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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. New-onset headache in patient with HIV/cancer DDx
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Oral prednisone
Neonate - infants - bilious vomiting - abdominal pain
Meningitis - brain abscess - metastasis

2. Cluster headache pflx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Neonate - infants - bilious vomiting - abdominal pain
ACEI - B-blocker - spironolactone

3. epiglottitis
Bacterial infxn of supraglottic tissue and surrounding areas
ACEI - B-blocker - spironolactone
H. flu - S. pneumo - S. aureus - Strep A/B/C
1st line: TZD

4. contraindications to thrombolytic therapy
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Oral prednisone

5. Organism that causes pneumonia post-influenza
Fasting blood glucose - LFTs - renal function - TSH
S. aureus
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

6. Test to best determine source of lower GI bleed
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
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
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Colonoscopy

7. Bronchiolitis sx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Mass lesion - pseudotumor cerebri - meningitis
Fiber (e.g. psyllium)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

8. Dextroamphetamine
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity; increased NE release
ACEI - ARB
5-HT blockers: tegasorad - alosetron

9. Phendimetrazine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity; increased NE release
10th postpartum day
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

10. Headaches increasing in severity + intensity DDx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Amitriptyline - propanolol - timolol - divalproex sodium
Mass lesion - subdural hematoma - medication overuse
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

11. Tx diverticulitis
Quinolone + metronidazole
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Lumbar puncture

12. Metabolic syndrome
Septic arthritis - fractures - congenital hip dysplasia
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Legionella
B-blocker - Ca-channel blocker

13. Epiglottitis pathogens
ACEI - B-blocker - spironolactone
Lumbar puncture
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
H. flu - S. pneumo - S. aureus - Strep A/B/C

14. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
S. aureus
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
IV labetalol - nicardipine - sodium nitroprusside

15. TCA
Uterine atony
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Dementia - incontinence - gait disturbance

16. GI 'alarm' features
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Alzheimer dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
S. aureus

17. causes of malignant hyperthernia
PCP pneumonia
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Halothane - succinylcholine
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

18. Headache with sx systemic illness DDx
Foot/leg deficits - cognitive + personality changes
3rd month postpartum
8%
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

19. Tx HTN
Lumbar puncture
1st line: TZD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Oral prednisone

20. DDx dementia
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
High K - high Ca - low Na

21. MCC non-traumatic hip pathology in adolescents
Moderate/severe alzheimer dementia
Bacterial infxn of supraglottic tissue and surrounding areas
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
SCFE (slipped capital femoral epiphysis)

22. Diethylpropion
Amiodarone/lidocaine
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Obesity; increased NE release

23. DDx postoperative fever
Quinolone + metronidazole
Cephalexin OR dicloxacillin
ACEI - ARB
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

24. Tx migraine
'steeple-sign' (subglottic narrowing)
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
'thumb sign' (protrusion of into anterior wall of hypopharynx)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

25. Stable vtach tx
S. aureus
Amiodarone/lidocaine
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Alzheimer dementia

26. Papilledema DDx
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Mass lesion - pseudotumor cerebri - meningitis
TCA's
Colonoscopy

27. DASH diet plan
High K - high Ca - low Na
Halothane - succinylcholine
1st line: TZD
IV labetalol - nicardipine - sodium nitroprusside

28. CXR of CHF
'thumb sign' (protrusion of into anterior wall of hypopharynx)
ACEI - B-blocker - diuretic - Ca-blocker
Temporal arteritis - mass lesion
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

29. Sibutramine
Colonoscopy
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

30. Galantamine use/sfx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
ACEI - B-blocker - diuretic - Ca-blocker

31. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Colonoscopy
ACEI - B-blocker - spironolactone
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

32. Antihypertensives in suspected stroke
Barium enema
5-HT blockers: tegasorad - alosetron
IV labetalol - nicardipine - sodium nitroprusside
S. aureus

33. Pyloric stenosis sx

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34. Evaluating limp w/o pain in children
Amiodarone/lidocaine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Obesity; NE-uptake inhibition

35. Sudden-onset headache DDx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Obesity; increased NE release
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
3 hours

36. Croup pathogens
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
= QT / sqrt(RR interval)

37. Cluster headache acute tx
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
100% O2 6L/min - dihydroergotamine - triptans
Phenelzine - tranylcypramine
B-blocker - Ca-channel blocker

38. Rivastigmine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Alzheimer dementia
Venlafaxine - duloxetine - mirtazapine
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

39. SSRI's
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

40. Bite injury pflx
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
1st line: TZD
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Phenelzine - tranylcypramine

41. ROME IBS criteria
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - B-blocker - diuretic - Ca-blocker
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

42. Tx HTN + CKD
100% O2 6L/min - dihydroergotamine - triptans
ACEI - ARB
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Dantrolene IV - antipyretics - O2 - cooling blankets

43. Retropharyngeal abscess Sx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
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
ACEI - diuretic

44. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - diuretic
Septic arthritis - fractures - congenital hip dysplasia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

45. X-ray epiglottitis

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46. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
PCP pneumonia
Eikenella species

47. Headache post-head trauma DDx
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Cephalexin OR dicloxacillin
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

48. vertebrobasilar stroke sx
Moderate/severe alzheimer dementia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Temporal arteritis - mass lesion
Amiodarone/lidocaine

49. Sx endometritis
ACEI - ARB
Postpartum fever - uterine tenderness - foul-smelling lochia
Dantrolene IV - antipyretics - O2 - cooling blankets
PCP pneumonia

50. Croup X-ray

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