Family Medicine EOR Exam || A+ Certified.
URGENT CARE: Respiratory arrest has a multitude of causes including pulmonary, cardiac,
neurologic, toxic/metabolic, etc. Name some. correct answers COPD, asthma, foreign objects,
angioedema, DKA, cancer etc.
Abnormal breath sounds:
____is an airway obstruction. ____ suggests obstruction above the vocal cords and ___ suggests
obstruction below the vocal cords.
____suggests obstruction below the level of the trachea.
____suggests presence of interalveolar fluid (PNA), pulmonary fibrosis. correct answers Stridor,
inspiratory stridor, expiratory stridor; Wheezing; crackles & rales
_____of respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial tamponade,
PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. correct answers
Differential Diagnosis
D/D for ____ includes DKA, hypoglycemia, UTI, sepsis, drug overdose, stroke, and seizure.
correct answers deteriorating mental status or unconscious patient
D/D for ____ includes appendicitis, pancreatitis, PID, obstruction, AAA, perforated viscous,
diverticulitis, mesenteric ischemia, or infarction. correct answers acute abdomen
What is the treatment for allergic reaction? immediate & subsequent? correct answers epi 1:1000
IM q 10 min 0.5mg; antihistamine (H1 & H2), steroids, bronchodilators
What is the rule of 9's in burn management? correct answers 9 head, 9 left arm, 9 right arm, 18
anterior torso, 18 posterior torso, 1 genitals
What is the Parkland formula in burn management? correct answers 4 cc LR per % body burned
per kg body weight --- insert 2 large bore IV's into unburned skin
Placenta previa presents with ____. correct answers painless vaginal bleeding.
Placenta abruption presents with ____. RF: maternal HTN, smoking, cocaine, multiples, PROM,
inherited thrombophilia. Labs: decreased fibrinogen, decreased platelets correct answers painful
vaginal bleeding.
____is a surgical emergency. RF: previous c/s, prior uterine surgery, hyperstimulation w
oxytocin, trauma, parity >4. correct answers Uterine rupture
____ is bleeding from umbilical cord resulting in loss of fetal blood. correct answers Vasa previa
With a black widow bite, what can be used for muscle spasms & rigidity? What about
antivenom? correct answers diazepam, calcium gluconate, robaxin; use antivenom judiciously
,Which pit viper snake has the most potent vemom: rattlesnake, cottonmouth, or copperhead?
correct answers rattlesnake
What do you apply to a jellyfish sting? correct answers acetic acid or vinegar
What's the classic triad of foreign body aspiration? correct answers generalized wheezing, cough,
diminished breath sounds
Explain the Salter-Harris classification of growth plate injuries? correct answers I - Straight
II - Above
III - Lower
IV - Through
V - Ram
____ is injury to a ligament. Graded I-III (complete). correct answers Sprain
____ =
a. pain at medial malleolus/distal fibula/inability to walk
b. pain at midfoot/5th metatarsal
c. pain at navicular bone/inability to bear weight for 4 steps correct answers Ottawa ankle rules
____ = tearing of muscle or tendon fibers caused by excessive stretch during vigorous activity.
Graded I-IV (complete). correct answers Strain
ST Elevations in II, III, aVF correct answers Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6 correct answers lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5 correct answers Anterioseptal MI, left anterior descending
artery
ST Elevations in V1, V2 correct answers posterior wall MI, posterior descending artery
No nitroglycerin in which type of MI? correct answers inferior wall MI bc of possible
hypotension
What are the pre hospital treatments for ACS? correct answers MONA; morphine, oxygen,
nitroglycerin (0.4mg SL x3 prn), aspirin (325mg)
What two meds should be given to all ACS patients that do not have contraindications? correct
answers BB - unless brady or severe COPD - then do NDCCB (verapamil/diltiazem)
ACEi - if cough, use ARB
How long should Plavix/Clopidogrel be used for bare metal or drug eluting stents? correct
answers bare metal - 30d-12m
drug eluting - >/=12mon
,What meds should a patient go home with after ACS? correct answers Nitroglycerin
BB
ACEi
ASA/Clopidogrel
anticoagulant (up to 8days for LMWH)
aldosterone agonist
statin
LIFESTYLE CHANGES
Cardiac Markers: _____is detectable within 1-2 hours after acute MI. Duration <1 day. Low
specificity. correct answers Myoglobin
Cardiac Markers: _____is the test of choice and appears 2-6 hours after MI and stays elevated for
5-10 days. correct answers Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated for 2-4 days. Specific to
heart muscle. correct answers Creatine Kinase Mb
Timeline:
Reperfusion should take place before ___hours of symptom onset.
