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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. Tx HTN
1st line: TZD
Amitriptyline - propanolol - timolol - divalproex sodium
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

2. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Foot/leg deficits - cognitive + personality changes
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Temporal arteritis - mass lesion

3. Bilateral 'ground glass' infiltrate on CXR
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
PCP pneumonia

4. Organism that causes pneumonia post-influenza
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
ACEI - ARB - diuretic - Ca-blocker - B-blocker
S. aureus
Lumbar puncture

5. 4 T's of postpartum hemorrhage
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Digoxin (B-blockers as needed)
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

6. Croup sx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Legionella
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

7. rtPA should be used within ____ of stroke
3 hours
Fiber (e.g. psyllium)
Phenelzine - tranylcypramine
Fever - sore throat - muffled voice - drooling - trismus - neck pain

8. Sx Lewy Body Dementia
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
'steeple-sign' (subglottic narrowing)
470ms+ in men - 480ms+ in women
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

9. most common valvular heart defect in USA
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
1st line: TZD
ACEI - B-blocker - spironolactone
MVP

10. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Oral prednisone
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
H. flu - S. pneumo - S. aureus - Strep A/B/C
SCFE (slipped capital femoral epiphysis)

11. Evaluating limp w/o pain in children
Quinolone + metronidazole
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Obesity; increased NE release

12. Tx mild/infrequent abd pain
PCP pneumonia
Dicyclomine - hyoscyamine (antispasmodics)
Barium enema
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement

13. atypical
Bupriopion - amoxipine - trazodone
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Quinolone + metronidazole

14. Stable vtach tx
Amiodarone/lidocaine
ACEI - diuretic
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

15. Headaches increasing in severity + intensity DDx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Mass lesion - subdural hematoma - medication overuse
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

16. MAOI
Halothane - succinylcholine
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Phenelzine - tranylcypramine
ACEI - ARB

17. Sx HoCM
MVP
Fasting blood glucose - LFTs - renal function - TSH
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

18. Tx migraine
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
IV labetalol - nicardipine - sodium nitroprusside
Temporal arteritis - mass lesion

19. epiglottitis
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Barium enema
Bacterial infxn of supraglottic tissue and surrounding areas
Obesity; NE-uptake inhibition

20. Refer to cardiologist post-sports physical if ____
Meningitis - brain abscess - metastasis
Cephalexin OR dicloxacillin
B-blocker - Ca-channel blocker
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

21. MCC HTN in child
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Dicyclomine - hyoscyamine (antispasmodics)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Renal parenchymal disease

22. Tx HTN + CKD
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - ARB
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

23. Croup
Legionella
Viral infxn of the subglottis
MVP
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

24. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - subdural hematoma - medication overuse

25. Sx endometritis
1st line: TZD
Postpartum fever - uterine tenderness - foul-smelling lochia
H. flu - S. pneumo - S. aureus - Strep A/B/C
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

26. Dx and Tx of intussception
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Dicyclomine - hyoscyamine (antispasmodics)
Barium enema

27. Epiglottitis pathogens
5-HT blockers: tegasorad - alosetron
H. flu - S. pneumo - S. aureus - Strep A/B/C
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

28. Focal neurologic sx (other than aura) DDx
Quinolone + metronidazole
Mass lesion - vascular malformation - stroke - collagen vascular disease
10th postpartum day
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

29. Fibrates
Amiodarone/lidocaine
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Quinolone + metronidazole
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

30. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Mass lesion - pseudotumor cerebri - meningitis
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
10th postpartum day

31. Drugs causing fever
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Viral infxn of the subglottis
ACEI - ARB

32. Chronic afib tx
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

33. SNRI
Venlafaxine - duloxetine - mirtazapine
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Postpartum fever - uterine tenderness - foul-smelling lochia
Temporal arteritis - mass lesion

34. Mastitis tx
5-HT blockers: tegasorad - alosetron
Cephalexin OR dicloxacillin
Meningitis - brain abscess - metastasis
100% O2 6L/min - dihydroergotamine - triptans

35. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Septic arthritis - fractures - congenital hip dysplasia
PCP pneumonia

36. IBS pain tx
Postpartum fever - uterine tenderness - foul-smelling lochia
Lumbar puncture
5-HT blockers: tegasorad - alosetron
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

37. Papilledema DDx
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Mass lesion - pseudotumor cerebri - meningitis
Furosemide - nitroglycerin - IV morphine sulphate
Septic arthritis - fractures - congenital hip dysplasia

38. CAGE questionnaire
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Quinolone + metronidazole
'thumb sign' (protrusion of into anterior wall of hypopharynx)

39. Dx subarachnoid hemorrhage with negative noncontrast CT
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Lumbar puncture
ACEI - B-blocker - spironolactone
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome

40. Sx normal-pressure hydrocephalus
TCA's
8%
5-HT blockers: tegasorad - alosetron
Dementia - incontinence - gait disturbance

41. Metabolic syndrome
TCA's
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Furosemide - nitroglycerin - IV morphine sulphate
Mass lesion - vascular malformation - stroke - collagen vascular disease

42. CXR of CHF
Septic arthritis - fractures - congenital hip dysplasia
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
H. flu - S. pneumo - S. aureus - Strep A/B/C

43. Headache with sx systemic illness DDx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

44. Prolonged QT interval (QTc)
Fasting blood glucose - LFTs - renal function - TSH
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
470ms+ in men - 480ms+ in women

45. Headache after 50 YO DDx
Temporal arteritis - mass lesion
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

46. Lochia
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
IV labetalol - nicardipine - sodium nitroprusside
ACEI - B-blocker - spironolactone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

47. malignant hyperthermia
ACEI - ARB
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Dantrolene IV - antipyretics - O2 - cooling blankets
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose

48. Statins
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
8%

49. Galantamine use/sfx
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Fever - sore throat - muffled voice - drooling - trismus - neck pain

50. Organism that causes pneumonia with diarrhea
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Uterine atony
Legionella