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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.
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. Commonly ingested foreign bodies
Flat disk - button - batteries
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

2. ROME IBS criteria
Legionella
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Bacterial infxn of supraglottic tissue and surrounding areas

3. Croup X-ray

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4. Chance of pregnancy after a single act of coitus
H. flu - S. pneumo - S. aureus - Strep A/B/C
8%
Mass lesion - pseudotumor cerebri - meningitis
TCA's

5. Afib - Aflutter tx
Dantrolene IV - antipyretics - O2 - cooling blankets
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Digoxin (B-blockers as needed)
Meningitis - brain abscess - metastasis

6. Lochia
3 hours
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

7. NMDA-R antagonist (memantine)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
8%
Moderate/severe alzheimer dementia
S. aureus

8. Dx subarachnoid hemorrhage with negative noncontrast CT
ACEI - B-blocker - spironolactone
Lumbar puncture
Dicyclomine - hyoscyamine (antispasmodics)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

9. Sudden-onset headache DDx
Mass lesion - pseudotumor cerebri - meningitis
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

10. Headache with sx systemic illness DDx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Halothane - succinylcholine
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

11. Croup
Oral prednisone
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
5-HT blockers: tegasorad - alosetron
Viral infxn of the subglottis

12. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
PCP pneumonia

13. Dx and Tx of intussception
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
H. flu - S. pneumo - S. aureus - Strep A/B/C
Obesity; increased NE release
Barium enema

14. Donepezil use/sfx
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
3 hours
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

15. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Obesity; NE-uptake inhibition
MVP
TCA's

16. MAOI
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
High K - high Ca - low Na
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Phenelzine - tranylcypramine

17. ACA stroke ssx
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Foot/leg deficits - cognitive + personality changes
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Temporal arteritis - mass lesion

18. Tx mild/infrequent abd pain
Dicyclomine - hyoscyamine (antispasmodics)
Obesity; NE-uptake inhibition
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

19. Phendimetrazine
Meningitis - brain abscess - metastasis
Bacterial infxn of supraglottic tissue and surrounding areas
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release

20. Tacrine use/sfx
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
ACEI - B-blocker - diuretic - Ca-blocker

21. contraindications to thrombolytic therapy
Uterine atony
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
PCP pneumonia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

22. DDx Limp w/o pain in children - orthopedic
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
Alzheimer dementia
ACEI - ARB - B-blocker - diuretic - Spironolactone

23. Peritonsillar abscess Sx
= QT / sqrt(RR interval)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Postpartum fever - uterine tenderness - foul-smelling lochia

24. Headache post-head trauma DDx
Digoxin (B-blockers as needed)
= QT / sqrt(RR interval)
Neonate - infants - bilious vomiting - abdominal pain
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

25. SNRI
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Venlafaxine - duloxetine - mirtazapine
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Colonoscopy

26. Sx of pneumococcal pneumonia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Amiodarone/lidocaine

27. atypical
Phenelzine - tranylcypramine
Bupriopion - amoxipine - trazodone
ACEI - B-blocker - diuretic - Ca-blocker
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

28. Stable vtach tx
Mass lesion - subdural hematoma - medication overuse
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB
Amiodarone/lidocaine

29. IBS pain tx
10th postpartum day
Amiodarone/lidocaine
Dantrolene IV - antipyretics - O2 - cooling blankets
5-HT blockers: tegasorad - alosetron

30. Rivastigmine
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Obesity; increased NE release
Alzheimer dementia

31. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
100% O2 6L/min - dihydroergotamine - triptans
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

32. Cluster headache pflx
S. aureus
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Obesity; NE-uptake inhibition
SCFE (slipped capital femoral epiphysis)

33. epiglottitis
Mass lesion - subdural hematoma - medication overuse
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
H. flu - S. pneumo - S. aureus - Strep A/B/C
Bacterial infxn of supraglottic tissue and surrounding areas

34. MCC HTN in child
Renal parenchymal disease
Uterine atony
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Bupriopion - amoxipine - trazodone

35. Tx uterine atony
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
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
H. flu - S. pneumo - S. aureus - Strep A/B/C

36. 4 T's of postpartum hemorrhage
Mass lesion - subdural hematoma - medication overuse
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
TCA's
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

37. Baby blues resolves by ______
Foot/leg deficits - cognitive + personality changes
Renal parenchymal disease
10th postpartum day
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

38. causes of malignant hyperthernia
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Halothane - succinylcholine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fever - sore throat - muffled voice - drooling - trismus - neck pain

39. Tx HTN + DM
470ms+ in men - 480ms+ in women
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Legionella
ACEI - ARB - diuretic - Ca-blocker - B-blocker

40. Prolonged QT interval (QTc)
Renal parenchymal disease
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
470ms+ in men - 480ms+ in women
Barium enema

41. Pyloric stenosis sx

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42. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
= QT / sqrt(RR interval)
Venlafaxine - duloxetine - mirtazapine
Fasting blood glucose - LFTs - renal function - TSH

43. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

44. Refer to cardiologist post-sports physical if ____
Alzheimer dementia
MVP
Foot/leg deficits - cognitive + personality changes
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

45. Tx HTN + CVA
Moderate/severe alzheimer dementia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - diuretic
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

46. Intussusception sx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Eikenella species
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

47. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Furosemide - nitroglycerin - IV morphine sulphate
IV labetalol - nicardipine - sodium nitroprusside
Obesity; NE-uptake inhibition

48. DDx postoperative fever
Flat disk - button - batteries
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
'thumb sign' (protrusion of into anterior wall of hypopharynx)

49. Metabolic syndrome
Flat disk - button - batteries
ACEI - ARB - B-blocker - diuretic - Spironolactone
5-HT blockers: tegasorad - alosetron
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

50. Phentermine
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
ACEI - ARB - B-blocker - diuretic - Spironolactone
Obesity; NE-uptake inhibition