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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. Pyloric stenosis sx

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2. Tx diverticulitis
Neonate - infants - bilious vomiting - abdominal pain
Quinolone + metronidazole
Venlafaxine - duloxetine - mirtazapine
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

3. X-ray epiglottitis

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4. CXR of CHF
3 hours
5-HT blockers: tegasorad - alosetron
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

5. Dx subarachnoid hemorrhage with negative noncontrast CT
Lumbar puncture
8%
Dantrolene IV - antipyretics - O2 - cooling blankets
Legionella

6. Refer to cardiologist post-sports physical if ____
Barium enema
Mass lesion - vascular malformation - stroke - collagen vascular disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

7. Sibutramine
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

8. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Oral prednisone

9. Sx HoCM
Digoxin (B-blockers as needed)
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Renal parenchymal disease
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

10. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Phenelzine - tranylcypramine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

11. Lochia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Meningitis - brain abscess - metastasis
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
470ms+ in men - 480ms+ in women

12. Croup pathogens
Obesity; increased NE release
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

13. Tx HTN + post-MI
ACEI - B-blocker - spironolactone
Renal parenchymal disease
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

14. Tx HTN + DM
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
High K - high Ca - low Na
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

15. causes of malignant hyperthernia
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
8%
Halothane - succinylcholine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

16. Chance of pregnancy after a single act of coitus
8%
10th postpartum day
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Halothane - succinylcholine

17. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
1st line: TZD
Alzheimer dementia

18. Afib - Aflutter tx
5-HT blockers: tegasorad - alosetron
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Digoxin (B-blockers as needed)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

19. 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
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Digoxin (B-blockers as needed)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

20. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
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
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

21. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
ACEI - ARB - B-blocker - diuretic - Spironolactone
S. aureus
Bupriopion - amoxipine - trazodone

22. MCC infxn in closed-fist injuries
Eikenella species
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Fiber (e.g. psyllium)
Cephalexin OR dicloxacillin

23. New-onset headache in patient with HIV/cancer DDx
100% O2 6L/min - dihydroergotamine - triptans
Dementia - incontinence - gait disturbance
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Meningitis - brain abscess - metastasis

24. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Dicyclomine - hyoscyamine (antispasmodics)
Digoxin (B-blockers as needed)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

25. Intussusception sx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Obesity; increased NE release
Quinolone + metronidazole

26. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
ACEI - ARB
'steeple-sign' (subglottic narrowing)
PCP pneumonia

27. Organism that causes pneumonia with diarrhea
SCFE (slipped capital femoral epiphysis)
Dementia - incontinence - gait disturbance
Legionella
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

28. Tx local - acute rxn to bee sting
Oral prednisone
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

29. Sx Lewy Body Dementia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

30. Prolonged QT interval (QTc)
Septic arthritis - fractures - congenital hip dysplasia
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Legionella
470ms+ in men - 480ms+ in women

31. Outpatient tx CHF
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer dementia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

32. SSRI's
S. aureus
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

33. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
High K - high Ca - low Na
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

34. DDx postoperative fever
Legionella
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.
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

35. SNRI
Venlafaxine - duloxetine - mirtazapine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

36. Tx HTN + CVA
ACEI - diuretic
= QT / sqrt(RR interval)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Quinolone + metronidazole

37. ACA stroke ssx
TCA's
Halothane - succinylcholine
Eikenella species
Foot/leg deficits - cognitive + personality changes

38. Cluster headache pflx
Eikenella species
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
PCP pneumonia
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

39. Focal neurologic sx (other than aura) DDx
Mass lesion - vascular malformation - stroke - collagen vascular disease
Dementia - incontinence - gait disturbance
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - B-blocker - spironolactone

40. NMDA-R antagonist (memantine)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Meningitis - brain abscess - metastasis
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Moderate/severe alzheimer dementia

41. Phentermine
Obesity; NE-uptake inhibition
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
10th postpartum day

42. Antihypertensives in suspected stroke
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
IV labetalol - nicardipine - sodium nitroprusside
H. flu - S. pneumo - S. aureus - Strep A/B/C
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

43. epiglottitis
Venlafaxine - duloxetine - mirtazapine
Bacterial infxn of supraglottic tissue and surrounding areas
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

44. Tx HTN + CKD
ACEI - ARB
Quinolone + metronidazole
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Viral infxn of the subglottis

45. Lubiprostone
Viral infxn of the subglottis
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Dicyclomine - hyoscyamine (antispasmodics)

46. atypical
Bupriopion - amoxipine - trazodone
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Eikenella species
Barium enema

47. Chronic afib tx
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
'steeple-sign' (subglottic narrowing)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

48. Dextroamphetamine
Obesity; increased NE release
ACEI - B-blocker - diuretic - Ca-blocker
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

49. Stable vtach tx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Legionella
Amiodarone/lidocaine

50. MCC HTN in child
Fiber (e.g. psyllium)
Renal parenchymal disease
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose