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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. Tx mild/infrequent abd pain
Dicyclomine - hyoscyamine (antispasmodics)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Amiodarone/lidocaine

2. Organism that causes pneumonia post-influenza
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
S. aureus
Legionella
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

3. Dx and Tx of intussception
Barium enema
10th postpartum day
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

4. 1st line tx in IBS constipation
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Fiber (e.g. psyllium)
Amiodarone/lidocaine

5. Headache with sx systemic illness DDx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Foot/leg deficits - cognitive + personality changes
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

6. Chance of pregnancy after a single act of coitus
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Temporal arteritis - mass lesion
IV labetalol - nicardipine - sodium nitroprusside
8%

7. Bite injury pflx
Venlafaxine - duloxetine - mirtazapine
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Fiber (e.g. psyllium)
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

8. Nicotinic acids
Obesity; increased NE release
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

9. Empiric CAP tx in hospitalized patient
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
'steeple-sign' (subglottic narrowing)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

10. DDx limp in infant/toddler
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Mass lesion - subdural hematoma - medication overuse
Obesity; increased NE release
Septic arthritis - fractures - congenital hip dysplasia

11. MCC non-traumatic hip pathology in adolescents
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
SCFE (slipped capital femoral epiphysis)

12. Outpatient tx CHF
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
TCA's
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

13. Tacrine use/sfx
Temporal arteritis - mass lesion
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

14. Fibrates
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Obesity; increased NE release
Barium enema

15. Intussusception sx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Obesity; increased NE release
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

16. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Dantrolene IV - antipyretics - O2 - cooling blankets
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

17. NMDA-R antagonist (memantine)
Mass lesion - subdural hematoma - medication overuse
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Moderate/severe alzheimer dementia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

18. MCA stroke sx
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

19. Baby blues resolves by ______
470ms+ in men - 480ms+ in women
Halothane - succinylcholine
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
10th postpartum day

20. ACA stroke ssx
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Foot/leg deficits - cognitive + personality changes

21. Croup X-ray

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22. Rivastigmine
Alzheimer dementia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Renal parenchymal disease

23. Phentermine
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Viral infxn of the subglottis
Obesity; NE-uptake inhibition

24. Bronchiolitis sx
Obesity; NE-uptake inhibition
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

25. Croup sx
Obesity; NE-uptake inhibition
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
8%
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

26. MCC HTN in child
MVP
Obesity; increased NE release
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Renal parenchymal disease

27. Standard workup for dyslipidemia
Barium enema
Fasting blood glucose - LFTs - renal function - TSH
Amitriptyline - propanolol - timolol - divalproex sodium
Moderate/severe alzheimer dementia

28. Donepezil use/sfx
10th postpartum day
Flat disk - button - batteries
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

29. Stable vtach tx
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amiodarone/lidocaine
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

30. TCA
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

31. Mastitis tx
Dicyclomine - hyoscyamine (antispasmodics)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Cephalexin OR dicloxacillin
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

32. Epiglottitis pathogens
Fiber (e.g. psyllium)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
H. flu - S. pneumo - S. aureus - Strep A/B/C
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

33. Sx normal-pressure hydrocephalus
Dementia - incontinence - gait disturbance
Cephalexin OR dicloxacillin
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

34. atypical
Bacterial infxn of supraglottic tissue and surrounding areas
High K - high Ca - low Na
Bupriopion - amoxipine - trazodone
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

35. Antihypertensives in suspected stroke
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
IV labetalol - nicardipine - sodium nitroprusside
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
100% O2 6L/min - dihydroergotamine - triptans

36. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Renal parenchymal disease
Moderate/severe alzheimer dementia

37. Tx acute pulmonary edema 2ndary to CHF
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Amiodarone/lidocaine
Furosemide - nitroglycerin - IV morphine sulphate

38. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

39. Sx HoCM
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Obesity; increased NE release

40. causes of malignant hyperthernia
Phenelzine - tranylcypramine
Neonate - infants - bilious vomiting - abdominal pain
Halothane - succinylcholine
'thumb sign' (protrusion of into anterior wall of hypopharynx)

41. Papilledema DDx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Mass lesion - pseudotumor cerebri - meningitis
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

42. Tx frequent/severe abd pain

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43. If not breast-feeding - when does menstruation restart?
8%
Flat disk - button - batteries
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
3rd month postpartum

44. DDx dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
5-HT blockers: tegasorad - alosetron
Digoxin (B-blockers as needed)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

45. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

46. Croup
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Viral infxn of the subglottis
8%
B-blocker - Ca-channel blocker

47. Refer to cardiologist post-sports physical if ____
B-blocker - Ca-channel blocker
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
S. aureus
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

48. CAGE questionnaire
Venlafaxine - duloxetine - mirtazapine
= QT / sqrt(RR interval)
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

49. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Dantrolene IV - antipyretics - O2 - cooling blankets
Venlafaxine - duloxetine - mirtazapine

50. Evaluating limp w/o pain in children
Cephalexin OR dicloxacillin
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Mass lesion - subdural hematoma - medication overuse
Obesity; increased NE release