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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. X-ray epiglottitis

2. Cluster headache pflx
Postpartum fever - uterine tenderness - foul-smelling lochia
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
3rd month postpartum
Obesity; NE-uptake inhibition

3. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
Neonate - infants - bilious vomiting - abdominal pain
Dicyclomine - hyoscyamine (antispasmodics)
Mass lesion - subdural hematoma - medication overuse

4. epiglottitis
Bacterial infxn of supraglottic tissue and surrounding areas
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Fiber (e.g. psyllium)

5. Lubiprostone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
ACEI - ARB - B-blocker - diuretic - Spironolactone

6. Tacrine use/sfx
Dicyclomine - hyoscyamine (antispasmodics)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
3rd month postpartum

7. Tx mild/infrequent abd pain
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
ACEI - ARB - B-blocker - diuretic - Spironolactone
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Dicyclomine - hyoscyamine (antispasmodics)

8. Headache post-head trauma DDx
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Legionella
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

9. New-onset headache in patient with HIV/cancer DDx
TCA's
Obesity; increased NE release
Meningitis - brain abscess - metastasis
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

10. Tx migraine
ACEI - B-blocker - spironolactone
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - diuretic
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

11. Headache after 50 YO DDx
S. aureus
Temporal arteritis - mass lesion
Mass lesion - vascular malformation - stroke - collagen vascular disease
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

12. vertebrobasilar stroke sx
Flat disk - button - batteries
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

13. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
PCP pneumonia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

14. MCC infxn in closed-fist injuries
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - diuretic
100% O2 6L/min - dihydroergotamine - triptans
Eikenella species

15. Rivastigmine
Alzheimer dementia
ACEI - ARB - diuretic - Ca-blocker - B-blocker
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

16. Headache with sx systemic illness DDx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
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
= QT / sqrt(RR interval)

17. Headaches increasing in severity + intensity DDx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Mass lesion - subdural hematoma - medication overuse
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Viral infxn of the subglottis

18. most common valvular heart defect in USA
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - ARB - diuretic - Ca-blocker - B-blocker
MVP

19. Tx HTN
8%
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
1st line: TZD

20. Diethylpropion
Obesity; increased NE release
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Alzheimer dementia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

21. Intussusception sx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

22. Evaluating limp w/o pain in children
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

23. Phendimetrazine
1st line: TZD
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Obesity; increased NE release

24. CAGE questionnaire
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
= QT / sqrt(RR interval)
IV labetalol - nicardipine - sodium nitroprusside

25. Croup X-ray

26. Prolonged QT interval (QTc)
Neonate - infants - bilious vomiting - abdominal pain
470ms+ in men - 480ms+ in women
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - pseudotumor cerebri - meningitis

27. SNRI
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Venlafaxine - duloxetine - mirtazapine

28. Fibrates
ACEI - B-blocker - spironolactone
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Septic arthritis - fractures - congenital hip dysplasia
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

29. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Cephalexin OR dicloxacillin
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Viral infxn of the subglottis

30. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Dicyclomine - hyoscyamine (antispasmodics)
Eikenella species

31. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
100% O2 6L/min - dihydroergotamine - triptans
Uterine atony
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

32. Dx and Tx of intussception
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Barium enema
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
= QT / sqrt(RR interval)

33. Commonly ingested foreign bodies
Quinolone + metronidazole
Septic arthritis - fractures - congenital hip dysplasia
Flat disk - button - batteries
ACEI - ARB

34. Drugs causing fever
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Septic arthritis - fractures - congenital hip dysplasia

35. Causes of diverticular bleeding
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Colonoscopy

36. TCA
S. aureus
470ms+ in men - 480ms+ in women
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

37. Phentermine
Furosemide - nitroglycerin - IV morphine sulphate
Lumbar puncture
Obesity; NE-uptake inhibition
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

38. Croup pathogens
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Furosemide - nitroglycerin - IV morphine sulphate
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

39. Sx of pneumococcal pneumonia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

40. Tx local - acute rxn to bee sting
ACEI - ARB - B-blocker - diuretic - Spironolactone
Oral prednisone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

41. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
5-HT blockers: tegasorad - alosetron
S. aureus

42. Cholesterol absorption blocker (ezetimibe)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
ACEI - diuretic
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

43. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Quinolone + metronidazole
Fasting blood glucose - LFTs - renal function - TSH
1st line: TZD

44. 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
Obesity; increased NE release
TCA's

45. Focal neurologic sx (other than aura) DDx
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - B-blocker - diuretic - Ca-blocker
Viral infxn of the subglottis
H. flu - S. pneumo - S. aureus - Strep A/B/C

46. MAOI
Phenelzine - tranylcypramine
Halothane - succinylcholine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
'thumb sign' (protrusion of into anterior wall of hypopharynx)

47. Tx HTN + post-MI
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Legionella
ACEI - B-blocker - spironolactone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

48. ROME IBS criteria
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
PCP pneumonia
Dicyclomine - hyoscyamine (antispasmodics)

49. Antihypertensives in suspected stroke
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
1st line: TZD
Barium enema
IV labetalol - nicardipine - sodium nitroprusside

50. Bite injury pflx
8%
Septic arthritis - fractures - congenital hip dysplasia
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Moderate/severe alzheimer dementia