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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. MCC infxn in closed-fist injuries
B-blocker - Ca-channel blocker
Obesity; increased NE release
Eikenella species
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

2. Sx of pneumococcal pneumonia
Renal parenchymal disease
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Dicyclomine - hyoscyamine (antispasmodics)

3. Pflx migraine
H. flu - S. pneumo - S. aureus - Strep A/B/C
Legionella
Amitriptyline - propanolol - timolol - divalproex sodium
ACEI - ARB - B-blocker - diuretic - Spironolactone

4. Tacrine use/sfx
Dicyclomine - hyoscyamine (antispasmodics)
Bacterial infxn of supraglottic tissue and surrounding areas
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
10th postpartum day

5. Baby blues resolves by ______
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
10th postpartum day
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

6. ROME IBS criteria
'steeple-sign' (subglottic narrowing)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
3rd month postpartum
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

7. Antihypertensives in suspected stroke
IV labetalol - nicardipine - sodium nitroprusside
Bupriopion - amoxipine - trazodone
Legionella
10th postpartum day

8. Phentermine
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity; NE-uptake inhibition
Viral infxn of the subglottis
S. aureus

9. Dx subarachnoid hemorrhage with negative noncontrast CT
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Lumbar puncture
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
H. flu - S. pneumo - S. aureus - Strep A/B/C

10. MAOI
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Phenelzine - tranylcypramine
Colonoscopy

11. Causes of diverticular bleeding
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

12. 1st line tx in IBS constipation
S. aureus
Fiber (e.g. psyllium)
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

13. Lubiprostone
Mass lesion - subdural hematoma - medication overuse
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Mass lesion - pseudotumor cerebri - meningitis

14. Tx acute pulmonary edema 2ndary to CHF
Furosemide - nitroglycerin - IV morphine sulphate
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

15. Epiglottitis pathogens
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
H. flu - S. pneumo - S. aureus - Strep A/B/C

16. Peritonsillar abscess Sx
Obesity; increased NE release
= QT / sqrt(RR interval)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fever - sore throat - muffled voice - drooling - trismus - neck pain

17. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

18. Tx diverticulitis
Uterine atony
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Quinolone + metronidazole
ACEI - ARB - B-blocker - diuretic - Spironolactone

19. Croup
Viral infxn of the subglottis
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

20. TCA
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fasting blood glucose - LFTs - renal function - TSH

21. Phendimetrazine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release

22. Headache with sx systemic illness DDx
10th postpartum day
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

23. Retropharyngeal abscess Sx
5-HT blockers: tegasorad - alosetron
Obesity; NE-uptake inhibition
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

24. Bite injury pflx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Mass lesion - vascular malformation - stroke - collagen vascular disease
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

25. Papilledema DDx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Mass lesion - pseudotumor cerebri - meningitis

26. Test to best determine source of lower GI bleed
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
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Colonoscopy

27. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
Phenelzine - tranylcypramine
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Halothane - succinylcholine

28. DDx Limp w/o pain in children - orthopedic
Legionella
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Foot/leg deficits - cognitive + personality changes

29. Fibrates
Temporal arteritis - mass lesion
Dementia - incontinence - gait disturbance
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

30. Commonly ingested foreign bodies
Flat disk - button - batteries
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Septic arthritis - fractures - congenital hip dysplasia

31. DDx pediatric intestinal obsutrction
TCA's
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Eikenella species

32. Empiric CAP tx in hospitalized patient
Furosemide - nitroglycerin - IV morphine sulphate
Renal parenchymal disease
'steeple-sign' (subglottic narrowing)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

33. NMDA-R antagonist (memantine)
Obesity; increased NE release
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Moderate/severe alzheimer dementia
Bacterial infxn of supraglottic tissue and surrounding areas

34. Rivastigmine
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Alzheimer dementia
Bacterial infxn of supraglottic tissue and surrounding areas

35. Sx endometritis
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
ACEI - ARB
Furosemide - nitroglycerin - IV morphine sulphate
Postpartum fever - uterine tenderness - foul-smelling lochia

36. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
5-HT blockers: tegasorad - alosetron
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

37. Cluster headache pflx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Postpartum fever - uterine tenderness - foul-smelling lochia
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Fiber (e.g. psyllium)

38. Mastitis tx
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Cephalexin OR dicloxacillin
Neonate - infants - bilious vomiting - abdominal pain
Fiber (e.g. psyllium)

39. contraindications to thrombolytic therapy
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Flat disk - button - batteries
Legionella

40. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
= QT / sqrt(RR interval)
Barium enema
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

41. Primary SVT tx
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Fiber (e.g. psyllium)
ACEI - diuretic
B-blocker - Ca-channel blocker

42. Diethylpropion
Obesity; increased NE release
High K - high Ca - low Na
Dicyclomine - hyoscyamine (antispasmodics)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

43. X-ray epiglottitis

44. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Fiber (e.g. psyllium)
Halothane - succinylcholine
Obesity; increased NE release

45. Tx local - acute rxn to bee sting
Oral prednisone
ACEI - B-blocker - spironolactone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - diuretic

46. SNRI
Dementia - incontinence - gait disturbance
Fasting blood glucose - LFTs - renal function - TSH
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Venlafaxine - duloxetine - mirtazapine

47. most common valvular heart defect in USA
Fiber (e.g. psyllium)
MVP
S. aureus
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

48. Cholesterol absorption blocker (ezetimibe)
S. aureus
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

49. DDx dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Quinolone + metronidazole
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

50. CXR of CHF
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Barium enema
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement