Test your basic knowledge |

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. Sibutramine
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Legionella
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

2. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
8%
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

3. Tx HTN + CVA
ACEI - diuretic
3 hours
B-blocker - Ca-channel blocker
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

4. Tx HTN + DM
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Septic arthritis - fractures - congenital hip dysplasia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

5. Commonly ingested foreign bodies
Quinolone + metronidazole
Oral prednisone
Flat disk - button - batteries
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

6. Donepezil use/sfx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
MVP
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Obesity; increased NE release

7. DDx Limp w/o pain in children - orthopedic
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
ACEI - ARB - B-blocker - diuretic - Spironolactone

8. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Moderate/severe alzheimer dementia
Obesity; increased NE release
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

9. DDx dementia
ACEI - B-blocker - spironolactone
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Obesity; NE-uptake inhibition
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

10. DDx postoperative fever
Renal parenchymal disease
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
H. flu - S. pneumo - S. aureus - Strep A/B/C
Oral prednisone

11. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Digoxin (B-blockers as needed)

12. 4 T's of postpartum hemorrhage
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Renal parenchymal disease
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

13. Lochia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
3 hours
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

14. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
TCA's
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

15. Croup
Viral infxn of the subglottis
SCFE (slipped capital femoral epiphysis)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Furosemide - nitroglycerin - IV morphine sulphate

16. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

17. contraindications to thrombolytic therapy
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Mass lesion - vascular malformation - stroke - collagen vascular disease
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

18. Croup sx
IV labetalol - nicardipine - sodium nitroprusside
Obesity; NE-uptake inhibition
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
1st line: TZD

19. Galantamine use/sfx
Uterine atony
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Dementia - incontinence - gait disturbance
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

20. New-onset headache in patient with HIV/cancer DDx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Meningitis - brain abscess - metastasis
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
TCA's

21. GI 'alarm' features
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
3rd month postpartum

22. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
ACEI - ARB - B-blocker - diuretic - Spironolactone
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

23. ROME IBS criteria
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Temporal arteritis - mass lesion
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
ACEI - ARB

24. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
SCFE (slipped capital femoral epiphysis)
Cephalexin OR dicloxacillin

25. Statins
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Obesity; NE-uptake inhibition
Obesity; increased NE release

26. Dx subarachnoid hemorrhage with negative noncontrast CT
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Lumbar puncture
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

27. MCC HTN in child
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Renal parenchymal disease
PCP pneumonia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

28. Mastitis tx
Halothane - succinylcholine
8%
Cephalexin OR dicloxacillin
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

29. Tx diverticulitis
SCFE (slipped capital femoral epiphysis)
Quinolone + metronidazole
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Bupriopion - amoxipine - trazodone

30. Tx HTN + post-MI
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
ACEI - B-blocker - spironolactone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

31. Test to best determine source of lower GI bleed
Obesity; increased NE release
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Colonoscopy
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

32. MAOI
Furosemide - nitroglycerin - IV morphine sulphate
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Phenelzine - tranylcypramine
Mass lesion - pseudotumor cerebri - meningitis

33. DDx limp in infant/toddler
PCP pneumonia
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Septic arthritis - fractures - congenital hip dysplasia
Mass lesion - subdural hematoma - medication overuse

34. Sx HoCM
100% O2 6L/min - dihydroergotamine - triptans
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Moderate/severe alzheimer dementia
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

35. Tx mild/infrequent abd pain
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Digoxin (B-blockers as needed)
Dicyclomine - hyoscyamine (antispasmodics)
Barium enema

36. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Meningitis - brain abscess - metastasis
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
8%

37. epiglottitis
Dantrolene IV - antipyretics - O2 - cooling blankets
Bacterial infxn of supraglottic tissue and surrounding areas
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
PCP pneumonia

38. Lubiprostone
Obesity; NE-uptake inhibition
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

39. Drugs causing fever
3rd month postpartum
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Foot/leg deficits - cognitive + personality changes
Colonoscopy

40. MCC infxn in closed-fist injuries
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
470ms+ in men - 480ms+ in women
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Eikenella species

41. Papilledema DDx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Mass lesion - subdural hematoma - medication overuse
Mass lesion - pseudotumor cerebri - meningitis
ACEI - B-blocker - spironolactone

42. Epiglottitis pathogens
Fever - sore throat - muffled voice - drooling - trismus - neck pain
H. flu - S. pneumo - S. aureus - Strep A/B/C
Dantrolene IV - antipyretics - O2 - cooling blankets
High K - high Ca - low Na

43. Sx Lewy Body Dementia
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
3 hours
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

44. Stable vtach tx
Amiodarone/lidocaine
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
H. flu - S. pneumo - S. aureus - Strep A/B/C
Halothane - succinylcholine

45. Headache after 50 YO DDx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Temporal arteritis - mass lesion
Renal parenchymal disease
MVP

46. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Obesity; increased NE release

47. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
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

48. Sx of pneumococcal pneumonia
SCFE (slipped capital femoral epiphysis)
1st line: TZD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

49. atypical
Cephalexin OR dicloxacillin
8%
Bupriopion - amoxipine - trazodone
Obesity; NE-uptake inhibition

50. Causes of diverticular bleeding
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
'steeple-sign' (subglottic narrowing)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV