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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. Dx and Tx of intussception
Dantrolene IV - antipyretics - O2 - cooling blankets
PCP pneumonia
Barium enema
Dementia - incontinence - gait disturbance

2. Tx HTN + post-MI
ACEI - B-blocker - spironolactone
10th postpartum day
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

3. DDx postoperative fever
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
'steeple-sign' (subglottic narrowing)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

4. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Colonoscopy

5. If not breast-feeding - when does menstruation restart?
Colonoscopy
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
3rd month postpartum
Alzheimer dementia

6. Empiric CAP tx in healthy person
10th postpartum day
Dementia - incontinence - gait disturbance
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

7. Headache with sx systemic illness DDx
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
ACEI - ARB
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

8. Tx HTN + CAD
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
TCA's
ACEI - B-blocker - diuretic - Ca-blocker
3 hours

9. Sibutramine
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

10. Tx HTN + CKD
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
ACEI - ARB
Obesity; increased NE release

11. Tx HTN + DM
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
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Obesity; increased NE release

12. Antihypertensives in suspected stroke
IV labetalol - nicardipine - sodium nitroprusside
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
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)

13. Refer to cardiologist post-sports physical if ____
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Postpartum fever - uterine tenderness - foul-smelling lochia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
'thumb sign' (protrusion of into anterior wall of hypopharynx)

14. Tx acute pulmonary edema 2ndary to CHF
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Bacterial infxn of supraglottic tissue and surrounding areas
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Furosemide - nitroglycerin - IV morphine sulphate

15. Tx HTN
TCA's
Fasting blood glucose - LFTs - renal function - TSH
1st line: TZD
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

16. NMDA-R antagonist (memantine)
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
Halothane - succinylcholine
Bupriopion - amoxipine - trazodone

17. Lochia
Neonate - infants - bilious vomiting - abdominal pain
Furosemide - nitroglycerin - IV morphine sulphate
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

18. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity; NE-uptake inhibition
Lumbar puncture

19. Empiric CAP tx in hospitalized patient
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

20. most common valvular heart defect in USA
MVP
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Bacterial infxn of supraglottic tissue and surrounding areas
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

21. MCC infxn in closed-fist injuries
10th postpartum day
Eikenella species
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

22. Orlistat
Alzheimer dementia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

23. Organism that causes pneumonia post-influenza
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
S. aureus
H. flu - S. pneumo - S. aureus - Strep A/B/C
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

24. Tx HTN + CVA
ACEI - diuretic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Obesity; increased NE release
Dementia - incontinence - gait disturbance

25. Tx mild/infrequent abd pain
Digoxin (B-blockers as needed)
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Dicyclomine - hyoscyamine (antispasmodics)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

26. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
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)

27. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
8%

28. Test to best determine source of lower GI bleed
470ms+ in men - 480ms+ in women
Colonoscopy
PCP pneumonia
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

29. MAOI
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
IV labetalol - nicardipine - sodium nitroprusside
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Phenelzine - tranylcypramine

30. SNRI
Venlafaxine - duloxetine - mirtazapine
ACEI - ARB - diuretic - Ca-blocker - B-blocker
3 hours
Dantrolene IV - antipyretics - O2 - cooling blankets

31. Metabolic syndrome
Neonate - infants - bilious vomiting - abdominal pain
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dementia - incontinence - gait disturbance
Lumbar puncture

32. Papilledema DDx
Obesity; increased NE release
Mass lesion - pseudotumor cerebri - meningitis
Obesity; increased NE release
Phenelzine - tranylcypramine

33. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Phenelzine - tranylcypramine
High K - high Ca - low Na
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

34. MCC postpartum hemorrhage
Uterine atony
Mass lesion - vascular malformation - stroke - collagen vascular disease
MVP
Mass lesion - subdural hematoma - medication overuse

35. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Postpartum fever - uterine tenderness - foul-smelling lochia
Bupriopion - amoxipine - trazodone
ACEI - ARB

36. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Temporal arteritis - mass lesion
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

37. atypical
Bupriopion - amoxipine - trazodone
Mass lesion - pseudotumor cerebri - meningitis
= QT / sqrt(RR interval)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

38. Tx frequent/severe abd pain

39. Diethylpropion
Temporal arteritis - mass lesion
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
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

40. Sx HoCM
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
8%
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Fiber (e.g. psyllium)

41. Dx subarachnoid hemorrhage with negative noncontrast CT
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Dementia - incontinence - gait disturbance
Lumbar puncture
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

42. MCA stroke sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
PCP pneumonia

43. Phendimetrazine
ACEI - B-blocker - spironolactone
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity; increased NE release

44. Commonly ingested foreign bodies
Oral prednisone
Flat disk - button - batteries
Neonate - infants - bilious vomiting - abdominal pain
Digoxin (B-blockers as needed)

45. Headache post-head trauma DDx
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
= QT / sqrt(RR interval)
Renal parenchymal disease

46. epiglottitis
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Furosemide - nitroglycerin - IV morphine sulphate
Bacterial infxn of supraglottic tissue and surrounding areas
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

47. Sx endometritis
Digoxin (B-blockers as needed)
Postpartum fever - uterine tenderness - foul-smelling lochia
Mass lesion - subdural hematoma - medication overuse
Eikenella species

48. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
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
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
H. flu - S. pneumo - S. aureus - Strep A/B/C

49. Tacrine use/sfx
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
S. aureus
Neonate - infants - bilious vomiting - abdominal pain
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

50. Phentermine
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Obesity; NE-uptake inhibition
ACEI - B-blocker - spironolactone
Mass lesion - subdural hematoma - medication overuse