Door to needle time for fibrinolysis is ____min.
Door to balloon time for PCI is ___min. correct answers 12 hours; 30 minutes; 90 minutes
If a patient has nondiagnostic changes in ST segment or T wave, consider what? correct answers
serial cardiac markers -- repeat EKGs
All patients should be on _____treatment for the 1st year after MI, then ____ indefinitely. correct
answers dual antiplatelet for 1st year; then ASA indefinitely
____ develops in 10-20% of anterior MI's; ST elevation present 4-8 weeks post MI & pulging
scar is diagnostic. correct answers LV aneurysm
In what patients should a "silent MI" be a concern? correct answers elderly, women, DM
ST elevation progresses to ____ which is a sign of dead muscle. correct answers Q waves
Hypertensive urgency is a bp > ____. While closely monitoring, use clonidine, nifedipine,
captopril, or labetalol. correct answers bp>220/110
Hypertensive ____ is severe elevation with evidence of rapidly progressive end organ damage --
encephalopathy, nephropathy, pulmonary edema etc. Decrease 10-20% in 1st hour, 5-10% over
next 23 hours to target <160/100. Use IV meds. correct answers hypertensive emergency
In acute phase of ____, bp is only lowered to <185/110 (if reperfusion candidate) or <220/120 (if
non reperfusion candidate). correct answers ischemic stroke
, PE: a negative ____ test rules out PE. What is the gold standard for PE dx? correct answers d
dimer test; angiography
PERC score criteria (HADCLOTS) used to rule out need for further imagin w PE. correct
answers H - hormone/estrogen use
A - age>50
D - dvt/pe hx
C - cough up blood
L - leg swelling disparity
O - O2 sat<95
T - tachy > 100
S - surgery/recent trauma
The ___ criteria = clinical signs of PE, PE #1 on d/d, HR>100 bpm, immobilization in last
3days/dx last 4 week, hemoptysis, hx of cancer, previous DVT/PE. correct answers Wells criteria
Tension pneumothorax is treated w ____ at 2nd intercostal space, mid-clavicular line. correct
answers needle decompression & chest tube; hypotension, tracheal deviation, elevated jugular
venous pressure
How is an open PTX treated? correct answers 3 sided occlusive dressing for flutter valve effect
& chest tube
INGESTED HARMFUL SUBSTANCES CHART correct answers INGESTED HARMFUL
SUBSTANCE CHART
____ is a dangerous infection of soft tissue of eyelids/periocular region anterior to orbital
septum. Causes: bacterial infection/trauma. Kids...H Flu, S aureus, sty correct answers Orbital
Cellulitis
What is a concern from a globe fracture? correct answers muscle entrapment
____ of orbital cellulitis are subperiostal abscess, cavernous sinus thrombosis, hearing loss,
septicemia, meningitis, optic nerve damage, blindness. correct answers Complications
DERMATOLOGY:_____ dermatitis is very common, chronic, redness, scaling occurs where
sebaceous glands are most active, M>F, MC between 20-50 yo. Tx: selenium or ketoconazole
shampoo - scalp; low potency steroids - face/trunk. correct answers Seborrheic dermatitis
____ dermatitis, caused by chemical irritant (tx - hydration, monitor for infection) or allergen (tx
- prednisone 1-2 mg/kg for 1 week then taper for 1 week). correct answers Contact dermatitis
An allergic contact dermatitis elicits a type 4 cell mediated reaction which is a _____. Begins 12-
24 hours after exposure. correct answers delayed response
URGENT CARE: Respiratory arrest has a multitude of causes including pulmonary, cardiac,
neurologic, toxic/metabolic, etc. Name some. correct answers COPD, asthma, foreign objects,
angioedema, DKA, cancer etc.
