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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. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
ACEI - B-blocker - diuretic - Ca-blocker
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Temporal arteritis - mass lesion

2. causes of malignant hyperthernia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Halothane - succinylcholine
Viral infxn of the subglottis
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

3. DASH diet plan
Postpartum fever - uterine tenderness - foul-smelling lochia
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
High K - high Ca - low Na
ACEI - B-blocker - diuretic - Ca-blocker

4. Tx HTN + CAD
'thumb sign' (protrusion of into anterior wall of hypopharynx)
B-blocker - Ca-channel blocker
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - B-blocker - diuretic - Ca-blocker

5. Tx frequent/severe abd pain

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6. Baby blues resolves by ______
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
10th postpartum day
Fever - sore throat - muffled voice - drooling - trismus - neck pain

7. MCC HTN in child
Phenelzine - tranylcypramine
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Renal parenchymal disease
Amiodarone/lidocaine

8. Chance of pregnancy after a single act of coitus
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
8%
3 hours
MVP

9. Donepezil use/sfx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

10. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Flat disk - button - batteries
ACEI - diuretic
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

11. Sx Lewy Body Dementia
Mass lesion - pseudotumor cerebri - meningitis
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

12. Nicotinic acids
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
470ms+ in men - 480ms+ in women
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Furosemide - nitroglycerin - IV morphine sulphate

13. DDx postoperative fever
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
100% O2 6L/min - dihydroergotamine - triptans

14. atypical
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity; increased NE release
Bupriopion - amoxipine - trazodone
Amitriptyline - propanolol - timolol - divalproex sodium

15. Tx HTN + post-MI
ACEI - B-blocker - spironolactone
Mass lesion - subdural hematoma - medication overuse
1st line: TZD
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

16. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Eikenella species
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

17. Bronchiolitis sx
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Furosemide - nitroglycerin - IV morphine sulphate
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

18. Prolonged QT interval (QTc)
Moderate/severe alzheimer dementia
470ms+ in men - 480ms+ in women
Renal parenchymal disease
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

19. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
1st line: TZD
Halothane - succinylcholine
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

20. IBS pain tx
5-HT blockers: tegasorad - alosetron
ACEI - ARB
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Neonate - infants - bilious vomiting - abdominal pain

21. Outpatient tx CHF
Legionella
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Dantrolene IV - antipyretics - O2 - cooling blankets

22. Papilledema DDx
Barium enema
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Mass lesion - pseudotumor cerebri - meningitis
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

23. Croup pathogens
10th postpartum day
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

24. QTc
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Bupriopion - amoxipine - trazodone
= QT / sqrt(RR interval)
100% O2 6L/min - dihydroergotamine - triptans

25. Lubiprostone
ACEI - B-blocker - diuretic - Ca-blocker
Obesity; increased NE release
Alzheimer dementia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

26. Orlistat
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - B-blocker - spironolactone

27. Intussusception sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Barium enema
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

28. Diethylpropion
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Obesity; increased NE release

29. SNRI
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Venlafaxine - duloxetine - mirtazapine
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

30. If not breast-feeding - when does menstruation restart?
Quinolone + metronidazole
3rd month postpartum
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

31. Tx diverticulitis
Dementia - incontinence - gait disturbance
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Quinolone + metronidazole
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

32. DDx dementia
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker

33. 'Alarm' sx for upper GI endoscopy
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Obesity; NE-uptake inhibition
Furosemide - nitroglycerin - IV morphine sulphate
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

34. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
ACEI - B-blocker - diuretic - Ca-blocker
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release

35. MCC non-traumatic hip pathology in adolescents
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
SCFE (slipped capital femoral epiphysis)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

36. MAOI
Temporal arteritis - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Phenelzine - tranylcypramine
Colonoscopy

37. Standard workup for dyslipidemia
Fiber (e.g. psyllium)
Fasting blood glucose - LFTs - renal function - TSH
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

38. X-ray epiglottitis

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39. Sibutramine
Obesity; increased NE release
Halothane - succinylcholine
Eikenella species
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

40. Bilateral 'ground glass' infiltrate on CXR
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
PCP pneumonia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

41. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
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

42. Afib - Aflutter tx
3 hours
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
5-HT blockers: tegasorad - alosetron
Digoxin (B-blockers as needed)

43. Bite injury pflx
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
ACEI - ARB - B-blocker - diuretic - Spironolactone
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Digoxin (B-blockers as needed)

44. Stable vtach tx
Obesity; NE-uptake inhibition
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
IV labetalol - nicardipine - sodium nitroprusside
Amiodarone/lidocaine

45. Tx mild/infrequent abd pain
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Mass lesion - vascular malformation - stroke - collagen vascular disease
Dicyclomine - hyoscyamine (antispasmodics)
H. flu - S. pneumo - S. aureus - Strep A/B/C

46. Primary SVT tx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Quinolone + metronidazole
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
B-blocker - Ca-channel blocker

47. MCC postpartum hemorrhage
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
Uterine atony
Alzheimer dementia

48. Test to best determine source of lower GI bleed
Colonoscopy
Mass lesion - subdural hematoma - medication overuse
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Oral prednisone

49. Croup
Obesity; increased NE release
1st line: TZD
Flat disk - button - batteries
Viral infxn of the subglottis

50. Tx HTN + CVA
Viral infxn of the subglottis
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
ACEI - diuretic
Eikenella species