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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. Bite injury pflx
Obesity; increased NE release
Neonate - infants - bilious vomiting - abdominal pain
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
1st line: TZD

2. TCA
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Foot/leg deficits - cognitive + personality changes
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

3. CXR of CHF
= QT / sqrt(RR interval)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

4. MAOI
Phenelzine - tranylcypramine
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

5. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
IV labetalol - nicardipine - sodium nitroprusside
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

6. Tx HTN + CVA
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACEI - diuretic
Dantrolene IV - antipyretics - O2 - cooling blankets
Lumbar puncture

7. Prolonged QT interval (QTc)
Fiber (e.g. psyllium)
1st line: TZD
'steeple-sign' (subglottic narrowing)
470ms+ in men - 480ms+ in women

8. Intussusception sx
Digoxin (B-blockers as needed)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
'steeple-sign' (subglottic narrowing)

9. Mastitis tx
Cephalexin OR dicloxacillin
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
B-blocker - Ca-channel blocker
Eikenella species

10. Peritonsillar abscess Sx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
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
Fever - sore throat - muffled voice - drooling - trismus - neck pain

11. Tx HTN + CAD
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
PCP pneumonia
ACEI - B-blocker - diuretic - Ca-blocker

12. Commonly ingested foreign bodies
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
Flat disk - button - batteries
Oral prednisone

13. Evaluating limp w/o pain in children
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Mass lesion - vascular malformation - stroke - collagen vascular disease
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

14. DDx dementia
Oral prednisone
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
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

15. Tx HTN + DM
'steeple-sign' (subglottic narrowing)
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Venlafaxine - duloxetine - mirtazapine
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

16. Cholesterol absorption blocker (ezetimibe)
Obesity; NE-uptake inhibition
Moderate/severe alzheimer dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

17. Chance of pregnancy after a single act of coitus
8%
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
MVP
Cephalexin OR dicloxacillin

18. rtPA should be used within ____ of stroke
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
'thumb sign' (protrusion of into anterior wall of hypopharynx)
3 hours
TCA's

19. Antihypertensives in suspected stroke
IV labetalol - nicardipine - sodium nitroprusside
Renal parenchymal disease
Septic arthritis - fractures - congenital hip dysplasia
High K - high Ca - low Na

20. Organism that causes pneumonia post-influenza
S. aureus
3 hours
Obesity; NE-uptake inhibition
Oral prednisone

21. Tx HTN + CKD
Quinolone + metronidazole
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Septic arthritis - fractures - congenital hip dysplasia
ACEI - ARB

22. MCA stroke sx
Legionella
470ms+ in men - 480ms+ in women
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

23. MCC postpartum hemorrhage
Halothane - succinylcholine
ACEI - ARB
Uterine atony
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

24. Refer to cardiologist post-sports physical if ____
Fasting blood glucose - LFTs - renal function - TSH
S. aureus
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Viral infxn of the subglottis

25. tx malignant hyperthermia
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Dantrolene IV - antipyretics - O2 - cooling blankets
Septic arthritis - fractures - congenital hip dysplasia
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

26. Tx mild/infrequent abd pain
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Bacterial infxn of supraglottic tissue and surrounding areas
Quinolone + metronidazole
Dicyclomine - hyoscyamine (antispasmodics)

27. Sx of pneumococcal pneumonia
'steeple-sign' (subglottic narrowing)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Neonate - infants - bilious vomiting - abdominal pain
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

28. ROME IBS criteria
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Meningitis - brain abscess - metastasis
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

29. Headache with sx systemic illness DDx
Obesity; increased NE release
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Viral infxn of the subglottis
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

30. Croup sx
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Amitriptyline - propanolol - timolol - divalproex sodium

31. malignant hyperthermia
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Dicyclomine - hyoscyamine (antispasmodics)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

32. Rivastigmine
Alzheimer dementia
SCFE (slipped capital femoral epiphysis)
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

33. Tx diverticulitis
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
TCA's
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Quinolone + metronidazole

34. MCC infxn in closed-fist injuries
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Obesity; increased NE release
Eikenella species
Fasting blood glucose - LFTs - renal function - TSH

35. contraindications to thrombolytic therapy
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

36. If not breast-feeding - when does menstruation restart?
Moderate/severe alzheimer dementia
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Mass lesion - vascular malformation - stroke - collagen vascular disease
3rd month postpartum

37. Croup pathogens
3 hours
3rd month postpartum
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Dantrolene IV - antipyretics - O2 - cooling blankets

38. Cluster headache pflx
Alzheimer dementia
ACEI - ARB
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Foot/leg deficits - cognitive + personality changes

39. Phentermine
Bupriopion - amoxipine - trazodone
Flat disk - button - batteries
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Obesity; NE-uptake inhibition

40. Dx and Tx of intussception
100% O2 6L/min - dihydroergotamine - triptans
Obesity; increased NE release
Bacterial infxn of supraglottic tissue and surrounding areas
Barium enema

41. Croup
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Viral infxn of the subglottis
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

42. Tx frequent/severe abd pain

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43. Tx local - acute rxn to bee sting
Oral prednisone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Venlafaxine - duloxetine - mirtazapine
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

44. epiglottitis
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Dicyclomine - hyoscyamine (antispasmodics)
Postpartum fever - uterine tenderness - foul-smelling lochia
Bacterial infxn of supraglottic tissue and surrounding areas

45. Organism that causes pneumonia with diarrhea
Viral infxn of the subglottis
Legionella
8%
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

46. Sibutramine
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

47. Baby blues resolves by ______
10th postpartum day
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
100% O2 6L/min - dihydroergotamine - triptans
Legionella

48. causes of malignant hyperthernia
Halothane - succinylcholine
Obesity; increased NE release
Colonoscopy
'thumb sign' (protrusion of into anterior wall of hypopharynx)

49. Tx migraine
Obesity; increased NE release
Mass lesion - pseudotumor cerebri - meningitis
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

50. atypical
Temporal arteritis - mass lesion
Obesity; NE-uptake inhibition
Bupriopion - amoxipine - trazodone
'steeple-sign' (subglottic narrowing)