Abnormal breath sounds:
____is an airway obstruction. ____ suggests obstruction above the vocal cords and ___ suggests
obstruction below the vocal cords.
____suggests obstruction below the level of the trachea.
____suggests presence of interalveolar fluid (PNA), pulmonary fibrosis. correct answers Stridor,
inspiratory stridor, expiratory stridor; Wheezing; crackles & rales
_____of respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial tamponade,
PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. correct answers
Differential Diagnosis
D/D for ____ includes DKA, hypoglycemia, UTI, sepsis, drug overdose, stroke, and seizure.
correct answers deteriorating mental status or unconscious patient
D/D for ____ includes appendicitis, pancreatitis, PID, obstruction, AAA, perforated viscous,
diverticulitis, mesenteric ischemia, or infarction. correct answers acute abdomen
What is the treatment for allergic reaction? immediate & subsequent? correct answers epi 1:1000
IM q 10 min 0.5mg; antihistamine (H1 & H2), steroids, bronchodilators
What is the rule of 9's in burn management? correct answers 9 head, 9 left arm, 9 right arm, 18
anterior torso, 18 posterior torso, 1 genitals
What is the Parkland formula in burn management? correct answers 4 cc LR per % body burned
per kg body weight --- insert 2 large bore IV's into unburned skin
Placenta previa presents with ____. correct answers painless vaginal bleeding.
Placenta abruption presents with ____. RF: maternal HTN, smoking, cocaine, multiples, PROM,
inherited thrombophilia. Labs: decreased fibrinogen, decreased platelets correct answers painful
vaginal bleeding.
____is a surgical emergency. RF: previous c/s, prior uterine surgery, hyperstimulation w
oxytocin, trauma, parity >4. correct answers Uterine rupture
____ is bleeding from umbilical cord resulting in loss of fetal blood. correct answers Vasa previa
With a black widow bite, what can be used for muscle spasms & rigidity? What about
antivenom? correct answers diazepam, calcium gluconate, robaxin; use antivenom judiciously
,Which pit viper snake has the most potent vemom: rattlesnake, cottonmouth, or copperhead?
correct answers rattlesnake
What do you apply to a jellyfish sting? correct answers acetic acid or vinegar
What's the classic triad of foreign body aspiration? correct answers generalized wheezing, cough,
diminished breath sounds
Explain the Salter-Harris classification of growth plate injuries? correct answers I - Straight
II - Above
III - Lower
IV - Through
V - Ram
____ is injury to a ligament. Graded I-III (complete). correct answers Sprain
____ =
a. pain at medial malleolus/distal fibula/inability to walk
b. pain at midfoot/5th metatarsal
c. pain at navicular bone/inability to bear weight for 4 steps correct answers Ottawa ankle rules
____ = tearing of muscle or tendon fibers caused by excessive stretch during vigorous activity.
Graded I-IV (complete). correct answers Strain
ST Elevations in II, III, aVF correct answers Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6 correct answers lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5 correct answers Anterioseptal MI, left anterior descending
artery
ST Elevations in V1, V2 correct answers posterior wall MI, posterior descending artery
No nitroglycerin in which type of MI? correct answers inferior wall MI bc of possible
hypotension
What are the pre hospital treatments for ACS? correct answers MONA; morphine, oxygen,
nitroglycerin (0.4mg SL x3 prn), aspirin (325mg)
What two meds should be given to all ACS patients that do not have contraindications? correct
answers BB - unless brady or severe COPD - then do NDCCB (verapamil/diltiazem)
ACEi - if cough, use ARB
How long should Plavix/Clopidogrel be used for bare metal or drug eluting stents? correct
answers bare metal - 30d-12m
drug eluting - >/=12mon
,What meds should a patient go home with after ACS? correct answers Nitroglycerin
BB
ACEi
ASA/Clopidogrel
anticoagulant (up to 8days for LMWH)
aldosterone agonist
statin
LIFESTYLE CHANGES
Cardiac Markers: _____is detectable within 1-2 hours after acute MI. Duration <1 day. Low
specificity. correct answers Myoglobin
Cardiac Markers: _____is the test of choice and appears 2-6 hours after MI and stays elevated for
5-10 days. correct answers Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated for 2-4 days. Specific to
heart muscle. correct answers Creatine Kinase Mb
Timeline:
Reperfusion should take place before ___hours of symptom onset.
