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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. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Meningitis - brain abscess - metastasis

2. Tx HTN + CKD
Cephalexin OR dicloxacillin
ACEI - ARB
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

3. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Moderate/severe alzheimer dementia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

4. SNRI
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - B-blocker - spironolactone
Venlafaxine - duloxetine - mirtazapine

5. Chance of pregnancy after a single act of coitus
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
8%
ACEI - diuretic
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

6. Croup
Viral infxn of the subglottis
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
High K - high Ca - low Na
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

7. Afib - Aflutter tx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Digoxin (B-blockers as needed)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

8. DDx limp in infant/toddler
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Septic arthritis - fractures - congenital hip dysplasia
Eikenella species

9. CAGE questionnaire
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

10. IBS pain tx
5-HT blockers: tegasorad - alosetron
Cephalexin OR dicloxacillin
Dementia - incontinence - gait disturbance
Mass lesion - vascular malformation - stroke - collagen vascular disease

11. Chronic afib tx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Obesity; increased NE release
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
ACEI - ARB - diuretic - Ca-blocker - B-blocker

12. Tx HTN + CAD
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Obesity; increased NE release
ACEI - B-blocker - diuretic - Ca-blocker
Neonate - infants - bilious vomiting - abdominal pain

13. Tx HTN + CHF
Furosemide - nitroglycerin - IV morphine sulphate
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB - B-blocker - diuretic - Spironolactone

14. DASH diet plan
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
High K - high Ca - low Na
100% O2 6L/min - dihydroergotamine - triptans

15. Phendimetrazine
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Neonate - infants - bilious vomiting - abdominal pain
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

16. Sudden-onset headache DDx
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
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

17. Bite injury pflx
ACEI - B-blocker - diuretic - Ca-blocker
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

18. Baby blues resolves by ______
Cephalexin OR dicloxacillin
3rd month postpartum
Obesity; increased NE release
10th postpartum day

19. Peritonsillar abscess Sx
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Fever - sore throat - muffled voice - drooling - trismus - neck pain

20. Tx frequent/severe abd pain

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21. Commonly ingested foreign bodies
H. flu - S. pneumo - S. aureus - Strep A/B/C
= QT / sqrt(RR interval)
Flat disk - button - batteries
100% O2 6L/min - dihydroergotamine - triptans

22. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Phenelzine - tranylcypramine
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

23. 4 T's of postpartum hemorrhage
Bacterial infxn of supraglottic tissue and surrounding areas
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

24. Antihypertensives in suspected stroke
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
IV labetalol - nicardipine - sodium nitroprusside
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Oral prednisone

25. Statins
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
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
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
10th postpartum day

26. MCC HTN in child
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Renal parenchymal disease
High K - high Ca - low Na

27. Tx local - acute rxn to bee sting
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Oral prednisone

28. MCC non-traumatic hip pathology in adolescents
High K - high Ca - low Na
Obesity; increased NE release
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
SCFE (slipped capital femoral epiphysis)

29. Croup X-ray

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30. Tx HTN + CVA
ACEI - B-blocker - diuretic - Ca-blocker
ACEI - diuretic
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo

31. Tx HTN + post-MI
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
ACEI - B-blocker - spironolactone
TCA's

32. Stable vtach tx
Amiodarone/lidocaine
Obesity; increased NE release
100% O2 6L/min - dihydroergotamine - triptans
Moderate/severe alzheimer dementia

33. Evaluating limp w/o pain in children
Moderate/severe alzheimer dementia
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Amiodarone/lidocaine
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

34. Outpatient tx CHF
Fiber (e.g. psyllium)
ACEI - B-blocker - spironolactone
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

35. Lochia
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Oral prednisone
Cephalexin OR dicloxacillin

36. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Venlafaxine - duloxetine - mirtazapine
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Fiber (e.g. psyllium)

37. Causes of diverticular bleeding
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Cephalexin OR dicloxacillin
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
1st line: TZD

38. Tx uterine atony
Mass lesion - pseudotumor cerebri - meningitis
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
3 hours
1st line: TZD

39. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Obesity; increased NE release
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

40. Primary SVT tx
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
B-blocker - Ca-channel blocker
Dementia - incontinence - gait disturbance
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

41. MAOI
Phenelzine - tranylcypramine
TCA's
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

42. Headaches increasing in severity + intensity DDx
Fiber (e.g. psyllium)
Quinolone + metronidazole
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

43. Organism that causes pneumonia with diarrhea
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
1st line: TZD
Legionella
3 hours

44. Nicotinic acids
Barium enema
Temporal arteritis - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Halothane - succinylcholine

45. If not breast-feeding - when does menstruation restart?
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
3rd month postpartum

46. Sx Lewy Body Dementia
Dantrolene IV - antipyretics - O2 - cooling blankets
Fiber (e.g. psyllium)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

47. vertebrobasilar stroke sx
Barium enema
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
10th postpartum day

48. Orlistat
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
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
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

49. ACA stroke ssx
TCA's
Foot/leg deficits - cognitive + personality changes
Temporal arteritis - mass lesion
PCP pneumonia

50. Mastitis tx
Obesity; increased NE release
Cephalexin OR dicloxacillin
Eikenella species
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer