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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)
TCA's
Mass lesion - pseudotumor cerebri - meningitis
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

2. SNRI
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
ACEI - B-blocker - spironolactone
Venlafaxine - duloxetine - mirtazapine

3. NMDA-R antagonist (memantine)
Quinolone + metronidazole
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Moderate/severe alzheimer dementia
Uterine atony

4. Statins
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
S. aureus
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

5. 4 T's of postpartum hemorrhage
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
10th postpartum day

6. Mastitis tx
Dantrolene IV - antipyretics - O2 - cooling blankets
Cephalexin OR dicloxacillin
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

7. DDx postoperative fever
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Obesity; increased NE release
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

8. Pyloric stenosis sx

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9. Tx local - acute rxn to bee sting
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Oral prednisone
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

10. Bilateral 'ground glass' infiltrate on CXR
Obesity; increased NE release
PCP pneumonia
Amitriptyline - propanolol - timolol - divalproex sodium
Moderate/severe alzheimer dementia

11. Refer to cardiologist post-sports physical if ____
Colonoscopy
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
100% O2 6L/min - dihydroergotamine - triptans
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

12. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Venlafaxine - duloxetine - mirtazapine

13. Bronchiolitis sx
3rd month postpartum
Legionella
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

14. Tx diverticulitis
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Barium enema
Quinolone + metronidazole

15. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Furosemide - nitroglycerin - IV morphine sulphate
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

16. Outpatient tx CHF
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Eikenella species
'steeple-sign' (subglottic narrowing)
ACEI - B-blocker - spironolactone

17. Cluster headache acute tx
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
100% O2 6L/min - dihydroergotamine - triptans
Mass lesion - subdural hematoma - medication overuse

18. Croup sx
Quinolone + metronidazole
High K - high Ca - low Na
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

19. Causes of diverticular bleeding
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

20. Standard workup for dyslipidemia
Obesity; increased NE release
Fasting blood glucose - LFTs - renal function - TSH
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Moderate/severe alzheimer dementia

21. DDx Limp w/o pain in children - orthopedic
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

22. causes of malignant hyperthernia
Halothane - succinylcholine
Furosemide - nitroglycerin - IV morphine sulphate
Dementia - incontinence - gait disturbance
Lumbar puncture

23. DASH diet plan
Oral prednisone
High K - high Ca - low Na
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
TCA's

24. ACA stroke ssx
Uterine atony
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Foot/leg deficits - cognitive + personality changes
Lumbar puncture

25. Baby blues resolves by ______
10th postpartum day
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

26. SSRI's
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

27. If not breast-feeding - when does menstruation restart?
3rd month postpartum
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
1st line: TZD
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

28. Evaluating limp w/o pain in children
Obesity; increased NE release
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

29. Sx normal-pressure hydrocephalus
Dementia - incontinence - gait disturbance
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Halothane - succinylcholine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

30. Drugs causing fever
H. flu - S. pneumo - S. aureus - Strep A/B/C
'steeple-sign' (subglottic narrowing)
Dementia - incontinence - gait disturbance
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

31. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
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

32. Rivastigmine
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
= QT / sqrt(RR interval)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Alzheimer dementia

33. Dextroamphetamine
8%
Obesity; increased NE release
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Viral infxn of the subglottis

34. Empiric CAP tx in healthy person
Oral prednisone
3 hours
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

35. DDx dementia
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
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
'steeple-sign' (subglottic narrowing)

36. MCA stroke sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Dementia - incontinence - gait disturbance
ACEI - ARB - B-blocker - diuretic - Spironolactone

37. Nicotinic acids
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Viral infxn of the subglottis
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

38. Headache with sx systemic illness DDx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Eikenella species
PCP pneumonia
5-HT blockers: tegasorad - alosetron

39. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
IV labetalol - nicardipine - sodium nitroprusside
Dantrolene IV - antipyretics - O2 - cooling blankets
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

40. Croup
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
ACEI - ARB
Digoxin (B-blockers as needed)
Viral infxn of the subglottis

41. QTc
= QT / sqrt(RR interval)
Quinolone + metronidazole
B-blocker - Ca-channel blocker
Legionella

42. Cluster headache pflx
8%
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Bacterial infxn of supraglottic tissue and surrounding areas

43. Sx Lewy Body Dementia
ACEI - B-blocker - spironolactone
ACEI - ARB - B-blocker - diuretic - Spironolactone
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
ACEI - ARB

44. Tx frequent/severe abd pain

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45. Sudden-onset headache DDx
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
'steeple-sign' (subglottic narrowing)
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

46. Retropharyngeal abscess Sx
Bupriopion - amoxipine - trazodone
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

47. Orlistat
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

48. MAOI
Phenelzine - tranylcypramine
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

49. atypical
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
8%
Bacterial infxn of supraglottic tissue and surrounding areas
Bupriopion - amoxipine - trazodone

50. malignant hyperthermia
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
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
Verapamil - Li+ - divalproex sodium - methysergide - prednisone