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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. Tx acute pulmonary edema 2ndary to CHF
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity; increased NE release
Bacterial infxn of supraglottic tissue and surrounding areas
Furosemide - nitroglycerin - IV morphine sulphate

2. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

3. Organism that causes pneumonia post-influenza
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
S. aureus
MVP

4. Chance of pregnancy after a single act of coitus
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
8%
1st line: TZD
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

5. MCC HTN in child
Eikenella species
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Fasting blood glucose - LFTs - renal function - TSH
Renal parenchymal disease

6. Headache with sx systemic illness DDx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Temporal arteritis - mass lesion

7. DASH diet plan
High K - high Ca - low Na
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
1st line: TZD

8. Sx HoCM
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
3rd month postpartum

9. DDx dementia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

10. Dx subarachnoid hemorrhage with negative noncontrast CT
Lumbar puncture
100% O2 6L/min - dihydroergotamine - triptans
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Dementia - incontinence - gait disturbance

11. 4 T's of postpartum hemorrhage
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

12. DDx limp in infant/toddler
Mass lesion - pseudotumor cerebri - meningitis
Septic arthritis - fractures - congenital hip dysplasia
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

13. Croup sx
470ms+ in men - 480ms+ in women
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Obesity; increased NE release

14. atypical
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Bupriopion - amoxipine - trazodone

15. Pyloric stenosis sx

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16. Organism that causes pneumonia with diarrhea
Mass lesion - vascular malformation - stroke - collagen vascular disease
Obesity; increased NE release
470ms+ in men - 480ms+ in women
Legionella

17. Bite injury pflx
Barium enema
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

18. TCA
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Barium enema
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

19. Malrotation sx
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Neonate - infants - bilious vomiting - abdominal pain
Mass lesion - pseudotumor cerebri - meningitis

20. Tx uterine atony
H. flu - S. pneumo - S. aureus - Strep A/B/C
ACEI - B-blocker - spironolactone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular 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

21. X-ray epiglottitis

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22. causes of malignant hyperthernia
Halothane - succinylcholine
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

23. Tx local - acute rxn to bee sting
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Lumbar puncture
Neonate - infants - bilious vomiting - abdominal pain
Oral prednisone

24. MAOI
High K - high Ca - low Na
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Phenelzine - tranylcypramine
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

25. Epiglottitis pathogens
1st line: TZD
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
H. flu - S. pneumo - S. aureus - Strep A/B/C
3 hours

26. Phendimetrazine
Obesity; increased NE release
Mass lesion - vascular malformation - stroke - collagen vascular disease
Neonate - infants - bilious vomiting - abdominal pain
Dantrolene IV - antipyretics - O2 - cooling blankets

27. Croup X-ray

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28. Primary SVT tx
PCP pneumonia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
B-blocker - Ca-channel blocker
Legionella

29. CAGE questionnaire
Obesity; NE-uptake inhibition
S. aureus
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

30. Retropharyngeal abscess Sx
Bacterial infxn of supraglottic tissue and surrounding areas
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

31. Refer to cardiologist post-sports physical if ____
ACEI - diuretic
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
ACEI - B-blocker - diuretic - Ca-blocker
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

32. Bronchiolitis sx
10th postpartum day
Cephalexin OR dicloxacillin
ACEI - B-blocker - spironolactone
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

33. Outpatient tx CHF
Legionella
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Meningitis - brain abscess - metastasis

34. MCA stroke sx
Meningitis - brain abscess - metastasis
H. flu - S. pneumo - S. aureus - Strep A/B/C
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

35. Cluster headache pflx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

36. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Obesity; NE-uptake inhibition

37. Tx migraine
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Obesity; NE-uptake inhibition

38. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

39. Tx HTN + CKD
Mass lesion - pseudotumor cerebri - meningitis
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Quinolone + metronidazole
ACEI - ARB

40. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
H. flu - S. pneumo - S. aureus - Strep A/B/C
Postpartum fever - uterine tenderness - foul-smelling lochia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

41. Tx HTN + CAD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - B-blocker - diuretic - Ca-blocker
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

42. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

43. Standard workup for dyslipidemia
SCFE (slipped capital femoral epiphysis)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fasting blood glucose - LFTs - renal function - TSH
ACEI - ARB

44. malignant hyperthermia
1st line: TZD
Legionella
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

45. Sx normal-pressure hydrocephalus
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Dementia - incontinence - gait disturbance
'steeple-sign' (subglottic narrowing)

46. MCC non-traumatic hip pathology in adolescents
Uterine atony
SCFE (slipped capital femoral epiphysis)
Flat disk - button - batteries
Fiber (e.g. psyllium)

47. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

48. Cluster headache acute tx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
100% O2 6L/min - dihydroergotamine - triptans
Legionella

49. Rivastigmine
Alzheimer dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

50. Papilledema DDx
Mass lesion - pseudotumor cerebri - meningitis
Furosemide - nitroglycerin - IV morphine sulphate
Dementia - incontinence - gait disturbance
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)