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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. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mass lesion - vascular malformation - stroke - collagen vascular disease
SCFE (slipped capital femoral epiphysis)
Meningitis - brain abscess - metastasis

2. Sibutramine
Dantrolene IV - antipyretics - O2 - cooling blankets
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
5-HT blockers: tegasorad - alosetron
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

3. Papilledema DDx
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer dementia
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

4. Sx endometritis
Postpartum fever - uterine tenderness - foul-smelling lochia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Bacterial infxn of supraglottic tissue and surrounding areas
ACEI - diuretic

5. Tx HTN + CKD
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
ACEI - ARB
100% O2 6L/min - dihydroergotamine - triptans
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

6. 1st line tx in IBS constipation
Amiodarone/lidocaine
470ms+ in men - 480ms+ in women
Fiber (e.g. psyllium)
3rd month postpartum

7. Tx local - acute rxn to bee sting
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Oral prednisone
Amitriptyline - propanolol - timolol - divalproex sodium
Bupriopion - amoxipine - trazodone

8. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Mass lesion - pseudotumor cerebri - meningitis
Fiber (e.g. psyllium)
SCFE (slipped capital femoral epiphysis)

9. Galantamine use/sfx
Mass lesion - subdural hematoma - medication overuse
1st line: TZD
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
10th postpartum day

10. DDx pediatric intestinal obsutrction
100% O2 6L/min - dihydroergotamine - triptans
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

11. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - B-blocker - diuretic - Ca-blocker

12. Commonly ingested foreign bodies
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
SCFE (slipped capital femoral epiphysis)
Flat disk - button - batteries
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

13. Dx subarachnoid hemorrhage with negative noncontrast CT
High K - high Ca - low Na
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
TCA's
Lumbar puncture

14. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dantrolene IV - antipyretics - O2 - cooling blankets
Amitriptyline - propanolol - timolol - divalproex sodium
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

15. 'Alarm' sx for upper GI endoscopy
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
100% O2 6L/min - dihydroergotamine - triptans
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

16. Tx HTN + CAD
Lumbar puncture
ACEI - B-blocker - diuretic - Ca-blocker
Dantrolene IV - antipyretics - O2 - cooling blankets
5-HT blockers: tegasorad - alosetron

17. Refer to cardiologist post-sports physical if ____
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
B-blocker - Ca-channel blocker
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

18. Epiglottitis pathogens
Obesity; NE-uptake inhibition
H. flu - S. pneumo - S. aureus - Strep A/B/C
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

19. Tx HTN + CVA
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - diuretic
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

20. most common valvular heart defect in USA
MVP
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer dementia

21. Pyloric stenosis sx

22. Croup X-ray

23. Empiric CAP tx in hospitalized patient
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Legionella
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Obesity; increased NE release

24. CXR of CHF
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
High K - high Ca - low Na
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

25. Bronchiolitis sx
Halothane - succinylcholine
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - ARB

26. Lubiprostone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fasting blood glucose - LFTs - renal function - TSH
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

27. DDx Limp w/o pain in children - orthopedic
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
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
Colonoscopy

28. GI 'alarm' features
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Postpartum fever - uterine tenderness - foul-smelling lochia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

29. Peritonsillar abscess Sx
Uterine atony
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Lumbar puncture

30. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Legionella
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

31. Headache after 50 YO DDx
Temporal arteritis - mass lesion
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

32. New-onset headache in patient with HIV/cancer DDx
Meningitis - brain abscess - metastasis
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

33. Outpatient tx CHF
Mass lesion - pseudotumor cerebri - meningitis
S. aureus
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Moderate/severe alzheimer dementia

34. Bilateral 'ground glass' infiltrate on CXR
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
PCP pneumonia
Dicyclomine - hyoscyamine (antispasmodics)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

35. Sx of pneumococcal pneumonia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Renal parenchymal disease
TCA's

36. DDx limp in infant/toddler
Cephalexin OR dicloxacillin
SCFE (slipped capital femoral epiphysis)
Septic arthritis - fractures - congenital hip dysplasia
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

37. Croup pathogens
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

38. tx malignant hyperthermia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Dantrolene IV - antipyretics - O2 - cooling blankets
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

39. Phendimetrazine
Obesity; increased NE release
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Postpartum fever - uterine tenderness - foul-smelling lochia
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

40. Orlistat
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Renal parenchymal disease

41. Tx frequent/severe abd pain

42. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Obesity; increased NE release

43. Dextroamphetamine
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Obesity; increased NE release
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

44. If not breast-feeding - when does menstruation restart?
3rd month postpartum
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
SCFE (slipped capital femoral epiphysis)
Septic arthritis - fractures - congenital hip dysplasia

45. atypical
Foot/leg deficits - cognitive + personality changes
Bupriopion - amoxipine - trazodone
Fasting blood glucose - LFTs - renal function - TSH
100% O2 6L/min - dihydroergotamine - triptans

46. Baby blues resolves by ______
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
10th postpartum day
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

47. Prolonged QT interval (QTc)
ACEI - diuretic
470ms+ in men - 480ms+ in women
Lumbar puncture
Legionella

48. QTc
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Colonoscopy
= QT / sqrt(RR interval)
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

49. ROME IBS criteria
Foot/leg deficits - cognitive + personality changes
Flat disk - button - batteries
S. aureus
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

50. Tx HTN + post-MI
Venlafaxine - duloxetine - mirtazapine
ACEI - ARB - diuretic - Ca-blocker - B-blocker
ACEI - B-blocker - spironolactone
470ms+ in men - 480ms+ in women