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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. Tacrine use/sfx
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

2. Galantamine use/sfx
Renal parenchymal disease
Dantrolene IV - antipyretics - O2 - cooling blankets
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
3rd month postpartum

3. Test to best determine source of lower GI bleed
Colonoscopy
Foot/leg deficits - cognitive + personality changes
B-blocker - Ca-channel blocker
Septic arthritis - fractures - congenital hip dysplasia

4. Croup X-ray

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5. Primary SVT tx
= QT / sqrt(RR interval)
B-blocker - Ca-channel blocker
S. aureus
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

6. Cholesterol absorption blocker (ezetimibe)
ACEI - ARB
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Amiodarone/lidocaine

7. atypical
Obesity; increased NE release
Foot/leg deficits - cognitive + personality changes
Bupriopion - amoxipine - trazodone
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

8. most common valvular heart defect in USA
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
B-blocker - Ca-channel blocker
MVP
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

9. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
Obesity; NE-uptake inhibition
Temporal arteritis - mass lesion
Dantrolene IV - antipyretics - O2 - cooling blankets

10. malignant hyperthermia
8%
S. aureus
Mass lesion - pseudotumor cerebri - meningitis
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

11. ROME IBS criteria
IV labetalol - nicardipine - sodium nitroprusside
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
3rd month postpartum
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

12. Tx frequent/severe abd pain

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13. DDx pediatric intestinal obsutrction
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Barium enema
Venlafaxine - duloxetine - mirtazapine
Eikenella species

14. TCA
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Barium enema
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Oral prednisone

15. Intussusception sx
Mass lesion - vascular malformation - stroke - collagen vascular disease
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Phenelzine - tranylcypramine
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction

16. Statins
ACEI - B-blocker - diuretic - Ca-blocker
Mass lesion - pseudotumor cerebri - meningitis
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

17. Croup pathogens
PCP pneumonia
Dantrolene IV - antipyretics - O2 - cooling blankets
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
ACEI - diuretic

18. MCA stroke sx
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Lumbar puncture

19. Bite injury pflx
Furosemide - nitroglycerin - IV morphine sulphate
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
3rd month postpartum
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

20. 4 T's of postpartum hemorrhage
470ms+ in men - 480ms+ in women
Mass lesion - subdural hematoma - medication overuse
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

21. MCC postpartum hemorrhage
Cephalexin OR dicloxacillin
Uterine atony
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
IV labetalol - nicardipine - sodium nitroprusside

22. SSRI's
MVP
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
ACEI - diuretic
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

23. Rivastigmine
Colonoscopy
Alzheimer dementia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Uterine atony

24. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
ACEI - B-blocker - diuretic - Ca-blocker

25. Lochia
Obesity; increased NE release
'thumb sign' (protrusion of into anterior wall of hypopharynx)
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

26. Epiglottitis pathogens
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Dicyclomine - hyoscyamine (antispasmodics)
H. flu - S. pneumo - S. aureus - Strep A/B/C
Oral prednisone

27. Pyloric stenosis sx

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28. Organism that causes pneumonia post-influenza
S. aureus
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
10th postpartum day
Lumbar puncture

29. X-ray epiglottitis

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30. Prolonged QT interval (QTc)
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
470ms+ in men - 480ms+ in women
Foot/leg deficits - cognitive + personality changes

31. Diethylpropion
470ms+ in men - 480ms+ in women
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Obesity; increased NE release
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

32. Tx mild/infrequent abd pain
Obesity; increased NE release
100% O2 6L/min - dihydroergotamine - triptans
Dicyclomine - hyoscyamine (antispasmodics)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

33. Mastitis tx
Cephalexin OR dicloxacillin
Obesity; increased NE release
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

34. Drugs causing fever
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
3rd month postpartum
PCP pneumonia

35. Tx diverticulitis
H. flu - S. pneumo - S. aureus - Strep A/B/C
= QT / sqrt(RR interval)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Quinolone + metronidazole

36. New-onset headache in patient with HIV/cancer DDx
Amiodarone/lidocaine
Meningitis - brain abscess - metastasis
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Postpartum fever - uterine tenderness - foul-smelling lochia

37. NMDA-R antagonist (memantine)
Digoxin (B-blockers as needed)
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Flat disk - button - batteries
Moderate/severe alzheimer dementia

38. Tx migraine
Uterine atony
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Eikenella species
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

39. Tx uterine atony
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Obesity; increased NE release
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

40. QTc
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
B-blocker - Ca-channel blocker
= QT / sqrt(RR interval)
3rd month postpartum

41. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Moderate/severe alzheimer dementia
Postpartum fever - uterine tenderness - foul-smelling lochia
Obesity; increased NE release

42. Sx endometritis
Neonate - infants - bilious vomiting - abdominal pain
Venlafaxine - duloxetine - mirtazapine
5-HT blockers: tegasorad - alosetron
Postpartum fever - uterine tenderness - foul-smelling lochia

43. causes of malignant hyperthernia
5-HT blockers: tegasorad - alosetron
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Halothane - succinylcholine

44. Tx HTN + CHF
ACEI - ARB - B-blocker - diuretic - Spironolactone
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Phenelzine - tranylcypramine

45. Dx subarachnoid hemorrhage with negative noncontrast CT
Lumbar puncture
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Amitriptyline - propanolol - timolol - divalproex sodium

46. Headache after 50 YO DDx
Dementia - incontinence - gait disturbance
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Temporal arteritis - mass lesion

47. Antihypertensives in suspected stroke
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
IV labetalol - nicardipine - sodium nitroprusside

48. Organism that causes pneumonia with diarrhea
Temporal arteritis - mass lesion
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Eikenella species
Legionella

49. Croup
Viral infxn of the subglottis
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

50. 1st line tx in IBS constipation
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
SCFE (slipped capital femoral epiphysis)
'steeple-sign' (subglottic narrowing)
Fiber (e.g. psyllium)