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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. Tx frequent/severe abd pain

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2. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Digoxin (B-blockers as needed)
ACEI - diuretic

3. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Venlafaxine - duloxetine - mirtazapine

4. Sx HoCM
PCP pneumonia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
ACEI - B-blocker - spironolactone
Moderate/severe alzheimer dementia

5. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Moderate/severe alzheimer dementia

6. Commonly ingested foreign bodies
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Flat disk - button - batteries
Septic arthritis - fractures - congenital hip dysplasia

7. Sx of pneumococcal pneumonia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

8. Prolonged QT interval (QTc)
5-HT blockers: tegasorad - alosetron
470ms+ in men - 480ms+ in women
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Mass lesion - subdural hematoma - medication overuse

9. Croup sx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Uterine atony
Furosemide - nitroglycerin - IV morphine sulphate
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

10. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Renal parenchymal disease
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

11. Retropharyngeal abscess Sx
B-blocker - Ca-channel blocker
470ms+ in men - 480ms+ in women
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

12. ROME IBS criteria
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACEI - ARB
Flat disk - button - batteries

13. Peritonsillar abscess Sx
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Furosemide - nitroglycerin - IV morphine sulphate
IV labetalol - nicardipine - sodium nitroprusside

14. MAOI
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - ARB
IV labetalol - nicardipine - sodium nitroprusside
Phenelzine - tranylcypramine

15. Epiglottitis pathogens
H. flu - S. pneumo - S. aureus - Strep A/B/C
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Bupriopion - amoxipine - trazodone
Mass lesion - vascular malformation - stroke - collagen vascular disease

16. Tx HTN + CAD
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
ACEI - B-blocker - diuretic - Ca-blocker
Flat disk - button - batteries
ACEI - diuretic

17. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Foot/leg deficits - cognitive + personality changes
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

18. contraindications to thrombolytic therapy
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Neonate - infants - bilious vomiting - abdominal pain
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

19. Phentermine
Obesity; NE-uptake inhibition
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

20. rtPA should be used within ____ of stroke
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
3 hours
Venlafaxine - duloxetine - mirtazapine
Moderate/severe alzheimer dementia

21. Phendimetrazine
B-blocker - Ca-channel blocker
= QT / sqrt(RR interval)
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Obesity; increased NE release

22. Stable vtach tx
Temporal arteritis - mass lesion
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Amiodarone/lidocaine
Fiber (e.g. psyllium)

23. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Bupriopion - amoxipine - trazodone
High K - high Ca - low Na
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

24. Dx and Tx of intussception
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Barium enema
Fiber (e.g. psyllium)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

25. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
ACEI - ARB
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

26. Chance of pregnancy after a single act of coitus
100% O2 6L/min - dihydroergotamine - triptans
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
8%

27. DDx Limp w/o pain in children - orthopedic
Amiodarone/lidocaine
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Postpartum fever - uterine tenderness - foul-smelling lochia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

28. Tacrine use/sfx
Neonate - infants - bilious vomiting - abdominal pain
ACEI - ARB - diuretic - Ca-blocker - B-blocker
3rd month postpartum
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

29. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

30. DDx pediatric intestinal obsutrction
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Fasting blood glucose - LFTs - renal function - TSH
Digoxin (B-blockers as needed)

31. Evaluating limp w/o pain in children
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

32. NMDA-R antagonist (memantine)
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Dantrolene IV - antipyretics - O2 - cooling blankets
Moderate/severe alzheimer dementia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

33. Headache post-head trauma DDx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Bupriopion - amoxipine - trazodone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

34. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Halothane - succinylcholine
Bupriopion - amoxipine - trazodone
ACEI - ARB - diuretic - Ca-blocker - B-blocker

35. Metabolic syndrome
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
= QT / sqrt(RR interval)
SCFE (slipped capital femoral epiphysis)

36. Dx subarachnoid hemorrhage with negative noncontrast CT
ACEI - ARB
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Lumbar puncture
MVP

37. Lubiprostone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
3rd month postpartum
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

38. Standard workup for dyslipidemia
IV labetalol - nicardipine - sodium nitroprusside
Fasting blood glucose - LFTs - renal function - TSH
Quinolone + metronidazole
Fiber (e.g. psyllium)

39. Cholesterol absorption blocker (ezetimibe)
High K - high Ca - low Na
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

40. Tx HTN + CVA
Mass lesion - subdural hematoma - medication overuse
ACEI - diuretic
Venlafaxine - duloxetine - mirtazapine
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

41. Headaches increasing in severity + intensity DDx
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Mass lesion - subdural hematoma - medication overuse
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

42. Cluster headache acute tx
Flat disk - button - batteries
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
SCFE (slipped capital femoral epiphysis)
100% O2 6L/min - dihydroergotamine - triptans

43. most common valvular heart defect in USA
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
MVP
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Bacterial infxn of supraglottic tissue and surrounding areas

44. Tx HTN
1st line: TZD
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

45. Bronchiolitis sx
S. aureus
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

46. Pyloric stenosis sx

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47. 1st line tx in IBS constipation
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
ACEI - diuretic
Fiber (e.g. psyllium)

48. QTc
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
= QT / sqrt(RR interval)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Flat disk - button - batteries

49. epiglottitis
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Bacterial infxn of supraglottic tissue and surrounding areas
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

50. Afib - Aflutter tx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Dantrolene IV - antipyretics - O2 - cooling blankets
Digoxin (B-blockers as needed)
Cephalexin OR dicloxacillin