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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. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
SCFE (slipped capital femoral epiphysis)
Temporal arteritis - mass lesion
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

2. Organism that causes pneumonia with diarrhea
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Legionella

3. DDx dementia
Amiodarone/lidocaine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

4. DDx Limp w/o pain in children - orthopedic
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

5. Organism that causes pneumonia post-influenza
S. aureus
ACEI - B-blocker - diuretic - Ca-blocker
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

6. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Obesity; increased NE release
5-HT blockers: tegasorad - alosetron
Oral prednisone

7. Tx diverticulitis
High K - high Ca - low Na
Quinolone + metronidazole
Colonoscopy
ACEI - diuretic

8. SSRI's
Obesity; increased NE release
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

9. causes of malignant hyperthernia
Halothane - succinylcholine
Mass lesion - pseudotumor cerebri - meningitis
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

10. DASH diet plan
High K - high Ca - low Na
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Postpartum fever - uterine tenderness - foul-smelling lochia

11. ROME IBS criteria
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Furosemide - nitroglycerin - IV morphine sulphate
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

12. NMDA-R antagonist (memantine)
Moderate/severe alzheimer dementia
Mass lesion - pseudotumor cerebri - meningitis
S. aureus
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

13. Outpatient tx CHF
Bupriopion - amoxipine - trazodone
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
10th postpartum day

14. Prolonged QT interval (QTc)
Barium enema
470ms+ in men - 480ms+ in women
8%
1st line: TZD

15. Bilateral 'ground glass' infiltrate on CXR
Legionella
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
PCP pneumonia

16. Test to best determine source of lower GI bleed
Septic arthritis - fractures - congenital hip dysplasia
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Colonoscopy

17. Sx Lewy Body Dementia
High K - high Ca - low Na
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Dantrolene IV - antipyretics - O2 - cooling blankets
IV labetalol - nicardipine - sodium nitroprusside

18. MCC postpartum hemorrhage
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Postpartum fever - uterine tenderness - foul-smelling lochia
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Uterine atony

19. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Dementia - incontinence - gait disturbance
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Obesity; increased NE release

20. TCA
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fasting blood glucose - LFTs - renal function - TSH
Bupriopion - amoxipine - trazodone

21. Pyloric stenosis sx

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22. GI 'alarm' features
100% O2 6L/min - dihydroergotamine - triptans
H. flu - S. pneumo - S. aureus - Strep A/B/C
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Amitriptyline - propanolol - timolol - divalproex sodium

23. Tx HTN + CKD
Bupriopion - amoxipine - trazodone
ACEI - diuretic
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - ARB

24. Stable vtach tx
Amiodarone/lidocaine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Fever - sore throat - muffled voice - drooling - trismus - neck pain

25. Sibutramine
Mass lesion - subdural hematoma - medication overuse
Renal parenchymal disease
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

26. Chance of pregnancy after a single act of coitus
8%
Viral infxn of the subglottis
Dicyclomine - hyoscyamine (antispasmodics)
Quinolone + metronidazole

27. Tx uterine atony
Dicyclomine - hyoscyamine (antispasmodics)
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
Bacterial infxn of supraglottic tissue and surrounding areas
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

28. Primary SVT tx
B-blocker - Ca-channel blocker
Oral prednisone
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

29. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Lumbar puncture
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

30. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
High K - high Ca - low Na
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Dementia - incontinence - gait disturbance

31. Bite injury pflx
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Barium enema
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

32. epiglottitis
Alzheimer dementia
MVP
Bacterial infxn of supraglottic tissue and surrounding areas
Foot/leg deficits - cognitive + personality changes

33. Focal neurologic sx (other than aura) DDx
Flat disk - button - batteries
Mass lesion - vascular malformation - stroke - collagen vascular disease
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

34. CXR of CHF
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
High K - high Ca - low Na
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

35. Croup
Viral infxn of the subglottis
S. aureus
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

36. Headache post-head trauma DDx
Lumbar puncture
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Postpartum fever - uterine tenderness - foul-smelling lochia
High K - high Ca - low Na

37. Galantamine use/sfx
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Dantrolene IV - antipyretics - O2 - cooling blankets
Eikenella species

38. Phendimetrazine
Halothane - succinylcholine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Obesity; increased NE release
8%

39. Rivastigmine
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Alzheimer dementia
Mass lesion - pseudotumor cerebri - meningitis

40. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Postpartum fever - uterine tenderness - foul-smelling lochia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

41. MCC HTN in child
Renal parenchymal disease
= QT / sqrt(RR interval)
Neonate - infants - bilious vomiting - abdominal pain
Fasting blood glucose - LFTs - renal function - TSH

42. Retropharyngeal abscess Sx
Flat disk - button - batteries
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
100% O2 6L/min - dihydroergotamine - triptans
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

43. Pflx migraine
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Lumbar puncture
Amitriptyline - propanolol - timolol - divalproex sodium
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

44. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Postpartum fever - uterine tenderness - foul-smelling lochia
Flat disk - button - batteries

45. Tx HTN + CAD
Uterine atony
10th postpartum day
ACEI - B-blocker - diuretic - Ca-blocker
Barium enema

46. Commonly ingested foreign bodies
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity; increased NE release
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Flat disk - button - batteries

47. Tx acute pulmonary edema 2ndary to CHF
Fiber (e.g. psyllium)
3rd month postpartum
Furosemide - nitroglycerin - IV morphine sulphate
Dicyclomine - hyoscyamine (antispasmodics)

48. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

49. Sx HoCM
MVP
Neonate - infants - bilious vomiting - abdominal pain
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

50. Empiric CAP tx in hospitalized patient
Moderate/severe alzheimer dementia
High K - high Ca - low Na
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance