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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. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
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)
Neonate - infants - bilious vomiting - abdominal pain

2. MCC HTN in child
= QT / sqrt(RR interval)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Venlafaxine - duloxetine - mirtazapine
Renal parenchymal disease

3. Primary SVT tx
Fiber (e.g. psyllium)
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
B-blocker - Ca-channel blocker
ACEI - ARB - B-blocker - diuretic - Spironolactone

4. malignant hyperthermia
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Colonoscopy
MVP

5. Sudden-onset headache DDx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Obesity; increased NE release
H. flu - S. pneumo - S. aureus - Strep A/B/C

6. Sx HoCM
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
5-HT blockers: tegasorad - alosetron
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

7. Fibrates
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Postpartum fever - uterine tenderness - foul-smelling lochia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

8. MCC postpartum hemorrhage
IV labetalol - nicardipine - sodium nitroprusside
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Uterine atony

9. Nicotinic acids
ACEI - B-blocker - spironolactone
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
Venlafaxine - duloxetine - mirtazapine

10. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
H. flu - S. pneumo - S. aureus - Strep A/B/C
Bacterial infxn of supraglottic tissue and surrounding areas
Temporal arteritis - mass lesion

11. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Alzheimer dementia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

12. Empiric CAP tx in healthy person
Obesity; increased NE release
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - ARB
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

13. Tx frequent/severe abd pain

14. Phentermine
TCA's
Obesity; NE-uptake inhibition
Obesity; increased NE release
Quinolone + metronidazole

15. Tx HTN + CKD
Quinolone + metronidazole
ACEI - ARB
Dicyclomine - hyoscyamine (antispasmodics)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

16. Causes of diverticular bleeding
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Moderate/severe alzheimer dementia
'steeple-sign' (subglottic narrowing)
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

17. Sibutramine
Halothane - succinylcholine
Septic arthritis - fractures - congenital hip dysplasia
TCA's
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

18. Papilledema DDx
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Mass lesion - pseudotumor cerebri - meningitis
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
10th postpartum day

19. Intussusception sx
3rd month postpartum
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
10th postpartum day
B-blocker - Ca-channel blocker

20. Tx HTN + DM
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Viral infxn of the subglottis
Cephalexin OR dicloxacillin

21. contraindications to thrombolytic therapy
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
100% O2 6L/min - dihydroergotamine - triptans
1st line: TZD
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

22. Croup pathogens
TCA's
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Amiodarone/lidocaine
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

23. Croup sx
Cephalexin OR dicloxacillin
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

24. Dextroamphetamine
Postpartum fever - uterine tenderness - foul-smelling lochia
Obesity; increased NE release
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
'steeple-sign' (subglottic narrowing)

25. Test to best determine source of lower GI bleed
Obesity; increased NE release
Colonoscopy
Moderate/severe alzheimer dementia
Renal parenchymal disease

26. NMDA-R antagonist (memantine)
Postpartum fever - uterine tenderness - foul-smelling lochia
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Moderate/severe alzheimer dementia

27. atypical
Digoxin (B-blockers as needed)
Bupriopion - amoxipine - trazodone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Cephalexin OR dicloxacillin

28. Tacrine use/sfx
Viral infxn of the subglottis
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

29. Croup
Viral infxn of the subglottis
ACEI - ARB - B-blocker - diuretic - Spironolactone
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

30. Empiric CAP tx in hospitalized patient
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

31. Tx migraine
10th postpartum day
= QT / sqrt(RR interval)
Renal parenchymal disease
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

32. Tx HTN + post-MI
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
ACEI - B-blocker - spironolactone
Bacterial infxn of supraglottic tissue and surrounding areas
Eikenella species

33. QTc
High K - high Ca - low Na
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
= QT / sqrt(RR interval)

34. Commonly ingested foreign bodies
MVP
Flat disk - button - batteries
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

35. Orlistat
Barium enema
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
H. flu - S. pneumo - S. aureus - Strep A/B/C

36. Metabolic syndrome
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Furosemide - nitroglycerin - IV morphine sulphate
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

37. ROME IBS criteria
Mass lesion - subdural hematoma - medication overuse
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
10th postpartum day
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

38. Sx endometritis
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Postpartum fever - uterine tenderness - foul-smelling lochia
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
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

39. Afib - Aflutter tx
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Digoxin (B-blockers as needed)
SCFE (slipped capital femoral epiphysis)
Legionella

40. rtPA should be used within ____ of stroke
Fasting blood glucose - LFTs - renal function - TSH
Furosemide - nitroglycerin - IV morphine sulphate
3 hours
Renal parenchymal disease

41. Croup X-ray

42. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
ACEI - ARB
Obesity; increased NE release
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

43. Tx mild/infrequent abd pain
Dicyclomine - hyoscyamine (antispasmodics)
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Phenelzine - tranylcypramine

44. DDx dementia
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Moderate/severe alzheimer dementia
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

45. Headaches increasing in severity + intensity DDx
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Mass lesion - subdural hematoma - medication overuse
Obesity; increased NE release
Halothane - succinylcholine

46. DDx pediatric intestinal obsutrction
Amitriptyline - propanolol - timolol - divalproex sodium
Colonoscopy
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Viral infxn of the subglottis

47. Refer to cardiologist post-sports physical if ____
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

48. Chronic afib tx
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Legionella
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

49. IBS pain tx
5-HT blockers: tegasorad - alosetron
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

50. Tx acute pulmonary edema 2ndary to CHF
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Furosemide - nitroglycerin - IV morphine sulphate
3 hours
Temporal arteritis - mass lesion