Door to needle time for fibrinolysis is ____min.
Door to balloon time for PCI is ___min. correct answers 12 hours; 30 minutes; 90 minutes
If a patient has nondiagnostic changes in ST segment or T wave, consider what? correct answers
serial cardiac markers -- repeat EKGs
All patients should be on _____treatment for the 1st year after MI, then ____ indefinitely. correct
answers dual antiplatelet for 1st year; then ASA indefinitely
____ develops in 10-20% of anterior MI's; ST elevation present 4-8 weeks post MI & pulging
scar is diagnostic. correct answers LV aneurysm
In what patients should a "silent MI" be a concern? correct answers elderly, women, DM
ST elevation progresses to ____ which is a sign of dead muscle. correct answers Q waves
Hypertensive urgency is a bp > ____. While closely monitoring, use clonidine, nifedipine,
captopril, or labetalol. correct answers bp>220/110
Hypertensive ____ is severe elevation with evidence of rapidly progressive end organ damage --
encephalopathy, nephropathy, pulmonary edema etc. Decrease 10-20% in 1st hour, 5-10% over
next 23 hours to target <160/100. Use IV meds. correct answers hypertensive emergency
In acute phase of ____, bp is only lowered to <185/110 (if reperfusion candidate) or <220/120 (if
non reperfusion candidate). correct answers ischemic stroke
, PE: a negative ____ test rules out PE. What is the gold standard for PE dx? correct answers d
dimer test; angiography
PERC score criteria (HADCLOTS) used to rule out need for further imagin w PE. correct
answers H - hormone/estrogen use
A - age>50
D - dvt/pe hx
C - cough up blood
L - leg swelling disparity
O - O2 sat<95
T - tachy > 100
S - surgery/recent trauma
The ___ criteria = clinical signs of PE, PE #1 on d/d, HR>100 bpm, immobilization in last
3days/dx last 4 week, hemoptysis, hx of cancer, previous DVT/PE. correct answers Wells criteria
Tension pneumothorax is treated w ____ at 2nd intercostal space, mid-clavicular line. correct
answers needle decompression & chest tube; hypotension, tracheal deviation, elevated jugular
venous pressure
How is an open PTX treated? correct answers 3 sided occlusive dressing for flutter valve effect
& chest tube
INGESTED HARMFUL SUBSTANCES CHART correct answers INGESTED HARMFUL
SUBSTANCE CHART
____ is a dangerous infection of soft tissue of eyelids/periocular region anterior to orbital
septum. Causes: bacterial infection/trauma. Kids...H Flu, S aureus, sty correct answers Orbital
Cellulitis
What is a concern from a globe fracture? correct answers muscle entrapment
____ of orbital cellulitis are subperiostal abscess, cavernous sinus thrombosis, hearing loss,
septicemia, meningitis, optic nerve damage, blindness. correct answers Complications
DERMATOLOGY:_____ dermatitis is very common, chronic, redness, scaling occurs where
sebaceous glands are most active, M>F, MC between 20-50 yo. Tx: selenium or ketoconazole
shampoo - scalp; low potency steroids - face/trunk. correct answers Seborrheic dermatitis
____ dermatitis, caused by chemical irritant (tx - hydration, monitor for infection) or allergen (tx
- prednisone 1-2 mg/kg for 1 week then taper for 1 week). correct answers Contact dermatitis
An allergic contact dermatitis elicits a type 4 cell mediated reaction which is a _____. Begins 12-
24 hours after exposure. correct answers delayed response
