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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. Antihypertensives in suspected stroke
Postpartum fever - uterine tenderness - foul-smelling lochia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
IV labetalol - nicardipine - sodium nitroprusside
3 hours

2. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
TCA's
Septic arthritis - fractures - congenital hip dysplasia
High K - high Ca - low Na

3. causes of malignant hyperthernia
Halothane - succinylcholine
= QT / sqrt(RR interval)
Septic arthritis - fractures - congenital hip dysplasia
ACEI - ARB

4. Headache post-head trauma DDx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Dementia - incontinence - gait disturbance
Viral infxn of the subglottis
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

5. Tx uterine atony
Fasting blood glucose - LFTs - renal function - TSH
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
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
5-HT blockers: tegasorad - alosetron

6. Croup sx
Foot/leg deficits - cognitive + personality changes
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Quinolone + metronidazole
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

7. Organism that causes pneumonia post-influenza
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Venlafaxine - duloxetine - mirtazapine
Renal parenchymal disease
S. aureus

8. CAGE questionnaire
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Eikenella species
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

9. TCA
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Moderate/severe alzheimer dementia
B-blocker - Ca-channel blocker

10. Tx diverticulitis
Digoxin (B-blockers as needed)
Fasting blood glucose - LFTs - renal function - TSH
Quinolone + metronidazole
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

11. Epiglottitis pathogens
Bupriopion - amoxipine - trazodone
H. flu - S. pneumo - S. aureus - Strep A/B/C
Dicyclomine - hyoscyamine (antispasmodics)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

12. Tx migraine
1st line: TZD
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

13. Evaluating limp w/o pain in children
Halothane - succinylcholine
10th postpartum day
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Foot/leg deficits - cognitive + personality changes

14. Stable vtach tx
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
Furosemide - nitroglycerin - IV morphine sulphate
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amiodarone/lidocaine

15. SSRI's
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Eikenella species
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACEI - B-blocker - spironolactone

16. Dx and Tx of intussception
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
TCA's
Barium enema
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

17. Empiric CAP tx in healthy person
'thumb sign' (protrusion of into anterior wall of hypopharynx)
10th postpartum day
Obesity; increased NE release
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

18. Baby blues resolves by ______
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACEI - B-blocker - diuretic - Ca-blocker
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
10th postpartum day

19. Tx mild/infrequent abd pain
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Dicyclomine - hyoscyamine (antispasmodics)
470ms+ in men - 480ms+ in women

20. rtPA should be used within ____ of stroke
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Viral infxn of the subglottis
3 hours
Quinolone + metronidazole

21. epiglottitis
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Amiodarone/lidocaine
MVP
Bacterial infxn of supraglottic tissue and surrounding areas

22. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Lumbar puncture
'steeple-sign' (subglottic narrowing)

23. Donepezil use/sfx
Venlafaxine - duloxetine - mirtazapine
Dementia - incontinence - gait disturbance
Cephalexin OR dicloxacillin
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

24. Phentermine
Dantrolene IV - antipyretics - O2 - cooling blankets
Cephalexin OR dicloxacillin
Obesity; NE-uptake inhibition
ACEI - diuretic

25. Sibutramine
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
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

26. Nicotinic acids
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity; NE-uptake inhibition

27. Sx HoCM
Fasting blood glucose - LFTs - renal function - TSH
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Dementia - incontinence - gait disturbance

28. Refer to cardiologist post-sports physical if ____
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Dementia - incontinence - gait disturbance
Legionella

29. Sx Lewy Body Dementia
MVP
100% O2 6L/min - dihydroergotamine - triptans
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

30. Cholesterol absorption blocker (ezetimibe)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
3rd month postpartum
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

31. 'Alarm' sx for upper GI endoscopy
Halothane - succinylcholine
Furosemide - nitroglycerin - IV morphine sulphate
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
High K - high Ca - low Na

32. Tx HTN + CKD
ACEI - ARB
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
High K - high Ca - low Na
Furosemide - nitroglycerin - IV morphine sulphate

33. Tx frequent/severe abd pain

34. Diethylpropion
Obesity; increased NE release
'thumb sign' (protrusion of into anterior wall of hypopharynx)
'steeple-sign' (subglottic narrowing)
ACEI - ARB

35. MCC postpartum hemorrhage
ACEI - B-blocker - spironolactone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Dantrolene IV - antipyretics - O2 - cooling blankets
Uterine atony

36. MCA stroke sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACEI - ARB - B-blocker - diuretic - Spironolactone
Fiber (e.g. psyllium)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

37. Lubiprostone
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

38. MCC infxn in closed-fist injuries
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Eikenella species
8%
Amiodarone/lidocaine

39. 1st line tx in IBS constipation
Uterine atony
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Fiber (e.g. psyllium)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

40. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Dicyclomine - hyoscyamine (antispasmodics)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

41. Tx local - acute rxn to bee sting
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Oral prednisone

42. Cardiac Resynchronization Therapy (CRT) is warranted when ___
SCFE (slipped capital femoral epiphysis)
Temporal arteritis - mass lesion
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

43. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
470ms+ in men - 480ms+ in women
Lumbar puncture
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

44. NMDA-R antagonist (memantine)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Moderate/severe alzheimer dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
S. aureus

45. MCC HTN in child
Uterine atony
Renal parenchymal disease
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Legionella

46. Papilledema DDx
TCA's
MVP
Flat disk - button - batteries
Mass lesion - pseudotumor cerebri - meningitis

47. Pyloric stenosis sx

48. DDx pediatric intestinal obsutrction
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
3 hours
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

49. Primary SVT tx
B-blocker - Ca-channel blocker
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Moderate/severe alzheimer dementia
ACEI - B-blocker - diuretic - Ca-blocker

50. Mastitis tx
Cephalexin OR dicloxacillin
Oral prednisone
Temporal arteritis - mass lesion
Bupriopion - amoxipine - trazodone