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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. Nicotinic acids
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
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Meningitis - brain abscess - metastasis

2. Croup
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
3 hours
Viral infxn of the subglottis
Moderate/severe alzheimer dementia

3. Prolonged QT interval (QTc)
Obesity; increased NE release
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
470ms+ in men - 480ms+ in women
= QT / sqrt(RR interval)

4. Dextroamphetamine
H. flu - S. pneumo - S. aureus - Strep A/B/C
Postpartum fever - uterine tenderness - foul-smelling lochia
Foot/leg deficits - cognitive + personality changes
Obesity; increased NE release

5. tx malignant hyperthermia
ACEI - B-blocker - spironolactone
S. aureus
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Dantrolene IV - antipyretics - O2 - cooling blankets

6. Papilledema DDx
Flat disk - button - batteries
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Mass lesion - pseudotumor cerebri - meningitis

7. Dx and Tx of intussception
Meningitis - brain abscess - metastasis
Barium enema
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
ACEI - B-blocker - spironolactone

8. Fibrates
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
TCA's
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Postpartum fever - uterine tenderness - foul-smelling lochia

9. Lubiprostone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
PCP pneumonia
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - ARB

10. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
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
Dementia - incontinence - gait disturbance

11. Tx uterine atony
ACEI - ARB - diuretic - Ca-blocker - B-blocker
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
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

12. contraindications to thrombolytic therapy
Venlafaxine - duloxetine - mirtazapine
= QT / sqrt(RR interval)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

13. MCA stroke sx
Postpartum fever - uterine tenderness - foul-smelling lochia
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
H. flu - S. pneumo - S. aureus - Strep A/B/C
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

14. If not breast-feeding - when does menstruation restart?
3rd month postpartum
470ms+ in men - 480ms+ in women
Halothane - succinylcholine
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction

15. Empiric CAP tx in healthy person
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Moderate/severe alzheimer dementia

16. Tx acute pulmonary edema 2ndary to CHF
Barium enema
Furosemide - nitroglycerin - IV morphine sulphate
ACEI - B-blocker - diuretic - Ca-blocker
= QT / sqrt(RR interval)

17. MCC non-traumatic hip pathology in adolescents
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
SCFE (slipped capital femoral epiphysis)
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Amiodarone/lidocaine

18. Sudden-onset headache DDx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Venlafaxine - duloxetine - mirtazapine
5-HT blockers: tegasorad - alosetron
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

19. New-onset headache in patient with HIV/cancer DDx
Meningitis - brain abscess - metastasis
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
ACEI - ARB - diuretic - Ca-blocker - B-blocker

20. Organism that causes pneumonia with diarrhea
Furosemide - nitroglycerin - IV morphine sulphate
Cephalexin OR dicloxacillin
Amiodarone/lidocaine
Legionella

21. Organism that causes pneumonia post-influenza
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Obesity; increased NE release
Legionella
S. aureus

22. malignant hyperthermia
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Mass lesion - vascular malformation - stroke - collagen vascular disease
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

23. Bronchiolitis sx
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
8%
'steeple-sign' (subglottic narrowing)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

24. Focal neurologic sx (other than aura) DDx
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Mass lesion - vascular malformation - stroke - collagen vascular disease
ACEI - ARB

25. GI 'alarm' features
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
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
Oral prednisone
MVP

26. Croup X-ray

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27. Statins
S. aureus
MVP
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

28. CAGE questionnaire
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Septic arthritis - fractures - congenital hip dysplasia

29. Rivastigmine
5-HT blockers: tegasorad - alosetron
Alzheimer dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Obesity; increased NE release

30. Cholesterol absorption blocker (ezetimibe)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
3 hours
Barium enema
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

31. Cluster headache pflx
MVP
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Renal parenchymal disease
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

32. TCA
PCP pneumonia
H. flu - S. pneumo - S. aureus - Strep A/B/C
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

33. Tx HTN + CVA
ACEI - diuretic
Mass lesion - pseudotumor cerebri - meningitis
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

34. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
S. aureus
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic

35. Outpatient tx CHF
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
S. aureus
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

36. causes of malignant hyperthernia
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Viral infxn of the subglottis
1st line: TZD
Halothane - succinylcholine

37. Tx HTN + DM
Dementia - incontinence - gait disturbance
S. aureus
ACEI - ARB - diuretic - Ca-blocker - B-blocker
100% O2 6L/min - dihydroergotamine - triptans

38. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
10th postpartum day
ACEI - diuretic
Viral infxn of the subglottis

39. Primary SVT tx
B-blocker - Ca-channel blocker
Moderate/severe alzheimer dementia
Eikenella species
IV labetalol - nicardipine - sodium nitroprusside

40. DASH diet plan
High K - high Ca - low Na
1st line: TZD
470ms+ in men - 480ms+ in women
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

41. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Dantrolene IV - antipyretics - O2 - cooling blankets
Neonate - infants - bilious vomiting - abdominal pain

42. IBS pain tx
Mass lesion - pseudotumor cerebri - meningitis
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
5-HT blockers: tegasorad - alosetron

43. DDx dementia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
MVP
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

44. Orlistat
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Dantrolene IV - antipyretics - O2 - cooling blankets
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools

45. Causes of diverticular bleeding
Digoxin (B-blockers as needed)
Lumbar puncture
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

46. Commonly ingested foreign bodies
Dantrolene IV - antipyretics - O2 - cooling blankets
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Flat disk - button - batteries
Fever - sore throat - muffled voice - drooling - trismus - neck pain

47. Pyloric stenosis sx

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48. CXR of CHF
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
ACEI - diuretic
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Bacterial infxn of supraglottic tissue and surrounding areas

49. DDx limp in infant/toddler
Septic arthritis - fractures - congenital hip dysplasia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Venlafaxine - duloxetine - mirtazapine
Alzheimer dementia

50. SSRI's
Oral prednisone
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
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine