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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. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
10th postpartum day
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
SCFE (slipped capital femoral epiphysis)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

2. Organism that causes pneumonia with diarrhea
Legionella
Colonoscopy
Mass lesion - subdural hematoma - medication overuse
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

3. Cluster headache acute tx
Mass lesion - subdural hematoma - medication overuse
H. flu - S. pneumo - S. aureus - Strep A/B/C
100% O2 6L/min - dihydroergotamine - triptans
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

4. Diethylpropion
Obesity; increased NE release
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

5. QTc
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
ACEI - ARB
= QT / sqrt(RR interval)
Fiber (e.g. psyllium)

6. New-onset headache in patient with HIV/cancer DDx
Meningitis - brain abscess - metastasis
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
SCFE (slipped capital femoral epiphysis)
Alzheimer dementia

7. Commonly ingested foreign bodies
Flat disk - button - batteries
Dementia - incontinence - gait disturbance
'steeple-sign' (subglottic narrowing)
8%

8. epiglottitis
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Bacterial infxn of supraglottic tissue and surrounding areas
B-blocker - Ca-channel blocker
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

9. DDx Limp w/o pain in children - orthopedic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
High K - high Ca - low Na
= QT / sqrt(RR interval)
Dantrolene IV - antipyretics - O2 - cooling blankets

10. Empiric CAP tx in hospitalized patient
Uterine atony
Dementia - incontinence - gait disturbance
Dicyclomine - hyoscyamine (antispasmodics)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

11. Nicotinic acids
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

12. Croup
3rd month postpartum
Cephalexin OR dicloxacillin
Renal parenchymal disease
Viral infxn of the subglottis

13. Phentermine
Obesity; NE-uptake inhibition
Digoxin (B-blockers as needed)
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
MVP

14. Lochia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Digoxin (B-blockers as needed)
ACEI - diuretic

15. tx malignant hyperthermia
8%
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Dantrolene IV - antipyretics - O2 - cooling blankets
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

16. Headache after 50 YO DDx
Temporal arteritis - mass lesion
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Viral infxn of the subglottis
1st line: TZD

17. Orlistat
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
3rd month postpartum
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

18. Mastitis tx
High K - high Ca - low Na
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Cephalexin OR dicloxacillin
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

19. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Mass lesion - pseudotumor cerebri - meningitis
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

20. vertebrobasilar stroke sx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Moderate/severe alzheimer dementia
10th postpartum day
Furosemide - nitroglycerin - IV morphine sulphate

21. Headache post-head trauma DDx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
PCP pneumonia

22. Malrotation sx
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Neonate - infants - bilious vomiting - abdominal pain
Amiodarone/lidocaine

23. MCC infxn in closed-fist injuries
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Bupriopion - amoxipine - trazodone
Eikenella species
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

24. SNRI
ACEI - ARB - B-blocker - diuretic - Spironolactone
Venlafaxine - duloxetine - mirtazapine
Amiodarone/lidocaine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

25. DDx limp in infant/toddler
Lumbar puncture
Legionella
Septic arthritis - fractures - congenital hip dysplasia
Eikenella species

26. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Amitriptyline - propanolol - timolol - divalproex sodium
Moderate/severe alzheimer dementia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

27. Tx migraine
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

28. Tx HTN + post-MI
Amiodarone/lidocaine
ACEI - B-blocker - diuretic - Ca-blocker
ACEI - B-blocker - spironolactone
Eikenella species

29. Pyloric stenosis sx

30. MCC non-traumatic hip pathology in adolescents
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
SCFE (slipped capital femoral epiphysis)
Amitriptyline - propanolol - timolol - divalproex sodium
High K - high Ca - low Na

31. Cholesterol absorption blocker (ezetimibe)
Temporal arteritis - mass lesion
TCA's
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

32. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
= QT / sqrt(RR interval)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

33. Causes of diverticular bleeding
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Bupriopion - amoxipine - trazodone

34. Fibrates
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Bacterial infxn of supraglottic tissue and surrounding areas
100% O2 6L/min - dihydroergotamine - triptans

35. most common valvular heart defect in USA
ACEI - B-blocker - diuretic - Ca-blocker
MVP
ACEI - ARB - B-blocker - diuretic - Spironolactone
10th postpartum day

36. Tx HTN + CAD
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
MVP
ACEI - B-blocker - diuretic - Ca-blocker

37. Statins
PCP pneumonia
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Legionella
Oral prednisone

38. Phendimetrazine
1st line: TZD
3 hours
470ms+ in men - 480ms+ in women
Obesity; increased NE release

39. Epiglottitis pathogens
B-blocker - Ca-channel blocker
MVP
10th postpartum day
H. flu - S. pneumo - S. aureus - Strep A/B/C

40. CAGE questionnaire
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

41. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
3 hours
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

42. DASH diet plan
Eikenella species
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
High K - high Ca - low Na
ACEI - B-blocker - diuretic - Ca-blocker

43. Standard workup for dyslipidemia
Colonoscopy
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fasting blood glucose - LFTs - renal function - TSH
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

44. Focal neurologic sx (other than aura) DDx
SCFE (slipped capital femoral epiphysis)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Furosemide - nitroglycerin - IV morphine sulphate

45. Peritonsillar abscess Sx
Fiber (e.g. psyllium)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Digoxin (B-blockers as needed)

46. Bronchiolitis sx
High K - high Ca - low Na
Dicyclomine - hyoscyamine (antispasmodics)
Obesity; NE-uptake inhibition
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

47. Test to best determine source of lower GI bleed
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Foot/leg deficits - cognitive + personality changes
Colonoscopy
Bupriopion - amoxipine - trazodone

48. SSRI's
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - subdural hematoma - medication overuse
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

49. Evaluating limp w/o pain in children
H. flu - S. pneumo - S. aureus - Strep A/B/C
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

50. Headaches increasing in severity + intensity DDx
Halothane - succinylcholine
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
Viral infxn of the subglottis
Mass lesion - subdural hematoma - medication overuse