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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. Refer to cardiologist post-sports physical if ____
Phenelzine - tranylcypramine
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
3 hours

2. SNRI
Venlafaxine - duloxetine - mirtazapine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Amitriptyline - propanolol - timolol - divalproex sodium
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

3. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
10th postpartum day
Legionella
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

4. GI 'alarm' features
10th postpartum day
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Halothane - succinylcholine
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

5. Tx HTN + CVA
Fiber (e.g. psyllium)
ACEI - diuretic
ACEI - ARB - diuretic - Ca-blocker - B-blocker
8%

6. MCC HTN in child
Renal parenchymal disease
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Mass lesion - vascular malformation - stroke - collagen vascular disease

7. Lochia
100% O2 6L/min - dihydroergotamine - triptans
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
'thumb sign' (protrusion of into anterior wall of hypopharynx)

8. Tx acute pulmonary edema 2ndary to CHF
Furosemide - nitroglycerin - IV morphine sulphate
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Uterine atony
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

9. atypical
Oral prednisone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Barium enema
Bupriopion - amoxipine - trazodone

10. Commonly ingested foreign bodies
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Flat disk - button - batteries
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
ACEI - ARB

11. QTc
= QT / sqrt(RR interval)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

12. Intussusception sx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Legionella
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Halothane - succinylcholine

13. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACEI - ARB - diuretic - Ca-blocker - B-blocker
ACEI - B-blocker - diuretic - Ca-blocker

14. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Legionella
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

15. Headaches increasing in severity + intensity DDx
High K - high Ca - low Na
Amitriptyline - propanolol - timolol - divalproex sodium
Dantrolene IV - antipyretics - O2 - cooling blankets
Mass lesion - subdural hematoma - medication overuse

16. Tx HTN + CHF
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
ACEI - ARB - B-blocker - diuretic - Spironolactone
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Venlafaxine - duloxetine - mirtazapine

17. 1st line tx in IBS constipation
Bupriopion - amoxipine - trazodone
Fiber (e.g. psyllium)
Renal parenchymal disease
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

18. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Postpartum fever - uterine tenderness - foul-smelling lochia
PCP pneumonia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

19. CAGE questionnaire
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Obesity; increased NE release
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

20. Cholesterol absorption blocker (ezetimibe)
100% O2 6L/min - dihydroergotamine - triptans
Foot/leg deficits - cognitive + personality changes
Digoxin (B-blockers as needed)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

21. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

22. IBS pain tx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
5-HT blockers: tegasorad - alosetron
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
H. flu - S. pneumo - S. aureus - Strep A/B/C

23. 4 T's of postpartum hemorrhage
Fasting blood glucose - LFTs - renal function - TSH
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Amiodarone/lidocaine
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

24. Pyloric stenosis sx

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25. NMDA-R antagonist (memantine)
Moderate/severe alzheimer dementia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
TCA's

26. Croup X-ray

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27. Focal neurologic sx (other than aura) DDx
ACEI - ARB - B-blocker - diuretic - Spironolactone
1st line: TZD
Mass lesion - vascular malformation - stroke - collagen vascular disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

28. Dx and Tx of intussception
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Barium enema
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
100% O2 6L/min - dihydroergotamine - triptans

29. New-onset headache in patient with HIV/cancer DDx
Meningitis - brain abscess - metastasis
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
'steeple-sign' (subglottic narrowing)
TCA's

30. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
'steeple-sign' (subglottic narrowing)
Mass lesion - vascular malformation - stroke - collagen vascular disease

31. Lubiprostone
Amitriptyline - propanolol - timolol - divalproex sodium
Obesity; increased NE release
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

32. Tx HTN + CAD
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amiodarone/lidocaine
ACEI - B-blocker - diuretic - Ca-blocker
= QT / sqrt(RR interval)

33. MCC non-traumatic hip pathology in adolescents
SCFE (slipped capital femoral epiphysis)
Venlafaxine - duloxetine - mirtazapine
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Halothane - succinylcholine

34. Rivastigmine
5-HT blockers: tegasorad - alosetron
Alzheimer dementia
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
S. aureus

35. Tx mild/infrequent abd pain
PCP pneumonia
Viral infxn of the subglottis
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dicyclomine - hyoscyamine (antispasmodics)

36. ACA stroke ssx
Temporal arteritis - mass lesion
Foot/leg deficits - cognitive + personality changes
= QT / sqrt(RR interval)
10th postpartum day

37. tx malignant hyperthermia
Dantrolene IV - antipyretics - O2 - cooling blankets
Dicyclomine - hyoscyamine (antispasmodics)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Legionella

38. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

39. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Colonoscopy
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Temporal arteritis - mass lesion

40. Antihypertensives in suspected stroke
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Cephalexin OR dicloxacillin
Neonate - infants - bilious vomiting - abdominal pain
IV labetalol - nicardipine - sodium nitroprusside

41. Galantamine use/sfx
Amiodarone/lidocaine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

42. vertebrobasilar stroke sx
Obesity; increased NE release
High K - high Ca - low Na
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

43. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
TCA's
Fasting blood glucose - LFTs - renal function - TSH
Furosemide - nitroglycerin - IV morphine sulphate

44. Phentermine
Obesity; NE-uptake inhibition
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Alzheimer dementia

45. MAOI
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Postpartum fever - uterine tenderness - foul-smelling lochia
Phenelzine - tranylcypramine

46. Tx migraine
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Barium enema

47. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
PCP pneumonia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Meningitis - brain abscess - metastasis

48. Mastitis tx
Cephalexin OR dicloxacillin
H. flu - S. pneumo - S. aureus - Strep A/B/C
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
ACEI - B-blocker - spironolactone

49. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
SCFE (slipped capital femoral epiphysis)
Moderate/severe alzheimer dementia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

50. malignant hyperthermia
Colonoscopy
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Mass lesion - vascular malformation - stroke - collagen vascular disease
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity