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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. Tx HTN
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
1st line: TZD
ACEI - diuretic
PCP pneumonia

2. Baby blues resolves by ______
10th postpartum day
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
3rd month postpartum

3. Croup pathogens
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
Obesity; increased NE release
Obesity; increased NE release
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

4. Bronchiolitis sx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Quinolone + metronidazole
Alzheimer dementia

5. Pflx migraine
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Meningitis - brain abscess - metastasis
Amitriptyline - propanolol - timolol - divalproex sodium
ACEI - ARB - B-blocker - diuretic - Spironolactone

6. causes of malignant hyperthernia
Halothane - succinylcholine
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Obesity; increased NE release

7. DASH diet plan
Amiodarone/lidocaine
High K - high Ca - low Na
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

8. Fibrates
Digoxin (B-blockers as needed)
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
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Fasting blood glucose - LFTs - renal function - TSH

9. Prolonged QT interval (QTc)
Lumbar puncture
ACEI - ARB - B-blocker - diuretic - Spironolactone
S. aureus
470ms+ in men - 480ms+ in women

10. Headaches increasing in severity + intensity DDx
H. flu - S. pneumo - S. aureus - Strep A/B/C
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Mass lesion - subdural hematoma - medication overuse

11. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Foot/leg deficits - cognitive + personality changes
Dantrolene IV - antipyretics - O2 - cooling blankets

12. Refer to cardiologist post-sports physical if ____
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Cephalexin OR dicloxacillin
Phenelzine - tranylcypramine

13. Croup sx
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
= QT / sqrt(RR interval)

14. Cluster headache pflx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Dicyclomine - hyoscyamine (antispasmodics)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

15. MCC infxn in closed-fist injuries
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Quinolone + metronidazole
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Eikenella species

16. rtPA should be used within ____ of stroke
Dementia - incontinence - gait disturbance
3 hours
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Cephalexin OR dicloxacillin

17. Phendimetrazine
Lumbar puncture
High K - high Ca - low Na
Obesity; increased NE release
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

18. MCA stroke sx
Neonate - infants - bilious vomiting - abdominal pain
MVP
Digoxin (B-blockers as needed)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

19. Empiric CAP tx in hospitalized patient
Temporal arteritis - mass lesion
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
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

20. DDx Limp w/o pain in children - orthopedic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Obesity; increased NE release
5-HT blockers: tegasorad - alosetron
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

21. Outpatient tx CHF
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
S. aureus
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

22. atypical
Bupriopion - amoxipine - trazodone
Renal parenchymal disease
Quinolone + metronidazole
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

23. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Furosemide - nitroglycerin - IV morphine sulphate

24. Evaluating limp w/o pain in children
Quinolone + metronidazole
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
8%
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

25. Dx subarachnoid hemorrhage with negative noncontrast CT
Meningitis - brain abscess - metastasis
3rd month postpartum
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Lumbar puncture

26. NMDA-R antagonist (memantine)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Moderate/severe alzheimer dementia
Phenelzine - tranylcypramine
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

27. Standard workup for dyslipidemia
TCA's
Obesity; increased NE release
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Fasting blood glucose - LFTs - renal function - TSH

28. Orlistat
Mass lesion - pseudotumor cerebri - meningitis
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

29. Test to best determine source of lower GI bleed
Fiber (e.g. psyllium)
Colonoscopy
8%
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

30. Metabolic syndrome
Amitriptyline - propanolol - timolol - divalproex sodium
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

31. 1st line tx in IBS constipation
= QT / sqrt(RR interval)
Fiber (e.g. psyllium)
Dicyclomine - hyoscyamine (antispasmodics)
Postpartum fever - uterine tenderness - foul-smelling lochia

32. Focal neurologic sx (other than aura) DDx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Mass lesion - vascular malformation - stroke - collagen vascular disease
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Bacterial infxn of supraglottic tissue and surrounding areas

33. Cluster headache acute tx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
100% O2 6L/min - dihydroergotamine - triptans
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

34. Bilateral 'ground glass' infiltrate on CXR
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
PCP pneumonia
Bacterial infxn of supraglottic tissue and surrounding areas

35. Galantamine use/sfx
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Alzheimer dementia
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

36. DDx dementia
Colonoscopy
Barium enema
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Renal parenchymal disease

37. Tx HTN + post-MI
Foot/leg deficits - cognitive + personality changes
ACEI - B-blocker - spironolactone
IV labetalol - nicardipine - sodium nitroprusside
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

38. Antihypertensives in suspected stroke
Obesity; NE-uptake inhibition
Digoxin (B-blockers as needed)
IV labetalol - nicardipine - sodium nitroprusside
Fasting blood glucose - LFTs - renal function - TSH

39. Pyloric stenosis sx

40. Lochia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Barium enema
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

41. Malrotation sx
Lumbar puncture
S. aureus
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Neonate - infants - bilious vomiting - abdominal pain

42. Causes of diverticular bleeding
Obesity; increased NE release
TCA's
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Dantrolene IV - antipyretics - O2 - cooling blankets

43. Dextroamphetamine
ACEI - diuretic
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Obesity; increased NE release

44. Sibutramine
Postpartum fever - uterine tenderness - foul-smelling lochia
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
ACEI - B-blocker - spironolactone
Fiber (e.g. psyllium)

45. Tx HTN + CHF
H. flu - S. pneumo - S. aureus - Strep A/B/C
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - ARB - B-blocker - diuretic - Spironolactone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

46. MAOI
Phenelzine - tranylcypramine
TCA's
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

47. CXR of CHF
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
S. aureus
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

48. DDx limp in infant/toddler
Mass lesion - subdural hematoma - medication overuse
10th postpartum day
Septic arthritis - fractures - congenital hip dysplasia
'steeple-sign' (subglottic narrowing)

49. Commonly ingested foreign bodies
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Fasting blood glucose - LFTs - renal function - TSH
ACEI - B-blocker - diuretic - Ca-blocker
Flat disk - button - batteries

50. MCC postpartum hemorrhage
Uterine atony
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Obesity; increased NE release
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache