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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. Refer to cardiologist post-sports physical if ____
Temporal arteritis - mass lesion
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
ACE-I (or ARB) - fluid+sodium restriction - B-blockers - loop diuretics (furosemide - bumetanide - torsemide - ethracrynic acid) - spironolactone - cardiac resynchronization therapy
Fiber (e.g. psyllium)

2. Focal neurologic sx (other than aura) DDx
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Mass lesion - vascular malformation - stroke - collagen vascular disease
Alzheimer - Parkinson - normal pressure hydrocephalus - Lewy Body - chronic EtOH - anticholinergic - benzodiazepines - sleeping pills - narcotics - hypothyroidism - B12 deficiency - neurosyphilis - hyponatremia - hypocalcemia - HIV

3. Bile acid sequestrants (cholestyramine - colestipol - colesevelam)
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
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
High K - high Ca - low Na

4. If not breast-feeding - when does menstruation restart?
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Cephalexin OR dicloxacillin
3rd month postpartum
Furosemide - nitroglycerin - IV morphine sulphate

5. Tx HTN + CAD
ACEI - B-blocker - diuretic - Ca-blocker
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Venlafaxine - duloxetine - mirtazapine
Foot/leg deficits - cognitive + personality changes

6. SSRI's
Neonate - infants - bilious vomiting - abdominal pain
Dementia - incontinence - gait disturbance
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
Obesity; NE-uptake inhibition

7. MCC postpartum hemorrhage
Class III/IV CHR - QRS > 120ms - LVED diameter > 55mm - LVEF =< 35% - already on maximal therapy
Uterine atony
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Lumbar puncture

8. Evaluating limp w/o pain in children
470ms+ in men - 480ms+ in women
Mass lesion - vascular malformation - stroke - collagen vascular disease
Neonate - infants - bilious vomiting - abdominal pain
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test

9. Sx endometritis
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool
Postpartum fever - uterine tenderness - foul-smelling lochia
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

10. Donepezil use/sfx
100% O2 6L/min - dihydroergotamine - triptans
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Obesity; increased NE release
Use: mild/mod alzheimer dementia - sfx: nausea - vomiting - diarrhea - dizzy - headache

11. Tx acute pulmonary edema 2ndary to CHF
IV labetalol - nicardipine - sodium nitroprusside
Furosemide - nitroglycerin - IV morphine sulphate
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Septic arthritis - fractures - congenital hip dysplasia

12. Peritonsillar abscess Sx
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia
Butterfly pattern of perihilar infiltrates on CXR - cardiomegaly - chamber enlargement
8%
Fever - sore throat - muffled voice - drooling - trismus - neck pain

13. vertebrobasilar stroke sx
Oral prednisone
MVP
Obesity; increased NE release
Motor/sensory loss x 4 limbs - crossed signs - disconjugate gaze - nystagmus - dysarthria - dysphagia

14. Cluster headache acute tx
Cephalexin OR dicloxacillin
100% O2 6L/min - dihydroergotamine - triptans
Uterine atony
ACEI - ARB

15. Tx HTN + CHF
Dicyclomine - hyoscyamine (antispasmodics)
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
ACEI - ARB - B-blocker - diuretic - Spironolactone

16. Antihypertensives in suspected stroke
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
IV labetalol - nicardipine - sodium nitroprusside
Effects: lower LDL; raise HDL - sfx: GI distress - constipation - decreased med absorption - CI: TGA > 400

17. Sudden-onset headache DDx
Bacterial infxn of supraglottic tissue and surrounding areas
Legionella
MVP
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

18. malignant hyperthermia
Barium enema
470ms+ in men - 480ms+ in women
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity

19. Cholesterol absorption blocker (ezetimibe)
Neonate - infants - bilious vomiting - abdominal pain
Effects: lower LDL - TGA; raise HDL - sfx: abdominal pain - diarrhea - CI: liver disease
ACEI - ARB - B-blocker - diuretic - Spironolactone
Venlafaxine - duloxetine - mirtazapine

20. Pflx migraine
Amitriptyline - propanolol - timolol - divalproex sodium
Venlafaxine - duloxetine - mirtazapine
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram
8%

21. Tacrine use/sfx
Use: alzheimer dementia - sfx: hepatotoxicity - arrhythmias - bradycardia - urinary obstruction
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Phenelzine - tranylcypramine
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

22. IBS pain tx
5-HT blockers: tegasorad - alosetron
Marfan syndrome stigmata - HCM murmur - 3/6 systolic - ANY diastolic
Oral prednisone
ACEI - ARB - diuretic - Ca-blocker - B-blocker

23. Tx HTN + CKD
ACEI - ARB
ACEI - diuretic
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Hallucinations - vivid dreams - fluctuating cognition - sleep disorder - frequent falls - visuospatial deficit - REM sleep disorder (vivid dreams)

24. Afib - Aflutter tx
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Digoxin (B-blockers as needed)
Cephalexin OR dicloxacillin
Amoxicillin-clavulanate (augmentin) p.o 7-14 days

25. contraindications to thrombolytic therapy
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
Dantrolene IV - antipyretics - O2 - cooling blankets
ACEI - ARB - B-blocker - diuretic - Spironolactone
Amitriptyline - nortriptyline - desipramine - clomipramine - doxepin - imipramine

26. Tx HTN
PCP pneumonia
1st line: TZD
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.
Obesity; increased NE release

27. Phentermine
Fever - sore throat - muffled voice - drooling - trismus - neck pain
Obesity; NE-uptake inhibition
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
Subarachnoid hemorrhage - pituitary apoplexy - hemorrhage into mass lesion/vascular malformation - mass lesion

28. Croup
Viral infxn of the subglottis
Recent surgery - trauma - GI bleeding - MI - uncontrolled HTN
100% O2 6L/min - dihydroergotamine - triptans
Triptans - dihydroergotamine - erogtamine - NSAIDsl; aspirin + acetaminophen + caffeine;

29. 4 T's of postpartum hemorrhage
Hemorrhoids > colorectal polyps > diverticulosis > CRC > UC - AVM - colonic strictures
Foot/leg deficits - cognitive + personality changes
Tone (uretine atony) - Trauma (cervical - vaginal - perineal) - Tissue (retained placenta - membranes) - Thrombin (coagulopathies)
Have been asked to CUT down? people have been ANNOYED? felt GUILTY? EYE opener

30. Diethylpropion
Barium enema
Measure umbilicus to medial malleolus; Barlow test; Galeazzi test
Obesity; increased NE release
Colonoscopy

31. Primary SVT tx
100% O2 6L/min - dihydroergotamine - triptans
Phenelzine - tranylcypramine
Moderate/severe alzheimer dementia
B-blocker - Ca-channel blocker

32. Prolonged QT interval (QTc)
Viral infxn of the subglottis
3 hours
ACEI - ARB - B-blocker - diuretic - Spironolactone
470ms+ in men - 480ms+ in women

33. DASH diet plan
High K - high Ca - low Na
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Renal parenchymal disease
Yellow-white discharge with blood cells - decidual cells - and fibrinous products post-delivery.

34. Sx HoCM
Systolic murmur. louder with valsalva - standing. softer with squatting - leg raising - handgrip.
Fiber (e.g. psyllium)
470ms+ in men - 480ms+ in women
Obesity; increased NE release

35. Malrotation sx
Bacterial infxn of supraglottic tissue and surrounding areas
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
Neonate - infants - bilious vomiting - abdominal pain
Fever - sore throat - muffled voice - drooling - trismus - neck pain

36. Dx subarachnoid hemorrhage with negative noncontrast CT
Amitriptyline - propanolol - timolol - divalproex sodium
Dicyclomine - hyoscyamine (antispasmodics)
Lumbar puncture
Halothane - succinylcholine

37. Headaches increasing in severity + intensity DDx
Mass lesion - subdural hematoma - medication overuse
Colonoscopy
'thumb sign' (protrusion of into anterior wall of hypopharynx)
Mass lesion - vascular malformation - stroke - collagen vascular disease

38. ROME IBS criteria
Fiber (e.g. psyllium)
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
Obesity; NE-uptake inhibition
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance

39. Nicotinic acids
Recurrent abd pain 3+ days/month for 3+ months with 2 of: improvement w/ defecation; change in stool freq; change in stool appearance
Amoxicillin-clavulanate (augmentin) p.o 7-14 days
Effects: lower LDL - TGA; raise HDL - sfx: flushing - hyperglycemia - hyperuricemia - upper GI distress - hepatotoxic - CI: liver disease - gout - DM - PUD
'thumb sign' (protrusion of into anterior wall of hypopharynx)

40. NMDA-R antagonist (memantine)
Insulin resistance - abdominal obesity - dyslipidemia - elevated BP - high fasting glucose
Dicyclomine - hyoscyamine (antispasmodics)
Effects: lower LDL - TGA; raise HDL - sfx: dyspepsia - gallstones - myopathy - CI: renal - hepatic disease
Moderate/severe alzheimer dementia

41. Intussusception sx
Congenital dislocation - cerebral palsy - leg-calve-perthes - leg-length discrepancy - proximal focal femoral dysplasia - congenital short femur - congenital tibial bowing
Temporal arteritis - mass lesion
Obesity; NE-uptake inhibition
Intermittent - severe abdominal pain - vomiting that becomes bilious - currant jelly stool

42. Chronic afib tx
1. macrolide OR doxycycline 2. if resistant: fluoroquinolone OR B-lactam + macrolide
Halothane - succinylcholine
B-blocker - Ca-channel blocker - Warfarin. Antiarrhythmics (amiodarone - sotalol - flecainide - propafenone)
Moderate/severe alzheimer dementia

43. Dx and Tx of intussception
Barium enema
5-HT blockers: tegasorad - alosetron
Renal parenchymal disease
Fluoxetine - Paroxetine - Sertraline - Fluvoxamine - Citalopram - Escitalopram

44. Tx local - acute rxn to bee sting
Effects: lower LDL - TGA; raise HDL - sfx: myopathy - myalgia - increased LFTs - CI: liver disease - P-450 inhibitors (cyclosporine - macrolides - antifungals)
ACEI - diuretic
Oral prednisone
Legionella

45. Tx HTN + DM
ACEI - ARB - diuretic - Ca-blocker - B-blocker
Wind (pneumonia) - Water (UTI) - Wound (SSI) - Walk (DVT) - Wonder drugs (drug fever)
H. flu - S. pneumo - S. aureus - Strep A/B/C
Fasting blood glucose - LFTs - renal function - TSH

46. Drugs causing fever
Moderate/severe alzheimer dementia
Halothane - succinylcholine
Cephalosporins - fluoroquinolones - sulfonamides - penicillins - heparin - amphotericin B
ACEI - ARB - B-blocker - diuretic - Spironolactone

47. Retropharyngeal abscess Sx
104F+ - tachycardia - metabolic acidosis - skeletal muscle rigidity
Obesity; increased NE release
Amiodarone/lidocaine
Fever - drooling - dysphagia - odynophagia - stridor - respiratory distress

48. tx malignant hyperthermia
Moderate/severe alzheimer dementia
1.B-lactam (cefuroxime/ cefotaxime/ceftriaxone / ampicillin-sulbatam) AND erythromycin/azithrymycin 2. IV fluoroquinolone
Dantrolene IV - antipyretics - O2 - cooling blankets
Quinolone + metronidazole

49. most common valvular heart defect in USA
MVP
1st line: TZD
Legionella
Intussception - hypertrophic pyloric stenosis - malrotation with volvulus - foreign-body ingestion - poisoning

50. Baby blues resolves by ______
Use: mild/mod alzheimer dementia - sfx: arrhythmia - dementia - bradycardia - urinary obstruction
Bacterial infxn of supraglottic tissue and surrounding areas
10th postpartum day
Mass lesion - vascular malformation - stroke - collagen vascular disease