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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. Lochia
Mass lesion - pseudotumor cerebri - meningitis
Obesity; increased NE release
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

2. Donepezil use/sfx
10th postpartum day
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Barium enema
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

3. Nicotinic acids
Dementia - incontinence - gait disturbance
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD
470ms+ in men - 480ms+ in women
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

4. Cholesterol absorption blocker (ezetimibe)
Legionella
Fiber (e.g. psyllium)
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN

5. If not breast-feeding - when does menstruation restart?
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
100% O2 6L/min - dihydroergotamine - triptans
3rd month postpartum
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

6. Cluster headache pflx
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

7. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Quinolone + metronidazole
= QT / sqrt(RR interval)

8. Sudden-onset headache DDx
Foot/leg deficits - cognitive + personality changes
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
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

9. tx malignant hyperthermia
Dantrolene IV - antipyretics - O2 - cooling blankets
Mass lesion - vascular malformation - stroke - collagen vascular disease
Moderate/severe alzheimer dementia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

10. DDx Limp w/o pain in children - orthopedic
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
10th postpartum day
ACEI - ARB - B-blocker - diuretic - Spironolactone

11. Papilledema DDx
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
Mass lesion - pseudotumor cerebri - meningitis
Septic arthritis - fractures - congenital hip dysplasia

12. Malrotation sx
Bupriopion - amoxipine - trazodone
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
MVP
Neonate - infants - bilious vomiting - abdominal pain

13. 1st line tx in IBS constipation
ACEI - ARB
Fiber (e.g. psyllium)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Dantrolene IV - antipyretics - O2 - cooling blankets

14. 4 T's of postpartum hemorrhage
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Temporal arteritis - mass lesion
B-blocker - Ca-channel blocker
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)

15. Sx of pneumococcal pneumonia
Renal parenchymal disease
3rd month postpartum
B-blocker - Ca-channel blocker
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

16. MCC infxn in closed-fist injuries
Eikenella species
Neonate - infants - bilious vomiting - abdominal pain
Viral infxn of the subglottis
Verapamil - Li+ - divalproex sodium - methysergide - prednisone

17. atypical
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Halothane - succinylcholine
= QT / sqrt(RR interval)
Bupriopion - amoxipine - trazodone

18. Refer to cardiologist post-sports physical if ____
High K - high Ca - low Na
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Obesity; increased NE release
Digoxin (B-blockers as needed)

19. DDx dementia
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Halothane - succinylcholine
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

20. Tx local - acute rxn to bee sting
Obesity; increased NE release
Mass lesion - subdural hematoma - medication overuse
Oral prednisone
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

21. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Barium enema
Alzheimer dementia
ACEI - diuretic
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

22. Phendimetrazine
Obesity; increased NE release
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
H. flu - S. pneumo - S. aureus - Strep A/B/C

23. MCC non-traumatic hip pathology in adolescents
Amitriptyline - propanolol - timolol - divalproex sodium
Digoxin (B-blockers as needed)
SCFE (slipped capital femoral epiphysis)
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

24. Baby blues resolves by ______
ACEI - diuretic
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)
10th postpartum day

25. Bilateral 'ground glass' infiltrate on CXR
PCP pneumonia
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Phenelzine - tranylcypramine
Postpartum fever - uterine tenderness - foul-smelling lochia

26. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Mass lesion - pseudotumor cerebri - meningitis
8%
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

27. Tacrine use/sfx
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Legionella

28. Headaches increasing in severity + intensity DDx
H. flu - S. pneumo - S. aureus - Strep A/B/C
Mass lesion - subdural hematoma - medication overuse
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

29. Chronic afib tx
Lumbar puncture
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Flat disk - button - batteries
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

30. Drugs causing fever
Mass lesion - vascular malformation - stroke - collagen vascular disease
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
High K - high Ca - low Na
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

31. Organism that causes pneumonia post-influenza
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
S. aureus
TCA's

32. Standard workup for dyslipidemia
Fasting blood glucose - LFTs - renal function - TSH
Amiodarone/lidocaine
Flat disk - button - batteries
ACEI - ARB - B-blocker - diuretic - Spironolactone

33. Statins
Temporal arteritis - mass lesion
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Meningitis - brain abscess - metastasis
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

34. Headache with sx systemic illness DDx
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease
Obesity; increased NE release
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
10th postpartum day

35. ROME IBS criteria
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

36. Empiric CAP tx in healthy person
Fasting blood glucose - LFTs - renal function - TSH
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

37. malignant hyperthermia
Temporal arteritis - mass lesion
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Amitriptyline - propanolol - timolol - divalproex sodium
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

38. QTc
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
= QT / sqrt(RR interval)
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
'steeple-sign' (subglottic narrowing)

39. epiglottitis
Foot/leg deficits - cognitive + personality changes
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Bacterial infxn of supraglottic tissue and surrounding areas
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

40. Organism that causes pneumonia with diarrhea
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Legionella
Quinolone + metronidazole
Furosemide - nitroglycerin - IV morphine sulphate

41. Epiglottitis pathogens
ACEI - diuretic
Venlafaxine - duloxetine - mirtazapine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
H. flu - S. pneumo - S. aureus - Strep A/B/C

42. Orlistat
B-blocker - Ca-channel blocker
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

43. Tx HTN + CHF
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Neonate - infants - bilious vomiting - abdominal pain
ACEI - ARB - B-blocker - diuretic - Spironolactone

44. NMDA-R antagonist (memantine)
10th postpartum day
Moderate/severe alzheimer dementia
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
ACEI - B-blocker - spironolactone

45. Croup
Viral infxn of the subglottis
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
ACEI - B-blocker - diuretic - Ca-blocker
Lumbar puncture

46. SNRI
Amitriptyline - propanolol - timolol - divalproex sodium
Venlafaxine - duloxetine - mirtazapine
Eikenella species
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

47. SSRI's
Lumbar puncture
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
470ms+ in men - 480ms+ in women
Mass lesion - pseudotumor cerebri - meningitis

48. Dextroamphetamine
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Obesity; increased NE release
Eikenella species
B-blocker - Ca-channel blocker

49. Causes of diverticular bleeding
Verapamil - Li+ - divalproex sodium - methysergide - 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
Obesity; increased NE release
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

50. vertebrobasilar stroke sx
IV labetalol - nicardipine - sodium nitroprusside
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
1st line: TZD
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old