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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. Sx of pneumococcal pneumonia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Lumbar puncture
Renal parenchymal disease

2. Standard workup for dyslipidemia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Lumbar puncture
Fasting blood glucose - LFTs - renal function - TSH
Uterine atony

3. causes of malignant hyperthernia
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Halothane - succinylcholine
Lumbar puncture
Meningitis - brain abscess - metastasis

4. Fibrates
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Colonoscopy

5. Orlistat
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Oral prednisone
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

6. Outpatient tx CHF
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Moderate/severe alzheimer dementia
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
470ms+ in men - 480ms+ in women

7. Intussusception sx
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
ACEI - ARB - B-blocker - diuretic - Spironolactone
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

8. Afib - Aflutter tx
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Digoxin (B-blockers as needed)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

9. epiglottitis
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Bacterial infxn of supraglottic tissue and surrounding areas
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

10. Bite injury pflx
Halothane - succinylcholine
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
S. aureus
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

11. Cluster headache acute tx
100% O2 6L/min - dihydroergotamine - triptans
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Lumbar puncture

12. Tx HTN + CHF
'thumb sign' (protrusion of into anterior wall of hypopharynx)
ACEI - diuretic
TCA's
ACEI - ARB - B-blocker - diuretic - Spironolactone

13. contraindications to thrombolytic therapy
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

14. Headache after 50 YO DDx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Temporal arteritis - mass lesion
Dicyclomine - hyoscyamine (antispasmodics)
ACEI - ARB - diuretic - Ca-blocker - B-blocker

15. Cluster headache pflx
Meningitis - brain abscess - metastasis
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Mass lesion - pseudotumor cerebri - meningitis

16. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Fasting blood glucose - LFTs - renal function - TSH
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Bupriopion - amoxipine - trazodone

17. MCA stroke sx
Temporal arteritis - mass lesion
Foot/leg deficits - cognitive + personality changes
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Digoxin (B-blockers as needed)

18. Phentermine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Obesity; NE-uptake inhibition
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

19. Causes of diverticular bleeding
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
ACEI - ARB - B-blocker - diuretic - Spironolactone
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
10th postpartum day

20. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Mass lesion - subdural hematoma - medication overuse
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

21. vertebrobasilar stroke sx
High K - high Ca - low Na
Meningitis - brain abscess - metastasis
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Fasting blood glucose - LFTs - renal function - TSH

22. Tx HTN + DM
Mass lesion - subdural hematoma - medication overuse
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
= QT / sqrt(RR interval)
ACEI - ARB - diuretic - Ca-blocker - B-blocker

23. Tacrine use/sfx
Renal parenchymal disease
Fasting blood glucose - LFTs - renal function - TSH
Obesity; NE-uptake inhibition
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

24. atypical
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
100% O2 6L/min - dihydroergotamine - triptans
Bupriopion - amoxipine - trazodone
Obesity; NE-uptake inhibition

25. New-onset headache in patient with HIV/cancer DDx
= QT / sqrt(RR interval)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Meningitis - brain abscess - metastasis

26. Empiric CAP tx in hospitalized patient
Obesity; increased NE release
Obesity; NE-uptake inhibition
Bupriopion - amoxipine - trazodone
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

27. Tx uterine atony
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
Obesity; increased NE release
Quinolone + metronidazole
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

28. Croup pathogens
ACEI - ARB
ACEI - diuretic
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
= QT / sqrt(RR interval)

29. Headache post-head trauma DDx
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

30. Dx and Tx of intussception
Barium enema
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Foot/leg deficits - cognitive + personality changes

31. Pyloric stenosis sx

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32. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Legionella
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

33. TCA
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
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
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
ACEI - ARB

34. Bilateral 'ground glass' infiltrate on CXR
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
PCP pneumonia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

35. Organism that causes pneumonia with diarrhea
Legionella
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

36. DDx limp in infant/toddler
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
ACEI - B-blocker - spironolactone
Septic arthritis - fractures - congenital hip dysplasia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

37. Donepezil use/sfx
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Cephalexin OR dicloxacillin
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

38. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Venlafaxine - duloxetine - mirtazapine
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release

39. NMDA-R antagonist (memantine)
ACEI - B-blocker - spironolactone
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Moderate/severe alzheimer dementia

40. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Cephalexin OR dicloxacillin
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Lumbar puncture

41. DDx postoperative fever
Mass lesion - subdural hematoma - medication overuse
3rd month postpartum
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

42. MCC HTN in child
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Bupriopion - amoxipine - trazodone
Septic arthritis - fractures - congenital hip dysplasia
Renal parenchymal disease

43. Tx HTN + post-MI
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
ACEI - B-blocker - spironolactone
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

44. ACA stroke ssx
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
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Foot/leg deficits - cognitive + personality changes

45. 1st line tx in IBS constipation
Dicyclomine - hyoscyamine (antispasmodics)
Fiber (e.g. psyllium)
Bacterial infxn of supraglottic tissue and surrounding areas
Amiodarone/lidocaine

46. Cholesterol absorption blocker (ezetimibe)
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Amitriptyline - propanolol - timolol - divalproex sodium
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

47. GI 'alarm' features
Lumbar puncture
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
B-blocker - Ca-channel blocker
Obesity; increased NE release

48. DASH diet plan
S. aureus
High K - high Ca - low Na
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

49. Evaluating limp w/o pain in children
Fiber (e.g. psyllium)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Moderate/severe alzheimer dementia

50. Focal neurologic sx (other than aura) DDx
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Mass lesion - vascular malformation - stroke - collagen vascular disease
470ms+ in men - 480ms+ in women
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)