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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. Tacrine use/sfx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - B-blocker - diuretic - Ca-blocker
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

2. QTc
= QT / sqrt(RR interval)
Bacterial infxn of supraglottic tissue and surrounding areas
H. flu - S. pneumo - S. aureus - Strep A/B/C
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

3. Baby blues resolves by ______
10th postpartum day
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
100% O2 6L/min - dihydroergotamine - triptans
IV labetalol - nicardipine - sodium nitroprusside

4. Sx endometritis
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Postpartum fever - uterine tenderness - foul-smelling lochia
Oral prednisone
Quinolone + metronidazole

5. Mastitis tx
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
ACEI - diuretic
Cephalexin OR dicloxacillin
High K - high Ca - low Na

6. Rivastigmine
Alzheimer dementia
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Halothane - succinylcholine

7. SNRI
Postpartum fever - uterine tenderness - foul-smelling lochia
Venlafaxine - duloxetine - mirtazapine
Temporal arteritis - mass lesion
Uterine atony

8. Croup X-ray

9. Cluster headache acute tx
Dementia - incontinence - gait disturbance
TCA's
100% O2 6L/min - dihydroergotamine - triptans
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

10. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
1st line: TZD
10th postpartum day

11. New-onset headache in patient with HIV/cancer DDx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Meningitis - brain abscess - metastasis
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Cephalexin OR dicloxacillin

12. MCC non-traumatic hip pathology in adolescents
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
SCFE (slipped capital femoral epiphysis)
Fiber (e.g. psyllium)

13. Dx and Tx of intussception
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Barium enema
Fever - sore throat - muffled voice - drooling - trismus - neck pain
3rd month postpartum

14. Focal neurologic sx (other than aura) DDx
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Mass lesion - vascular malformation - stroke - collagen vascular disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

15. Tx diverticulitis
1st line: TZD
100% O2 6L/min - dihydroergotamine - triptans
Quinolone + metronidazole
Postpartum fever - uterine tenderness - foul-smelling lochia

16. CXR of CHF
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Viral infxn of the subglottis
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Moderate/severe alzheimer dementia

17. Sx of pneumococcal pneumonia
MVP
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
ACEI - ARB - diuretic - Ca-blocker - B-blocker

18. Organism that causes pneumonia post-influenza
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
S. aureus
Viral infxn of the subglottis
Halothane - succinylcholine

19. Sx Lewy Body Dementia
Viral infxn of the subglottis
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Flat disk - button - batteries

20. Orlistat
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
3 hours

21. Refer to cardiologist post-sports physical if ____
Dantrolene IV - antipyretics - O2 - cooling blankets
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Septic arthritis - fractures - congenital hip dysplasia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

22. Tx frequent/severe abd pain

23. MCC postpartum hemorrhage
ACEI - B-blocker - diuretic - Ca-blocker
470ms+ in men - 480ms+ in women
Uterine atony
Dementia - incontinence - gait disturbance

24. Diethylpropion
Uterine atony
= QT / sqrt(RR interval)
Obesity; increased NE release
Legionella

25. contraindications to thrombolytic therapy
B-blocker - Ca-channel blocker
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Obesity; NE-uptake inhibition
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

26. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Foot/leg deficits - cognitive + personality changes
Temporal arteritis - mass lesion
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

27. vertebrobasilar stroke sx
Mass lesion - pseudotumor cerebri - meningitis
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

28. DDx postoperative fever
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Oral prednisone
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

29. If not breast-feeding - when does menstruation restart?
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Dementia - incontinence - gait disturbance
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
3rd month postpartum

30. Lochia
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity; increased NE release

31. Test to best determine source of lower GI bleed
Colonoscopy
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Bacterial infxn of supraglottic tissue and surrounding areas

32. Empiric CAP tx in healthy person
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
TCA's
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

33. atypical
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Bupriopion - amoxipine - trazodone
Meningitis - brain abscess - metastasis
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

34. Retropharyngeal abscess Sx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Dicyclomine - hyoscyamine (antispasmodics)
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

35. Cholesterol absorption blocker (ezetimibe)
10th postpartum day
8%
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Uterine atony

36. Tx HTN
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Dicyclomine - hyoscyamine (antispasmodics)
Fiber (e.g. psyllium)
1st line: TZD

37. Primary SVT tx
B-blocker - Ca-channel blocker
ACEI - B-blocker - diuretic - Ca-blocker
SCFE (slipped capital femoral epiphysis)
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

38. Empiric CAP tx in hospitalized patient
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Mass lesion - pseudotumor cerebri - meningitis
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Dementia - incontinence - gait disturbance

39. Antihypertensives in suspected stroke
ACEI - B-blocker - spironolactone
Meningitis - brain abscess - metastasis
'thumb sign' (protrusion of into anterior wall of hypopharynx)
IV labetalol - nicardipine - sodium nitroprusside

40. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Neonate - infants - bilious vomiting - abdominal pain
Bupriopion - amoxipine - trazodone

41. Pflx migraine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Amitriptyline - propanolol - timolol - divalproex sodium
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

42. Tx local - acute rxn to bee sting
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Oral prednisone
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

43. Drugs causing fever
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Uterine atony

44. causes of malignant hyperthernia
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
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
Halothane - succinylcholine
Digoxin (B-blockers as needed)

45. Commonly ingested foreign bodies
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Flat disk - button - batteries

46. Croup
Cephalexin OR dicloxacillin
Mass lesion - subdural hematoma - medication overuse
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Viral infxn of the subglottis

47. 4 T's of postpartum hemorrhage
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

48. Papilledema DDx
5-HT blockers: tegasorad - alosetron
ACEI - B-blocker - spironolactone
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - pseudotumor cerebri - meningitis

49. Afib - Aflutter tx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Digoxin (B-blockers as needed)

50. Cluster headache pflx
10th postpartum day
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Fasting blood glucose - LFTs - renal function - TSH