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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. CAGE questionnaire
TCA's
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Halothane - succinylcholine

2. epiglottitis
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Bacterial infxn of supraglottic tissue and surrounding areas

3. X-ray epiglottitis

4. Tx HTN + CKD
ACEI - ARB
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

5. Prolonged QT interval (QTc)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
MVP
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
470ms+ in men - 480ms+ in women

6. Stable vtach tx
Amiodarone/lidocaine
ACEI - diuretic
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Foot/leg deficits - cognitive + personality changes

7. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Mass lesion - subdural hematoma - medication overuse
Obesity; increased NE release
1st line: TZD

8. Dx subarachnoid hemorrhage with negative noncontrast CT
Colonoscopy
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Lumbar puncture
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

9. Sudden-onset headache DDx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
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
Quinolone + metronidazole

10. Diethylpropion
Obesity; increased NE release
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
8%
Colonoscopy

11. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Alzheimer dementia
High K - high Ca - low Na
Fiber (e.g. psyllium)

12. Lochia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Amiodarone/lidocaine
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

13. DDx postoperative fever
Septic arthritis - fractures - congenital hip dysplasia
S. aureus
Venlafaxine - duloxetine - mirtazapine
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

14. Orlistat
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

15. contraindications to thrombolytic therapy
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
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

16. MCA stroke sx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Alzheimer dementia
'steeple-sign' (subglottic narrowing)

17. Tx local - acute rxn to bee sting
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Oral prednisone
Fever - sore throat - muffled voice - drooling - trismus - neck pain

18. tx malignant hyperthermia
Dantrolene IV - antipyretics - O2 - cooling blankets
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - B-blocker - diuretic - Ca-blocker
H. flu - S. pneumo - S. aureus - Strep A/B/C

19. Tx HTN + post-MI
Quinolone + metronidazole
ACEI - B-blocker - spironolactone
Fiber (e.g. psyllium)
1st line: TZD

20. Headaches increasing in severity + intensity DDx
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Meningitis - brain abscess - metastasis
B-blocker - Ca-channel blocker
Mass lesion - subdural hematoma - medication overuse

21. Bronchiolitis sx
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Dicyclomine - hyoscyamine (antispasmodics)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

22. Sx normal-pressure hydrocephalus
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Dementia - incontinence - gait disturbance
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

23. Tx HTN + CHF
'thumb sign' (protrusion of into anterior wall of hypopharynx)
ACEI - ARB - B-blocker - diuretic - Spironolactone
Eikenella species
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

24. Tx acute pulmonary edema 2ndary to CHF
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Furosemide - nitroglycerin - IV morphine sulphate
Lumbar puncture

25. Test to best determine source of lower GI bleed
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Colonoscopy

26. SSRI's
Eikenella species
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity; increased NE release
3rd month postpartum

27. New-onset headache in patient with HIV/cancer DDx
Cephalexin OR dicloxacillin
Meningitis - brain abscess - metastasis
5-HT blockers: tegasorad - alosetron
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

28. Malrotation sx
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Mass lesion - vascular malformation - stroke - collagen vascular disease

29. Outpatient tx CHF
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
ACEI - B-blocker - diuretic - Ca-blocker
Quinolone + metronidazole
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

30. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
High K - high Ca - low Na
Postpartum fever - uterine tenderness - foul-smelling lochia

31. Organism that causes pneumonia with diarrhea
Legionella
Barium enema
B-blocker - Ca-channel blocker
Digoxin (B-blockers as needed)

32. NMDA-R antagonist (memantine)
Moderate/severe alzheimer dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Foot/leg deficits - cognitive + personality changes
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

33. atypical
Septic arthritis - fractures - congenital hip dysplasia
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Bupriopion - amoxipine - trazodone

34. Epiglottitis pathogens
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Amiodarone/lidocaine
Moderate/severe alzheimer dementia
H. flu - S. pneumo - S. aureus - Strep A/B/C

35. most common valvular heart defect in USA
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
MVP
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Mass lesion - pseudotumor cerebri - meningitis

36. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Temporal arteritis - mass lesion
Phenelzine - tranylcypramine
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

37. Tx diverticulitis
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Cephalexin OR dicloxacillin
Quinolone + metronidazole
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

38. ROME IBS criteria
Obesity; increased NE release
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Obesity; increased NE release
Obesity; increased NE release

39. Lubiprostone
3 hours
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

40. Croup pathogens
Amitriptyline - propanolol - timolol - divalproex sodium
Temporal arteritis - mass lesion
Lumbar puncture
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

41. DASH diet plan
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Halothane - succinylcholine
High K - high Ca - low Na
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

42. Tx frequent/severe abd pain

43. Fibrates
Obesity; increased NE release
Moderate/severe alzheimer dementia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

44. Headache after 50 YO DDx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Temporal arteritis - mass lesion
S. aureus
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

45. Tx HTN + DM
Amiodarone/lidocaine
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Postpartum fever - uterine tenderness - foul-smelling lochia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

46. Tx uterine atony
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
ACEI - ARB - B-blocker - diuretic - Spironolactone
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

47. 1st line tx in IBS constipation
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Barium enema
Fiber (e.g. psyllium)

48. Peritonsillar abscess Sx
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
MVP
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

49. Intussusception sx
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Furosemide - nitroglycerin - IV morphine sulphate
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

50. DDx dementia
Dantrolene IV - antipyretics - O2 - cooling blankets
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)