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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. Papilledema DDx
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Barium enema
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Mass lesion - pseudotumor cerebri - meningitis

2. NMDA-R antagonist (memantine)
Furosemide - nitroglycerin - IV morphine sulphate
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Moderate/severe alzheimer dementia
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

3. Headaches increasing in severity + intensity DDx
Neonate - infants - bilious vomiting - abdominal pain
Postpartum fever - uterine tenderness - foul-smelling lochia
Mass lesion - subdural hematoma - medication overuse
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease

4. Lubiprostone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
470ms+ in men - 480ms+ in women
Oral prednisone
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea

5. rtPA should be used within ____ of stroke
Obesity; increased NE release
Oral prednisone
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
3 hours

6. IBS pain tx
5-HT blockers: tegasorad - alosetron
Barium enema
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Meningitis - encephalitis - Lyme disease - systemic infxn - collagen vascular disease

7. SSRI's
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Temporal arteritis - mass lesion

8. Phendimetrazine
Obesity; increased NE release
1st line: TZD
Quinolone + metronidazole
ACEI - ARB - diuretic - Ca-blocker - B-blocker

9. Standard workup for dyslipidemia
1st line: TZD
8%
Fasting blood glucose - LFTs - renal function - TSH
Lumbar puncture

10. Cardiac Resynchronization Therapy (CRT) is warranted when ___
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Eikenella species
8%
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy

11. Primary SVT tx
B-blocker - Ca-channel blocker
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

12. Lochia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
H. flu - S. pneumo - S. aureus - Strep A/B/C
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
ACEI - ARB - B-blocker - diuretic - Spironolactone

13. atypical
Dicyclomine - hyoscyamine (antispasmodics)
Bupriopion - amoxipine - trazodone
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

14. Tx migraine
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
Amitriptyline - propanolol - timolol - divalproex sodium
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

15. Commonly ingested foreign bodies
Flat disk - button - batteries
Neonate - infants - bilious vomiting - abdominal pain
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

16. X-ray epiglottitis

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17. Antihypertensives in suspected stroke
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Renal parenchymal disease
IV labetalol - nicardipine - sodium nitroprusside

18. Test to best determine source of lower GI bleed
PCP pneumonia
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Septic arthritis - fractures - congenital hip dysplasia
Colonoscopy

19. Organism that causes pneumonia with diarrhea
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Legionella
Moderate/severe alzheimer dementia
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.

20. DASH diet plan
High K - high Ca - low Na
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

21. Drugs causing fever
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
Fever - anemia - weight loss 10+ lbs - hematochezia - melena - refractory/bloody diarrhea - FHx colon cancer/IBD

22. Headache after 50 YO DDx
Colonoscopy
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Temporal arteritis - mass lesion
S. aureus

23. Refer to cardiologist post-sports physical if ____
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Legionella
3 hours

24. Rivastigmine
8%
Alzheimer dementia
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
'thumb sign' (protrusion of into anterior wall of hypopharynx)

25. Empiric CAP tx in hospitalized patient
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
= QT / sqrt(RR interval)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

26. 4 T's of postpartum hemorrhage
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
5-HT blockers: tegasorad - alosetron
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)

27. Intussusception sx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
ACEI - ARB - B-blocker - diuretic - Spironolactone
Obesity; increased NE release
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

28. malignant hyperthermia
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
8%

29. Tx HTN
S. aureus
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
ACEI - B-blocker - spironolactone
1st line: TZD

30. MCA stroke sx
Aphasia (dom hemisphere) - contralateral hemiparesis - sensory loss - spatial neglect - contralateral impaired conjugate gaze
Postpartum fever - uterine tenderness - foul-smelling lochia
Obesity; increased NE release
Mass lesion - subdural hematoma - medication overuse

31. Phentermine
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
100% O2 6L/min - dihydroergotamine - triptans
Obesity; NE-uptake inhibition

32. Organism that causes pneumonia post-influenza
SCFE (slipped capital femoral epiphysis)
ACEI - B-blocker - spironolactone
Dementia - incontinence - gait disturbance
S. aureus

33. Tx acute pulmonary edema 2ndary to CHF
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Obesity (short/long term); 5-HT reuptake inhibition; sfx: 5-HT syndrome
= QT / sqrt(RR interval)
Furosemide - nitroglycerin - IV morphine sulphate

34. Orlistat
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

35. Sx Lewy Body Dementia
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Oral prednisone

36. Metabolic syndrome
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Flat disk - button - batteries
100% O2 6L/min - dihydroergotamine - triptans
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

37. MAOI
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Phenelzine - tranylcypramine

38. Nicotinic acids
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Fasting blood glucose - LFTs - renal function - TSH
TCA's
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

39. Tx mild/infrequent abd pain
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Dicyclomine - hyoscyamine (antispasmodics)
Legionella
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

40. Empiric CAP tx in healthy person
MVP
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Dicyclomine - hyoscyamine (antispasmodics)
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide

41. ACA stroke ssx
Mass lesion - pseudotumor cerebri - meningitis
Foot/leg deficits - cognitive + personality changes
Barium enema
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

42. ROME IBS criteria
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Septic arthritis - fractures - congenital hip dysplasia
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

43. 1st line tx in IBS constipation
Fiber (e.g. psyllium)
3 hours
Barium enema
Acute - cough w/ rust-colored sputum - fever - chills - lobar infiltrate on CXR

44. Tx HTN + CVA
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
ACEI - diuretic
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

45. Croup
Viral infxn of the subglottis
3 hours
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone

46. Afib - Aflutter tx
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Obesity (short/long term); inhibit pancreatic lipase; sfx: bloating - gas - oily stools
Digoxin (B-blockers as needed)

47. Sx normal-pressure hydrocephalus
Obesity; NE-uptake inhibition
Dementia - incontinence - gait disturbance
IV labetalol - nicardipine - sodium nitroprusside
Fever - sore throat - muffled voice - drooling - trismus - neck pain

48. QTc
= QT / sqrt(RR interval)
5-HT blockers: tegasorad - alosetron
Amiodarone/lidocaine
Quinolone + metronidazole

49. Dx subarachnoid hemorrhage with negative noncontrast CT
Lumbar puncture
Furosemide - nitroglycerin - IV morphine sulphate
8%
Venlafaxine - duloxetine - mirtazapine

50. Tx HTN + CHF
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Flat disk - button - batteries
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
ACEI - ARB - B-blocker - diuretic - Spironolactone