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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. Croup
SCFE (slipped capital femoral epiphysis)
100% O2 6L/min - dihydroergotamine - triptans
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Viral infxn of the subglottis

2. Orlistat
B-blocker - Ca-channel blocker
Obesity; increased NE release
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Bacterial infxn of supraglottic tissue and surrounding areas

3. tx malignant hyperthermia
Obesity; increased NE release
Dantrolene IV - antipyretics - O2 - cooling blankets
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Viral infxn of the subglottis

4. Tx HTN + CAD
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Obesity; NE-uptake inhibition
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - B-blocker - diuretic - Ca-blocker

5. MCC infxn in closed-fist injuries
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
TCA's
Eikenella species
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

6. Evaluating limp w/o pain in children
Legionella
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Foot/leg deficits - cognitive + personality changes
Temporal arteritis - mass lesion

7. Sx endometritis
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mass lesion - pseudotumor cerebri - meningitis
Postpartum fever - uterine tenderness - foul-smelling lochia

8. Lochia
Neonate - infants - bilious vomiting - abdominal pain
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACEI - B-blocker - spironolactone

9. Sudden-onset headache DDx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
TCA's
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
IV labetalol - nicardipine - sodium nitroprusside

10. Headache with sx systemic illness DDx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
ACEI - ARB - B-blocker - diuretic - Spironolactone
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

11. Malrotation sx
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Neonate - infants - bilious vomiting - abdominal pain
Foot/leg deficits - cognitive + personality changes
Quinolone + metronidazole

12. Chance of pregnancy after a single act of coitus
ACEI - diuretic
8%
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

13. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
B-blocker - Ca-channel blocker
Fasting blood glucose - LFTs - renal function - TSH
'steeple-sign' (subglottic narrowing)

14. IBS pain tx
Mass lesion - vascular malformation - stroke - collagen vascular disease
470ms+ in men - 480ms+ in women
Uterine atony
5-HT blockers: tegasorad - alosetron

15. Phentermine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Obesity; NE-uptake inhibition
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

16. SNRI
Venlafaxine - duloxetine - mirtazapine
Furosemide - nitroglycerin - IV morphine sulphate
Amiodarone/lidocaine
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

17. Cholesterol absorption blocker (ezetimibe)
Dantrolene IV - antipyretics - O2 - cooling blankets
ACEI - diuretic
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Obesity; increased NE release

18. Tx HTN + CHF
H. flu - S. pneumo - S. aureus - Strep A/B/C
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fasting blood glucose - LFTs - renal function - TSH
ACEI - ARB - B-blocker - diuretic - Spironolactone

19. Statins
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Fasting blood glucose - LFTs - renal function - TSH
100% O2 6L/min - dihydroergotamine - triptans

20. Mastitis tx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Cephalexin OR dicloxacillin
Mass lesion - pseudotumor cerebri - meningitis

21. vertebrobasilar stroke sx
Meningitis - brain abscess - metastasis
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

22. Metabolic syndrome
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Viral infxn of the subglottis
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

23. Causes of diverticular bleeding
Uterine atony
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Barium enema
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

24. Sx normal-pressure hydrocephalus
ACEI - B-blocker - diuretic - Ca-blocker
Dementia - incontinence - gait disturbance
Mass lesion - pseudotumor cerebri - meningitis
PCP pneumonia

25. CXR of CHF
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
= QT / sqrt(RR interval)

26. TCA
H. flu - S. pneumo - S. aureus - Strep A/B/C
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fiber (e.g. psyllium)

27. Bite injury pflx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Quinolone + metronidazole

28. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Neonate - infants - bilious vomiting - abdominal pain
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

29. Intussusception sx
Obesity; NE-uptake inhibition
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

30. Antihypertensives in suspected stroke
IV labetalol - nicardipine - sodium nitroprusside
Septic arthritis - fractures - congenital hip dysplasia
3 hours
Amitriptyline - propanolol - timolol - divalproex sodium

31. Sx of pneumococcal pneumonia
Amiodarone/lidocaine
S. aureus
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

32. Lubiprostone
Viral infxn of the subglottis
Eikenella species
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

33. 'Alarm' sx for upper GI endoscopy
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Obesity; increased NE release
8%
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

34. Stable vtach tx
Meningitis - brain abscess - metastasis
IV labetalol - nicardipine - sodium nitroprusside
Amiodarone/lidocaine
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

35. ROME IBS criteria
Barium enema
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

36. Cluster headache pflx
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Alzheimer dementia

37. Diethylpropion
470ms+ in men - 480ms+ in women
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

38. most common valvular heart defect in USA
Flat disk - button - batteries
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
MVP

39. Empiric CAP tx in hospitalized patient
ACEI - ARB
Fiber (e.g. psyllium)
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
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

40. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Bacterial infxn of supraglottic tissue and surrounding areas
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

41. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Barium enema

42. X-ray epiglottitis

43. Tx mild/infrequent abd pain
ACEI - ARB - B-blocker - diuretic - Spironolactone
Dicyclomine - hyoscyamine (antispasmodics)
Septic arthritis - fractures - congenital hip dysplasia
Fiber (e.g. psyllium)

44. DASH diet plan
Digoxin (B-blockers as needed)
High K - high Ca - low Na
Lumbar puncture
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

45. DDx postoperative fever
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Foot/leg deficits - cognitive + personality changes

46. Standard workup for dyslipidemia
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Venlafaxine - duloxetine - mirtazapine
Fasting blood glucose - LFTs - renal function - TSH

47. Sx HoCM
Lumbar puncture
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Temporal arteritis - mass lesion

48. Headache post-head trauma DDx
High K - high Ca - low Na
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Meningitis - brain abscess - metastasis
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

49. Chronic afib tx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

50. Dx and Tx of intussception
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Barium enema
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion