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Family Medicine/ambulatory 2

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
S. aureus
Mass lesion - pseudotumor cerebri - meningitis
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

2. Bilateral 'ground glass' infiltrate on CXR
Renal parenchymal disease
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
PCP pneumonia
B-blocker - Ca-channel blocker

3. SNRI
Venlafaxine - duloxetine - mirtazapine
Obesity; increased NE release
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACEI - B-blocker - spironolactone

4. MAOI
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Obesity; increased NE release
Oral prednisone
Phenelzine - tranylcypramine

5. Sx of pneumococcal pneumonia
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Legionella
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

6. DDx limp in infant/toddler
Venlafaxine - duloxetine - mirtazapine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Septic arthritis - fractures - congenital hip dysplasia

7. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
3rd month postpartum
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

8. Fibrates
Neonate - infants - bilious vomiting - abdominal pain
Quinolone + metronidazole
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

9. Croup
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Viral infxn of the subglottis

10. MCC HTN in child
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Postpartum fever - uterine tenderness - foul-smelling lochia
Renal parenchymal disease
= QT / sqrt(RR interval)

11. Tx local - acute rxn to bee sting
B-blocker - Ca-channel blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Oral prednisone
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

12. SSRI's
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Barium enema
ACEI - ARB - diuretic - Ca-blocker - B-blocker

13. Drugs causing fever
Bupriopion - amoxipine - trazodone
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

14. Tx HTN + CKD
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Obesity; NE-uptake inhibition
ACEI - ARB
Cephalexin OR dicloxacillin

15. Focal neurologic sx (other than aura) DDx
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Eikenella species
Mass lesion - vascular malformation - stroke - collagen vascular disease

16. Sx HoCM
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release
TCA's
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

17. Dextroamphetamine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Uterine atony
Obesity; increased NE release

18. Croup pathogens
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Septic arthritis - fractures - congenital hip dysplasia

19. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Obesity; increased NE release
ACEI - B-blocker - spironolactone

20. most common valvular heart defect in USA
3rd month postpartum
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
MVP
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

21. causes of malignant hyperthernia
Dicyclomine - hyoscyamine (antispasmodics)
H. flu - S. pneumo - S. aureus - Strep A/B/C
Halothane - succinylcholine
SCFE (slipped capital femoral epiphysis)

22. Tx HTN + DM
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
SCFE (slipped capital femoral epiphysis)
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

23. vertebrobasilar stroke sx
Mass lesion - subdural hematoma - medication overuse
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
PCP pneumonia

24. Croup X-ray

25. Lochia
Fasting blood glucose - LFTs - renal function - TSH
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Obesity; increased NE release
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

26. 4 T's of postpartum hemorrhage
Dementia - incontinence - gait disturbance
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Obesity; increased NE release
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

27. Diethylpropion
Obesity; increased NE release
Oral prednisone
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
SCFE (slipped capital femoral epiphysis)

28. Sx Lewy Body Dementia
Obesity; increased NE release
IV labetalol - nicardipine - sodium nitroprusside
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
B-blocker - Ca-channel blocker

29. Tx HTN + post-MI
Oral prednisone
ACEI - B-blocker - spironolactone
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Legionella

30. Tacrine use/sfx
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Phenelzine - tranylcypramine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

31. DASH diet plan
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
High K - high Ca - low Na
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker

32. Bite injury pflx
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dantrolene IV - antipyretics - O2 - cooling blankets
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

33. Sx normal-pressure hydrocephalus
Dantrolene IV - antipyretics - O2 - cooling blankets
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
100% O2 6L/min - dihydroergotamine - triptans
Dementia - incontinence - gait disturbance

34. Chronic afib tx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
10th postpartum day
3rd month postpartum
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

35. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Bacterial infxn of supraglottic tissue and surrounding areas
'thumb sign' (protrusion of into anterior wall of hypopharynx)

36. Tx frequent/severe abd pain

37. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Fiber (e.g. psyllium)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

38. Chance of pregnancy after a single act of coitus
PCP pneumonia
Postpartum fever - uterine tenderness - foul-smelling lochia
Dantrolene IV - antipyretics - O2 - cooling blankets
8%

39. Pyloric stenosis sx

40. MCA stroke sx
Digoxin (B-blockers as needed)
Postpartum fever - uterine tenderness - foul-smelling lochia
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Quinolone + metronidazole

41. Tx mild/infrequent abd pain
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Alzheimer dementia
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Dicyclomine - hyoscyamine (antispasmodics)

42. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Obesity; increased NE release
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

43. Dx subarachnoid hemorrhage with negative noncontrast CT
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Lumbar puncture
= QT / sqrt(RR interval)

44. Peritonsillar abscess Sx
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Dementia - incontinence - gait disturbance
Postpartum fever - uterine tenderness - foul-smelling lochia

45. Organism that causes pneumonia with diarrhea
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Temporal arteritis - mass lesion
Legionella
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

46. Retropharyngeal abscess Sx
Postpartum fever - uterine tenderness - foul-smelling lochia
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Dicyclomine - hyoscyamine (antispasmodics)
Furosemide - nitroglycerin - IV morphine sulphate

47. atypical
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Bupriopion - amoxipine - trazodone
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Amitriptyline - propanolol - timolol - divalproex sodium

48. Metabolic syndrome
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Fiber (e.g. psyllium)

49. Tx acute pulmonary edema 2ndary to CHF
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Furosemide - nitroglycerin - IV morphine sulphate
Amitriptyline - propanolol - timolol - divalproex sodium

50. CAGE questionnaire
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
S. aureus
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing