ROME IBS criteria
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

25. Refer to cardiologist post-sports physical if ____
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

26. Lochia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
S. aureus
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

27. atypical
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - B-blocker - spironolactone
Fiber (e.g. psyllium)
Bupriopion - amoxipine - trazodone

28. Tx HTN + CKD
High K - high Ca - low Na
ACEI - ARB
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

29. Cluster headache pflx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Venlafaxine - duloxetine - mirtazapine
B-blocker - Ca-channel blocker

30. Sx endometritis
Barium enema
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Postpartum fever - uterine tenderness - foul-smelling lochia
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

31. Sudden-onset headache DDx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Mass lesion - pseudotumor cerebri - meningitis
Neonate - infants - bilious vomiting - abdominal pain
H. flu - S. pneumo - S. aureus - Strep A/B/C

32. Sx of pneumococcal pneumonia
Lumbar puncture
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
3 hours
Phenelzine - tranylcypramine

33. Tx HTN + CVA
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Viral infxn of the subglottis
ACEI - diuretic
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

34. Phentermine
Obesity; NE-uptake inhibition
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
8%
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

35. Tx HTN + CHF
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACEI - ARB - B-blocker - diuretic - Spironolactone
'thumb sign' (protrusion of into anterior wall of hypopharynx)

36. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
10th postpartum day
Amitriptyline - propanolol - timolol - divalproex sodium

37. Bite injury pflx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Neonate - infants - bilious vomiting - abdominal pain

38. Lubiprostone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
= QT / sqrt(RR interval)
Renal parenchymal disease

39. TCA
Fasting blood glucose - LFTs - renal function - TSH
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Septic arthritis - fractures - congenital hip dysplasia

40. Dextroamphetamine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity; increased NE release
Fiber (e.g. psyllium)
Barium enema

41. Croup sx
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Dicyclomine - hyoscyamine (antispasmodics)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

42. Headache after 50 YO DDx
PCP pneumonia
1st line: TZD
Bupriopion - amoxipine - trazodone
Temporal arteritis - mass lesion

43. QTc
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
IV labetalol - nicardipine - sodium nitroprusside
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
= QT / sqrt(RR interval)

44. SSRI's
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
470ms+ in men - 480ms+ in women
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Postpartum fever - uterine tenderness - foul-smelling lochia

45. Metabolic syndrome
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Quinolone + metronidazole
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

46. CAGE questionnaire
Septic arthritis - fractures - congenital hip dysplasia
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Fiber (e.g. psyllium)

47. vertebrobasilar stroke sx
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Viral infxn of the subglottis

48. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Dementia - incontinence - gait disturbance
Lumbar puncture

49. Sx HoCM
Venlafaxine - duloxetine - mirtazapine
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
MVP

50. Organism that causes pneumonia post-influenza
Septic arthritis - fractures - congenital hip dysplasia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
S. aureus
Furosemide - nitroglycerin - IV morphine sulphate

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Family Medicine/ambulatory 2

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