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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. Epiglottitis pathogens
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
H. flu - S. pneumo - S. aureus - Strep A/B/C
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

2. Orlistat
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
1st line: TZD
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Fiber (e.g. psyllium)

3. Focal neurologic sx (other than aura) DDx
Venlafaxine - duloxetine - mirtazapine
MVP
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Mass lesion - vascular malformation - stroke - collagen vascular disease

4. Dx subarachnoid hemorrhage with negative noncontrast CT
3 hours
Obesity; NE-uptake inhibition
Lumbar puncture
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

5. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Obesity; increased NE release

6. Sudden-onset headache DDx
Venlafaxine - duloxetine - mirtazapine
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Digoxin (B-blockers as needed)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

7. CAGE questionnaire
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Furosemide - nitroglycerin - IV morphine sulphate

8. MCC non-traumatic hip pathology in adolescents
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Legionella
SCFE (slipped capital femoral epiphysis)
Obesity; NE-uptake inhibition

9. Croup pathogens
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

10. MAOI
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Venlafaxine - duloxetine - mirtazapine
Amiodarone/lidocaine
Phenelzine - tranylcypramine

11. Headaches increasing in severity + intensity DDx
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Fasting blood glucose - LFTs - renal function - TSH
Mass lesion - subdural hematoma - medication overuse
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

12. Headache post-head trauma DDx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Septic arthritis - fractures - congenital hip dysplasia
1st line: TZD
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

13. vertebrobasilar stroke sx
Neonate - infants - bilious vomiting - abdominal pain
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - diuretic

14. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
5-HT blockers: tegasorad - alosetron
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

15. 4 T's of postpartum hemorrhage
Mass lesion - pseudotumor cerebri - meningitis
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Fasting blood glucose - LFTs - renal function - TSH
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

16. Peritonsillar abscess Sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
1st line: TZD
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Fiber (e.g. psyllium)

17. Bite injury pflx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity; NE-uptake inhibition
Uterine atony

18. Phentermine
Obesity; NE-uptake inhibition
Meningitis - brain abscess - metastasis
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

19. IBS pain tx
PCP pneumonia
Fasting blood glucose - LFTs - renal function - TSH
Quinolone + metronidazole
5-HT blockers: tegasorad - alosetron

20. MCC infxn in closed-fist injuries
S. aureus
Bacterial infxn of supraglottic tissue and surrounding areas
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Eikenella species

21. Evaluating limp w/o pain in children
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
10th postpartum day
Amitriptyline - propanolol - timolol - divalproex sodium

22. Tx mild/infrequent abd pain
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
TCA's
Meningitis - brain abscess - metastasis
Dicyclomine - hyoscyamine (antispasmodics)

23. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Septic arthritis - fractures - congenital hip dysplasia
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity; NE-uptake inhibition

24. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

25. X-ray epiglottitis

26. Outpatient tx CHF
Obesity; increased NE release
Bacterial infxn of supraglottic tissue and surrounding areas
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

27. Empiric CAP tx in healthy person
Obesity; increased NE release
Fiber (e.g. psyllium)
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

28. Sx endometritis
Oral prednisone
Dantrolene IV - antipyretics - O2 - cooling blankets
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

29. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Temporal arteritis - mass lesion
Postpartum fever - uterine tenderness - foul-smelling lochia

30. Empiric CAP tx in hospitalized patient
Dantrolene IV - antipyretics - O2 - cooling blankets
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Colonoscopy
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

31. Tx diverticulitis
ACEI - B-blocker - diuretic - Ca-blocker
Phenelzine - tranylcypramine
Mass lesion - pseudotumor cerebri - meningitis
Quinolone + metronidazole

32. Baby blues resolves by ______
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
10th postpartum day
'steeple-sign' (subglottic narrowing)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

33. Metabolic syndrome
Colonoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

34. Croup X-ray

35. Afib - Aflutter tx
Digoxin (B-blockers as needed)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - B-blocker - diuretic - Ca-blocker

36. MCC HTN in child
Alzheimer dementia
Mass lesion - pseudotumor cerebri - meningitis
Renal parenchymal disease
Fasting blood glucose - LFTs - renal function - TSH

37. Croup
Viral infxn of the subglottis
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Alzheimer dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

38. Cluster headache pflx
ACEI - B-blocker - diuretic - Ca-blocker
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Mass lesion - subdural hematoma - medication overuse
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

39. Tx local - acute rxn to bee sting
Oral prednisone
'steeple-sign' (subglottic narrowing)
Lumbar puncture
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

40. Commonly ingested foreign bodies
Flat disk - button - batteries
Digoxin (B-blockers as needed)
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
ACEI - ARB - diuretic - Ca-blocker - B-blocker

41. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
IV labetalol - nicardipine - sodium nitroprusside
Oral prednisone

42. tx malignant hyperthermia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Dantrolene IV - antipyretics - O2 - cooling blankets
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
ACEI - B-blocker - spironolactone

43. If not breast-feeding - when does menstruation restart?
B-blocker - Ca-channel blocker
High K - high Ca - low Na
Renal parenchymal disease
3rd month postpartum

44. Bronchiolitis sx
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Obesity; increased NE release
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - diuretic

45. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Lumbar puncture
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

46. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Moderate/severe alzheimer dementia

47. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
IV labetalol - nicardipine - sodium nitroprusside
Mass lesion - pseudotumor cerebri - meningitis
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

48. Headache after 50 YO DDx
Quinolone + metronidazole
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Alzheimer dementia
Temporal arteritis - mass lesion

49. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Postpartum fever - uterine tenderness - foul-smelling lochia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

50. DDx dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
H. flu - S. pneumo - S. aureus - Strep A/B/C
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV