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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. QTc
Meningitis - brain abscess - metastasis
Fiber (e.g. psyllium)
Lumbar puncture
= QT / sqrt(RR interval)

2. Tx migraine
Dantrolene IV - antipyretics - O2 - cooling blankets
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

3. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Halothane - succinylcholine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

4. Stable vtach tx
1st line: TZD
10th postpartum day
H. flu - S. pneumo - S. aureus - Strep A/B/C
Amiodarone/lidocaine

5. SSRI's
8%
'steeple-sign' (subglottic narrowing)
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Alzheimer dementia

6. Retropharyngeal abscess Sx
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Renal parenchymal disease

7. Tx diverticulitis
Quinolone + metronidazole
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
100% O2 6L/min - dihydroergotamine - triptans
Venlafaxine - duloxetine - mirtazapine

8. Diethylpropion
Obesity; increased NE release
Meningitis - brain abscess - metastasis
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

9. epiglottitis
Dementia - incontinence - gait disturbance
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Bacterial infxn of supraglottic tissue and surrounding areas
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

10. Tx uterine atony
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
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
Renal parenchymal disease
Legionella

11. Tx HTN + CAD
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
100% O2 6L/min - dihydroergotamine - triptans
ACEI - B-blocker - diuretic - Ca-blocker

12. Dx and Tx of intussception
Barium enema
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
SCFE (slipped capital femoral epiphysis)
Lumbar puncture

13. vertebrobasilar stroke sx
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
100% O2 6L/min - dihydroergotamine - triptans
'steeple-sign' (subglottic narrowing)
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

14. 1st line tx in IBS constipation
Neonate - infants - bilious vomiting - abdominal pain
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Fiber (e.g. psyllium)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

15. ACA stroke ssx
Flat disk - button - batteries
Foot/leg deficits - cognitive + personality changes
Septic arthritis - fractures - congenital hip dysplasia
Obesity; increased NE release

16. Lubiprostone
8%
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
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
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

17. Headaches increasing in severity + intensity DDx
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Obesity; increased NE release
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

18. Phendimetrazine
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
SCFE (slipped capital femoral epiphysis)
Lumbar puncture
Obesity; increased NE release

19. Drugs causing fever
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Colonoscopy
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

20. Headache post-head trauma DDx
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
100% O2 6L/min - dihydroergotamine - triptans
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

21. DDx postoperative fever
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
= QT / sqrt(RR interval)
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
MVP

22. X-ray epiglottitis

23. Croup X-ray

24. Malrotation sx
Bupriopion - amoxipine - trazodone
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Neonate - infants - bilious vomiting - abdominal pain
ACEI - ARB

25. Donepezil use/sfx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Postpartum fever - uterine tenderness - foul-smelling lochia
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
ACEI - ARB

26. Mastitis tx
Bacterial infxn of supraglottic tissue and surrounding areas
Cephalexin OR dicloxacillin
Alzheimer dementia
Venlafaxine - duloxetine - mirtazapine

27. IBS pain tx
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)
5-HT blockers: tegasorad - alosetron

28. MCC postpartum hemorrhage
Uterine atony
MVP
Cephalexin OR dicloxacillin
'steeple-sign' (subglottic narrowing)

29. TCA
ACEI - B-blocker - diuretic - Ca-blocker
Furosemide - nitroglycerin - IV morphine sulphate
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Obesity; increased NE release

30. Tx HTN
5-HT blockers: tegasorad - alosetron
8%
1st line: TZD
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

31. Papilledema DDx
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Mass lesion - pseudotumor cerebri - meningitis
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

32. DASH diet plan
High K - high Ca - low Na
Digoxin (B-blockers as needed)
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

33. Nicotinic acids
Fiber (e.g. psyllium)
'steeple-sign' (subglottic narrowing)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

34. Chance of pregnancy after a single act of coitus
'steeple-sign' (subglottic narrowing)
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
8%
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze

35. MCA stroke sx
Fasting blood glucose - LFTs - renal function - TSH
Obesity; increased NE release
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

36. Cardiac Resynchronization Therapy (CRT) is warranted when ___
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
PCP pneumonia
Obesity; NE-uptake inhibition
Alzheimer dementia

37. DDx pediatric intestinal obsutrction
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Viral infxn of the subglottis
Renal parenchymal disease
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

38. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Postpartum fever - uterine tenderness - foul-smelling lochia
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Legionella

39. If not breast-feeding - when does menstruation restart?
3rd month postpartum
TCA's
Dementia - incontinence - gait disturbance
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

40. Refer to cardiologist post-sports physical if ____
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Colonoscopy
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

41. Fibrates
B-blocker - Ca-channel blocker
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

42. atypical
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
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
Bupriopion - amoxipine - trazodone

43. Sx Lewy Body Dementia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Dicyclomine - hyoscyamine (antispasmodics)
Uterine atony

44. Tx HTN + CVA
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
ACEI - diuretic

45. Tx HTN + CHF
Mass lesion - pseudotumor cerebri - meningitis
Halothane - succinylcholine
ACEI - ARB - B-blocker - diuretic - Spironolactone
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

46. Sibutramine
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
Obesity; increased NE release
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Moderate/severe alzheimer dementia

47. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Dantrolene IV - antipyretics - O2 - cooling blankets
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
MVP

48. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
5-HT blockers: tegasorad - alosetron
Obesity; NE-uptake inhibition

49. 'Alarm' sx for upper GI endoscopy
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Dicyclomine - hyoscyamine (antispasmodics)
Barium enema

50. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Foot/leg deficits - cognitive + personality changes
Renal parenchymal disease