Primary Care/Family Medicine EOR Exam questions and answers| latest 2023 ,all correct

Primary Care/Family Medicine EOR Exam questions and answers| latest 2023 ,all correct Progressive, ascending, symmetric muscle weakness beginning in lower extremities & loss of deep tendon reflexes s/p URI think..... Guillain-Barre Syndrome (tx =mostly supportive care) Progressively worsening sore throat, fever, muffled voice, and hyoid bone tenderness w/ minimal pharyngeal erythema think..... Epiglottitis (tx = IV abx & admit) % of Mallory-Weiss tears that resolve spontaneously? 80-90% Predisposing RF in pts with Mallory-Weiss tears? Hiatal hernia (tx = H2 blockers or PPIs) "3 Ds": dysmenorrhea, dyspareunia, and dyschezia are a/w..... Endometriosis (MC in ovaries; dx = laparoscopy) Triad of ophthalmoplegia, ataxia and confusion? Wernicke's encephalopathy (thiamine def) Fever/chills, post-auricular erythema and tenderness, and discharge from external auditory canal think..... Mastoiditis (tx = IV abx & CT scan) Excessive daytime sleepiness, nocturia, & snoring indicates need for what diagnostic test? Polysomnography sleep study (likely sleep apnea) Loss of central vision think..... Macular degeneration "Curtain" spreading across the field of vision think..... Retinal detachment Blurred vision w/ glares noticed while driving at night think..... Cataracts Gradual bilateral peripheral vision loss think..... Chronic glaucoma Prophylactic meds for migraines? Beta-blockers (Propranolol) CCBs (Verapamil) TCAs (Amitriptyline) Anticonvulsants (valproic acid or Topiramate) Sumatriptan (Imitrex) is a suitable med for migraine treatment or prophylaxis? Treatment (c/i in pts w/ coronary/peripheral vascular dz; Propranolol is a good 1st-line prophylactic med) T/F: All pts age 40 & older w/ DM should receive statin therapy? True H/o peptic ulcer dz w/ post-shower pruritus, burning in hands/feet, hepato/splenomegaly, elevated Hb/Hct/RBC think..... Polycythemia vera "Erroneous beliefs that usually involve a misinterpretation of perceptions or experiences" are called..... Delusions "Sensory perceptions w/o external stimulation" are called..... Hallucinations "Marked disorientation, confusion, and fluctuating consciousness" is called..... Delirium MC type of delusion? Persecutory Abx of choice for uncomplicated UTI? Macrobid (nitrofurantoin) or Bactrim (trimethoprim-sulfamethoxazole) x 3-5 days MC organism a/w UTI? E. coli Recommended daily supplement for women of child-bearing age? Folic acid 0.4-0.8 mg (4 mg w/ h/o neural tube defects) First-choice for mild-moderate HTN in pregnancy? Methyldopa Wrist drop w/ inability to extend wrist against resistance think..... Radial nerve (Sat night) palsy MC joint affected by pseudogout (calcium pyrophosphate dihydrate crystals)? Knee (tx = NSAIDs +/- aspiration) Peaked T wave and dropped P wave think..... Hyperkalemia (tx = calcium supplementation) Ex H2 blocker meds? famotidine (Pepcid) ranitidine (Zantac) Ex PPI meds? omeprazole (Prilosec) pantoprazole (Protonix) esomeprazole (Nexium) lansoprazole (Prevacid) Biliary colic is worse after what type of meal? Fatty (d/t CCK-mediated contraction of gallbladder - bile salt release) MCC esophagitis? GERD (tx = H2 blockers -tidines PRN or PPIs -prazoles if mod/severe) DOC in moderate-severe GERD? PPIs (omeprazole, pantoprazole, etc.) MCC esophageal varices in adults? Cirrhosis DOC for acute esophageal varice bleed? Octreotride (somatostatin analog - vasoconstriction of portal venous flow) Tx of choice for acute esophageal varice bleed? Endoscopic ligation Tx of choice in primary prophylaxis of esophageal varice rebleed? Non-selective Beta-blockers (propranolol, nadolol) Management of sliding hernia? H2 blockers (-tidines) PPIs (-prazoles) MCC gastritis? H. pylori (tx = "CAP" = clarithromycin + amoxicillin + PPI) 2nd MCC gastritis? NSAIDs/aspirin (tx = acid suppression - -tidines or -prazoles) MCC peptic ulcer disease? H. pylori (tx = "CAP" = clarithromycin + amoxicillin + PPI) 2nd MCC peptic ulcer disease? NSAIDs (tx = acid suppression - -tidines or -prazoles) Gold standard test for peptic ulcer disease? Endoscopy Gold standard test for gastritis? Endoscopy Term for gastrin-producing tumor a/w peptic ulcer disease? Zollinger-Ellison syndrome Non-healing gastric ulcer think..... Malignancy Gold standard in dxing H. pylori infection? Endoscopy w/ biopsy (other options: urea breath test, stool antigen test, serologic Ab test) Which H. pylori test CANNOT be used to confirm eradication? Serum Ab test (because Ab levels can remain elevated long after eradication) Which PPI causes CP450 inhibition? omeprazole (Prilosec) Duodenal ulcers are almost always benign or malignant? Benign % gastric ulcers that are malignant? 