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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. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Septic arthritis - fractures - congenital hip dysplasia
Flat disk - button - batteries
Obesity; increased NE release

2. Evaluating limp w/o pain in children
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
TCA's
High K - high Ca - low Na
ACEI - ARB

3. MAOI
Phenelzine - tranylcypramine
470ms+ in men - 480ms+ in women
ACEI - diuretic
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

4. Intussusception sx
PCP pneumonia
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
'thumb sign' (protrusion of into anterior wall of hypopharynx)

5. Diethylpropion
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Obesity; increased NE release
Dementia - incontinence - gait disturbance
SCFE (slipped capital femoral epiphysis)

6. Dx subarachnoid hemorrhage with negative noncontrast CT
Dantrolene IV - antipyretics - O2 - cooling blankets
SCFE (slipped capital femoral epiphysis)
Lumbar puncture
Dementia - incontinence - gait disturbance

7. DDx limp in infant/toddler
Oral prednisone
= QT / sqrt(RR interval)
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Septic arthritis - fractures - congenital hip dysplasia

8. Croup
Meningitis - brain abscess - metastasis
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
Viral infxn of the subglottis
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

9. Orlistat
B-blocker - Ca-channel blocker
Septic arthritis - fractures - congenital hip dysplasia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

10. Headache after 50 YO DDx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Temporal arteritis - mass lesion
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

11. Metabolic syndrome
Cephalexin OR dicloxacillin
Amiodarone/lidocaine
Digoxin (B-blockers as needed)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

12. Tx mild/infrequent abd pain
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Dicyclomine - hyoscyamine (antispasmodics)
SCFE (slipped capital femoral epiphysis)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

13. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
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
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Phenelzine - tranylcypramine

14. Tx HTN + CVA
Colonoscopy
Obesity; NE-uptake inhibition
ACEI - diuretic
Obesity; increased NE release

15. 1st line tx in IBS constipation
'steeple-sign' (subglottic narrowing)
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Amitriptyline - propanolol - timolol - divalproex sodium
Fiber (e.g. psyllium)

16. Tx local - acute rxn to bee sting
Oral prednisone
Septic arthritis - fractures - congenital hip dysplasia
Cephalexin OR dicloxacillin
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

17. malignant hyperthermia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

18. Dextroamphetamine
Fiber (e.g. psyllium)
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Obesity; increased NE release
Viral infxn of the subglottis

19. ROME IBS criteria
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

20. Papilledema DDx
Mass lesion - pseudotumor cerebri - meningitis
Septic arthritis - fractures - congenital hip dysplasia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Bupriopion - amoxipine - trazodone

21. tx malignant hyperthermia
Dantrolene IV - antipyretics - O2 - cooling blankets
Fiber (e.g. psyllium)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

22. Headache with sx systemic illness DDx
PCP pneumonia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Quinolone + metronidazole
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

23. rtPA should be used within ____ of stroke
3 hours
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
H. flu - S. pneumo - S. aureus - Strep A/B/C
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

24. Tx HTN + CAD
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
ACEI - B-blocker - diuretic - Ca-blocker
Bupriopion - amoxipine - trazodone

25. DDx postoperative fever
Obesity; increased NE release
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Foot/leg deficits - cognitive + personality changes

26. Stable vtach tx
Obesity; increased NE release
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Amiodarone/lidocaine
Postpartum fever - uterine tenderness - foul-smelling lochia

27. IBS pain tx
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
IV labetalol - nicardipine - sodium nitroprusside
5-HT blockers: tegasorad - alosetron

28. Sx endometritis
Flat disk - button - batteries
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Postpartum fever - uterine tenderness - foul-smelling lochia
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

29. Bite injury pflx
Amitriptyline - propanolol - timolol - divalproex sodium
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

30. Sx HoCM
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

31. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Legionella
Lumbar puncture
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

32. Nicotinic acids
Cephalexin OR dicloxacillin
ACEI - B-blocker - diuretic - Ca-blocker
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

33. Drugs causing fever
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Halothane - succinylcholine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Bupriopion - amoxipine - trazodone

34. Tx HTN + DM
Meningitis - brain abscess - metastasis
PCP pneumonia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker

35. Tx acute pulmonary edema 2ndary to CHF
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Furosemide - nitroglycerin - IV morphine sulphate

36. SSRI's
Foot/leg deficits - cognitive + personality changes
Obesity; increased NE release
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Legionella

37. Headache post-head trauma DDx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

38. Chronic afib tx
Fasting blood glucose - LFTs - renal function - TSH
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Phenelzine - tranylcypramine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

39. Tx HTN + CHF
IV labetalol - nicardipine - sodium nitroprusside
Fiber (e.g. psyllium)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
ACEI - ARB - B-blocker - diuretic - Spironolactone

40. Tx diverticulitis
IV labetalol - nicardipine - sodium nitroprusside
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Quinolone + metronidazole
ACEI - ARB - B-blocker - diuretic - Spironolactone

41. Statins
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Bacterial infxn of supraglottic tissue and surrounding areas
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

42. DDx Limp w/o pain in children - orthopedic
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Renal parenchymal disease
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

43. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
B-blocker - Ca-channel blocker
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer

44. Cardiac Resynchronization Therapy (CRT) is warranted when ___
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Amitriptyline - propanolol - timolol - divalproex sodium
Barium enema

45. 4 T's of postpartum hemorrhage
Legionella
MVP
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

46. SNRI
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Venlafaxine - duloxetine - mirtazapine
Mass lesion - vascular malformation - stroke - collagen vascular disease
Moderate/severe alzheimer dementia

47. Sudden-onset headache DDx
Dementia - incontinence - gait disturbance
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
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
IV labetalol - nicardipine - sodium nitroprusside

48. Croup pathogens
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

49. Epiglottitis pathogens
Alzheimer dementia
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
5-HT blockers: tegasorad - alosetron
H. flu - S. pneumo - S. aureus - Strep A/B/C

50. X-ray epiglottitis

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