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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.
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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 + CKD
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
8%
Fever - sore throat - muffled voice - drooling - trismus - neck pain
ACEI - ARB

2. Donepezil use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache
RSV - PIV - adenoviris - rhinovirus - enterovirus - influenza - m. pneumo
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)

3. Headache post-head trauma DDx
Septic arthritis - fractures - congenital hip dysplasia
Dementia - incontinence - gait disturbance
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Intracranial hemorrhage - subdural hematoma - epidural hematoma - posttraumatic headache

4. Tx HTN + CHF
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Fiber (e.g. psyllium)
ACEI - ARB - B-blocker - diuretic - Spironolactone

5. Retropharyngeal abscess Sx
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Moderate/severe alzheimer dementia
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

6. Lochia
Dantrolene IV - antipyretics - O2 - cooling blankets
Neonate - infants - bilious vomiting - abdominal pain
Postpartum fever - uterine tenderness - foul-smelling lochia
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

7. Empiric CAP tx in healthy person
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
High K - high Ca - low Na

8. Phentermine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Obesity; NE-uptake inhibition
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

9. Rivastigmine
ACEI - B-blocker - diuretic - Ca-blocker
Temporal arteritis - mass lesion
MVP
Alzheimer dementia

10. DDx Limp w/o pain in children - orthopedic
B-blocker - Ca-channel blocker
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Lumbar puncture
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

11. QTc
= QT / sqrt(RR interval)
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old
SCFE (slipped capital femoral epiphysis)

12. Prolonged QT interval (QTc)
470ms+ in men - 480ms+ in women
Dementia - incontinence - gait disturbance
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
H. flu - S. pneumo - S. aureus - Strep A/B/C

13. Tx migraine
Dementia - incontinence - gait disturbance
TCA's
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

14. Lubiprostone
3rd month postpartum
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Mech: Activates intestinal chloride channels - use: IBS in women w/ constipation - sfx: nausea
Alzheimer dementia

15. Malrotation sx
Neonate - infants - bilious vomiting - abdominal pain
Dicyclomine - hyoscyamine (antispasmodics)
Temporal arteritis - mass lesion
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

16. Primary SVT tx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
High K - high Ca - low Na
B-blocker - Ca-channel blocker
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

17. most common valvular heart defect in USA
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Dantrolene IV - antipyretics - O2 - cooling blankets
MVP

18. Cluster headache acute tx
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Mass lesion - pseudotumor cerebri - meningitis
100% O2 6L/min - dihydroergotamine - triptans
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic

19. Tx HTN + CVA
Bacterial infxn of supraglottic tissue and surrounding areas
Legionella
Moderate/severe alzheimer dementia
ACEI - diuretic

20. Dx subarachnoid hemorrhage with negative noncontrast CT
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Lumbar puncture
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
Quinolone + metronidazole

21. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Oral prednisone
Furosemide - nitroglycerin - IV morphine sulphate
IV labetalol - nicardipine - sodium nitroprusside

22. Tx uterine atony
Amitriptyline - propanolol - timolol - divalproex sodium
Cephalexin OR dicloxacillin
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
Temporal arteritis - mass lesion

23. Sx normal-pressure hydrocephalus
Dementia - incontinence - gait disturbance
Bacterial infxn of supraglottic tissue and surrounding areas
TCA's
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

24. Sx Lewy Body Dementia
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Obesity; increased NE release
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

25. Antihypertensives in suspected stroke
TCA's
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
3 hours
IV labetalol - nicardipine - sodium nitroprusside

26. TCA
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

27. Croup sx
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

28. Causes of diverticular bleeding
Flat disk - button - batteries
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
ACEI - B-blocker - diuretic - Ca-blocker

29. ROME IBS criteria
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
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
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B

30. Evaluating limp w/o pain in children
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Fasting blood glucose - LFTs - renal function - TSH
S. aureus
'steeple-sign' (subglottic narrowing)

31. Bite injury pflx
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
ACEI - B-blocker - diuretic - Ca-blocker
Flat disk - button - batteries
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy

32. causes of malignant hyperthernia
Laryngotracheitis; laryngotracheobronchitis; laryngotracheobronchopneumonitis; spasmodic
5-HT blockers: tegasorad - alosetron
Halothane - succinylcholine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

33. ACA stroke ssx
Foot/leg deficits - cognitive + personality changes
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Cephalexin OR dicloxacillin
Meningitis - brain abscess - metastasis

34. Cluster headache pflx
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Verapamil - Li+ - divalproex sodium - methysergide - prednisone
Cephalexin OR dicloxacillin
Barium enema

35. DDx dementia
High K - high Ca - low Na
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Postpartum fever - uterine tenderness - foul-smelling lochia
Moderate/severe alzheimer dementia

36. DDx postoperative fever
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener
5-HT blockers: tegasorad - alosetron
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

37. Test to best determine source of lower GI bleed
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Colonoscopy
100% O2 6L/min - dihydroergotamine - triptans
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures

38. 'Alarm' sx for upper GI endoscopy
Weight loss - progressive dysphagia - recurring vomiting - GI bleeding - FHx cancer
Venlafaxine - duloxetine - mirtazapine
ACEI - B-blocker - diuretic - Ca-blocker
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

39. Focal neurologic sx (other than aura) DDx
Legionella
Mass lesion - vascular malformation - stroke - collagen vascular disease
5-HT blockers: tegasorad - alosetron
Coryza - congestion - pharyngitis - nasal discharge - fever - cough - dyspnea

40. New-onset headache in patient with HIV/cancer DDx
Cephalexin OR dicloxacillin
'thumb sign' (protrusion of into anterior wall of hypopharynx)
B-blocker - Ca-channel blocker
Meningitis - brain abscess - metastasis

41. Cholesterol absorption blocker (ezetimibe)
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine
SCFE (slipped capital femoral epiphysis)
1st line: TZD
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease

42. Intussusception sx
Obesity; increased NE release
1st line: TZD
TCA's
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

43. Chance of pregnancy after a single act of coitus
Temporal arteritis - mass lesion
8%
Dicyclomine - hyoscyamine (antispasmodics)
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)

44. Nicotinic acids
Dicyclomine - hyoscyamine (antispasmodics)
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

45. NMDA-R antagonist (memantine)
Flat disk - button - batteries
Moderate/severe alzheimer dementia
Obesity; increased NE release
Bacterial infxn of supraglottic tissue and surrounding areas

46. DDx pediatric intestinal obsutrction
ACEI - B-blocker - spironolactone
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD

47. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
MVP
'steeple-sign' (subglottic narrowing)
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

48. Organism that causes pneumonia post-influenza
S. aureus
Dementia - incontinence - gait disturbance
ACEI - B-blocker - diuretic - Ca-blocker
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing

49. Dx and Tx of intussception
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV
Barium enema
Halothane - succinylcholine
'olive' mass in URQ - 'double-track sign -' nonbilious vomiting postparandial - 3-6 weeks old

50. Dextroamphetamine
Obesity; increased NE release
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Viral infxn of the subglottis
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

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Family Medicine/ambulatory 2

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