4% Pain better w/ meals indicates duodenal or gastric ulcer? Duodenal (more common in younger pts) Pain worse w/ meals indicates duodenal or gastric ulcer? Gastric (more common in older pts) Best screening test for Zollinger-Ellison Syndrome? Fasting gastrin level (makes sense bc ZES is a GASTRIN-producing tumor; need to discontinue H2 blockers and PPIs prior bc these can increase gastrin levels) Most important RF for gastric carcinoma? H. pylori Test of choice for cholelithiasis? USN (remember USN class) Diagnostic test of choice for choledocholithiasis (gallstones in common bile duct)? ERCP (bc stones can be extracted @ time of test) Components of Charcot's triad? Fever/chills RUQ pain Jaundice (a/w cholangitis = biliary tract infection) Triad a/w acute cholangitis (biliary tract infection)? Charcot's triad (fever/chills, RUQ pain, jaundice) Elevated ALP (alkaline phosphatase) + elevated GGT (gamma-glutamyl transferase) think..... Biliary obstruction Cholangitis = infection of..... Biliary tract Cholecystitis = infection of...... Gallbladder MC organism a/w cholecystitis (gallbladder infection)? E.coli MC organism a/w cholangitis (biliary tract infection)? E. coli Physical exam sign indicative of cholecystitis (gallbladder infection)? Murphy's sign Term for referred pain to right shoulder often seen w/ cholecystitis (gallbladder infection)? Boas sign Initial test of choice for cholecystitis (gallbladder infection)? USN (HIDA = gold standard) Gold standard test of choice for cholecystitis (gallbladder infection)? HIDA Management of cholecystitis? NPO + IV fluids + abx (Ceftriaxone + Metronidazole) - cholecystectomy Abx of choice for cholecystitis (gallbladder infection)? Ceftriaxone + Metronidazole MCC fulminant hepatitis? Acetaminophen use Hepatitis is chronic if duration ..... 6 months Expected LFTs in viral hepatitis? Elevated ALT AST Viral hepatitis type a/w spiking a fever? A Management HepA? Symptomatic Transmission HepA? Fecal-oral Transmission HepC? Parenteral % HepC pts that develop chronic infection? 80% % HepB pts that develop chronic infection? 10% Transmission HepB? Parenteral Sexual Perinatal/vertical Percutaneous HepB vaccine schedule? 0, 1, 6 months Screening for hepatocellular carcinoma in HepC pts? Serum AFP (alpha-fetoprotein) + USN MCC cirrhosis in US? ETOH 2 MCCs of acute pancreatitis? Gallstones ETOH Constant epigastric pain radiating to the back, relieved by sitting forward think..... Acute pancreatitis Diagnostic test of choice for acute pancreatitis? Abdominal CT Criteria used for pancreatitis prognosis? Ransons criteria MCC small bowel obstruction? Post-surgical adhesions (60%) Cramping abdominal pain, abdominal distention, vomiting, and obstipation ("CAVO") think..... Small bowel obstruction 1st-line imaging for suspected small bowel obstruction? Abdominal XR Management non-strangulated small bowel obstruction? NPO IV fluids Bowel decompression Management strangulated small bowel obstruction? Surgery MCC acute lower GI bleeding? Diverticulosis Test of choice for diverticular disease? CT scan Anorexia and periumbilical/epigastric pain followed by RLQ pain think..... Appendicitis Term for RLQ pain w/ LLQ pain palpation? Rovsing sign (APPENDICITIS) Term for RLQ pain w/ internal/external hip rotation w/ flexed knee? Obturator sign (APPENDICITIS) Term for RLQ pain w/ right hip flexion/extension? Psoas sign (APPENDICITIS) Abdominal pain a/w altered bowel habits and relieved by defecation think..... IBS Hernia that protrudes through the internal inguinal ring? INdirect Hernia that protrudes medial to inferior epigastric vessels? Direct Can indirect or direct hernias protrude into the scrotum? INdirect Severe rectal pain and bleeding w/ bowel movements think..... Anal fissure MC site of anal fissure? Posterior midline % anal fissures that resolve spontaneously? 80% (tx = suuportive) MCC gastroenteritis in adults in US? Norovirus MCC diarrhea in children? Rotavirus 1st-choice abx for severe shigellosis? Trimethoprim-sulfamethoxazole (Bactrim) (2nd line = fluoroquinolones) 1st-choice abx for severe salmonellosis? Fluoroquinolones (2nd line = ceftriaxone, trimethoprim-sulfamethoxazole) Frothy, greasy, foul diarrhea w/ cramping and bloating s/p camping think..... Giardia (tx = fluids + Metronidazole) Examples of stimulant laxatives? Bisacodyl (Dulcolax) Senna Pealed T wave may indicated what electrolyte abnormality? Hyperkalemia 1st-line tx of symptomatic bradycardia? Atropine Tx sick sinus syndrome? Permanent pacemaker "Saw tooth" patterns on ECG think..... Atrial FLUTTER "Irregularly irregular" rhythm w/o P waves think..... Atrial FIBRILLATION MC chronic arrhythmia? Atrial fibrillation Most useful test to dx heart failure? Echocardiogram (transthoracic (TTE) preferred) Primary non-invasive test for assessing cardiac anatomy and function? TransThoracic ECHOCARDIOGRAM Most useful non-invasive test for pts w/ suspected CAD? Stress test MCC CAD? Atherosclerosis 1st-line drug for chronic stable angina management? B-blockers MCC MI? Atherosclerosis (plaque rupture - acute coronary artery thrombosis) Average % artery occlusion to experience anginal pain @ rest? 90%