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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. Bilateral 'ground glass' infiltrate on CXR
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
PCP pneumonia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

2. Epiglottitis pathogens
Colonoscopy
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - pseudotumor cerebri - meningitis
Amitriptyline - propanolol - timolol - divalproex sodium

3. QTc
Bacterial infxn of supraglottic tissue and surrounding areas
100% O2 6L/min - dihydroergotamine - triptans
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
= QT / sqrt(RR interval)

4. Papilledema DDx
Mass lesion - pseudotumor cerebri - meningitis
Obesity; NE-uptake inhibition
Fasting blood glucose - LFTs - renal function - TSH
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

5. Test to best determine source of lower GI bleed
ACEI - diuretic
Colonoscopy
= QT / sqrt(RR interval)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

6. MCC postpartum hemorrhage
Eikenella species
Uterine atony
Obesity; increased NE release
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

7. Pflx migraine
TCA's
Postpartum fever - uterine tenderness - foul-smelling lochia
Amitriptyline - propanolol - timolol - divalproex sodium
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

8. TCA
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

9. DASH diet plan
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
470ms+ in men - 480ms+ in women
High K - high Ca - low Na
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

10. tx malignant hyperthermia
Temporal arteritis - mass lesion
ACEI - ARB
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Dantrolene IV - antipyretics - O2 - cooling blankets

11. CXR of CHF
Renal parenchymal disease
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

12. GI 'alarm' features
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release

13. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
3rd month postpartum
Obesity; increased NE release
Meningitis - brain abscess - metastasis

14. Empiric CAP tx in healthy person
Fasting blood glucose - LFTs - renal function - TSH
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - ARB - diuretic - Ca-blocker - B-blocker

15. Commonly ingested foreign bodies
Flat disk - button - batteries
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

16. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Septic arthritis - fractures - congenital hip dysplasia
Quinolone + metronidazole

17. Phendimetrazine
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Legionella
Colonoscopy
Obesity; increased NE release

18. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Bacterial infxn of supraglottic tissue and surrounding areas
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
8%
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

19. Orlistat
High K - high Ca - low Na
Eikenella species
Dantrolene IV - antipyretics - O2 - cooling blankets
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

20. Standard workup for dyslipidemia
Cephalexin OR dicloxacillin
Fasting blood glucose - LFTs - renal function - TSH
Renal parenchymal disease
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

21. Tx HTN + CVA
ACEI - diuretic
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Obesity; increased NE release
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

22. MCC infxn in closed-fist injuries
Eikenella species
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Venlafaxine - duloxetine - mirtazapine
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

23. 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
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Foot/leg deficits - cognitive + personality changes

24. MCC HTN in child
Renal parenchymal disease
TCA's
Obesity; NE-uptake inhibition
SCFE (slipped capital femoral epiphysis)

25. Metabolic syndrome
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
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

26. SSRI's
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Furosemide - nitroglycerin - IV morphine sulphate
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Dementia - incontinence - gait disturbance

27. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Bacterial infxn of supraglottic tissue and surrounding areas
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

28. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Amitriptyline - propanolol - timolol - divalproex sodium
Obesity; NE-uptake inhibition
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

29. Stable vtach tx
= QT / sqrt(RR interval)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Amiodarone/lidocaine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

30. Tx HTN + CKD
ACEI - ARB
High K - high Ca - low Na
Quinolone + metronidazole
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

31. Organism that causes pneumonia with diarrhea
TCA's
Legionella
Digoxin (B-blockers as needed)
Halothane - succinylcholine

32. Sx of pneumococcal pneumonia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Furosemide - nitroglycerin - IV morphine sulphate
Oral prednisone
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

33. Sx normal-pressure hydrocephalus
Oral prednisone
Dementia - incontinence - gait disturbance
SCFE (slipped capital femoral epiphysis)
S. aureus

34. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
3 hours
ACEI - diuretic
Barium enema

35. causes of malignant hyperthernia
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Neonate - infants - bilious vomiting - abdominal pain
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Halothane - succinylcholine

36. Tx acute pulmonary edema 2ndary to CHF
Furosemide - nitroglycerin - IV morphine sulphate
Alzheimer dementia
Fever - sore throat - muffled voice - drooling - trismus - neck pain
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

37. vertebrobasilar stroke sx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Colonoscopy
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

38. Peritonsillar abscess Sx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - ARB - B-blocker - diuretic - Spironolactone
Dementia - incontinence - gait disturbance

39. Afib - Aflutter tx
Digoxin (B-blockers as needed)
Septic arthritis - fractures - congenital hip dysplasia
ACEI - ARB - diuretic - Ca-blocker - B-blocker
'steeple-sign' (subglottic narrowing)

40. Tx HTN
IV labetalol - nicardipine - sodium nitroprusside
Obesity; increased NE release
1st line: TZD
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

41. 1st line tx in IBS constipation
Fiber (e.g. psyllium)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
B-blocker - Ca-channel blocker

42. DDx Limp w/o pain in children - orthopedic
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

43. 'Alarm' sx for upper GI endoscopy
Amitriptyline - propanolol - timolol - divalproex sodium
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Obesity; increased NE release

44. Primary SVT tx
Renal parenchymal disease
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
B-blocker - Ca-channel blocker
10th postpartum day

45. contraindications to thrombolytic therapy
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
H. flu - S. pneumo - S. aureus - Strep A/B/C
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

46. Sx HoCM
Dicyclomine - hyoscyamine (antispasmodics)
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Obesity; increased NE release
5-HT blockers: tegasorad - alosetron

47. Galantamine use/sfx
Barium enema
5-HT blockers: tegasorad - alosetron
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

48. CAGE questionnaire
MVP
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Bacterial infxn of supraglottic tissue and surrounding areas
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

49. Dx and Tx of intussception
B-blocker - Ca-channel blocker
Amitriptyline - propanolol - timolol - divalproex sodium
Barium enema
Furosemide - nitroglycerin - IV morphine sulphate

50. SNRI
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Venlafaxine - duloxetine - mirtazapine
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)