FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
URGENT CARE: Respiratory arrest has a multitude of causes including pulmonary, cardiac, neurologic,
toxic/metabolic, etc. Name some. - correct answer 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 answer Stridor,
inspiratory stridor, expiratory stridor; Wheezing; crackles & rales
Ddx for _____respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial tamponade,
PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. - correct answer respiratory
arrest
D/D for ____ includes DKA, hypoglycemia, UTI, sepsis, drug overdose, stroke, and seizure. - correct
answer deteriorating mental status or unconscious patient
D/D for ____ includes appendicitis, pancreatitis, PID, obstruction, AAA, perforated viscous, diverticulitis,
mesenteric ischemia, or infarction. - correct answer acute abdomen
What is the treatment for allergic reaction? immediate & subsequent? - correct answer 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 answer 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 answer 4 cc LR per % body burned per
kg body weight --- insert 2 large bore IV's into unburned skin
Placenta previa presents with ____. - correct answer painless vaginal bleeding.
Placenta abruption presents with ____.
RF:
Labs: - correct answer painful vaginal bleeding.
RF: maternal HTN, smoking, cocaine, multiples, PROM, inherited thrombophilia.
,FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
Labs: decreased fibrinogen, decreased platelets
Uterine rupture is a _____
RF: - correct answer surgical emergency.
RF: previous c/s, prior uterine surgery, hyperstimulation w oxytocin, trauma, parity >4.
Vasa Previa - correct answer bleeding from umbilical cord resulting in loss of fetal blood.
With a black widow bite, what can be used for muscle spasms & rigidity? What about antivenom? -
correct answer diazepam, calcium gluconate, robaxin;
use antivenom judiciously
Which pit viper snake has the most potent vemom: rattlesnake, cottonmouth, or copperhead? - correct
answer rattlesnake
What's the classic triad of foreign body aspiration? - correct answer generalized wheezing
cough
diminished breath sounds
Explain the Salter-Harris classification of growth plate injuries? - correct answer I - Straight
II - Above
III - Lower
IV - Through
V - Ram
Sprain - correct answer injury to a ligament. Graded I-III (complete).
Ottawa Ankle Rules - correct answer 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
Strain - correct answer tearing of muscle or tendon fibers caused by excessive stretch during vigorous
activity. Graded I-IV (complete).
ST Elevations in II, III, aVF - correct answer Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6 - correct answer lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5 - correct answer Anterioseptal MI, left anterior descending artery
ST Elevations in V1, V2 - correct answer posterior wall MI, posterior descending artery
No nitroglycerin in which type of MI? - correct answer inferior wall MI bc of possible hypotension
,FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
What are the pre hospital treatments for ACS? - correct answer 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
answer 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 answer
bare metal - 30d-12m
drug eluting - >/=12mon
What meds should a patient go home with after ACS? - correct answer 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 answer Myoglobin
Cardiac Markers: _____is the test of choice and appears 2-6 hours after MI and stays elevated for 5-10
days. - correct answer Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated for 2-4 days. Specific to heart
muscle. - correct answer 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 answer 12 hours; 30 minutes; 90 minutes
If a patient has nondiagnostic changes in ST segment or T wave, consider what? - correct answer serial
cardiac markers -- repeat EKGs
All patients should be on _____treatment for the 1st year after MI, then ____ indefinitely. - correct
answer dual antiplatelet for 1st year; then ASA indefinitely
, FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
____ develops in 10-20% of anterior MI's; ST elevation present 4-8 weeks post MI & pulging scar is
diagnostic. - correct answer LV aneurysm
In what patients should a "silent MI" be a concern? - correct answer elderly, women, DM
ST elevation progresses to ____ which is a sign of dead muscle. - correct answer Q waves
Hypertensive urgency is a bp > ____.
Tx - correct answer bp>220/110
While closely monitoring, use clonidine, nifedipine, captopril, or labetalol.
Hypertensive ____ is severe elevation with evidence of rapidly progressive end organ damage --
encephalopathy, nephropathy, pulmonary edema etc.
Tx: Decrease 10-20% in 1st hour, 5-10% over next 23 hours to target <160/100.
Use IV meds. bp diastolic >170 - correct answer hypertensive emergency
In acute phase of ____, bp is only lowered to <185/110 (if reperfusion candidate) or <220/120 (if non
reperfusion candidate). - correct answer ischemic stroke
PE: a negative ____ test rules out PE. What is the gold standard for PE dx? - correct answer d dimer
test; angiography
PERC score criteria (HADCLOTS) used to rule out need for further imagin w PE. - correct answer 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 answer Wells criteria
Tension pneumothorax is treated w ____ at 2nd intercostal space, mid-clavicular line. - correct answer
needle decompression & chest tube; hypotension, tracheal deviation, elevated jugular venous pressure
How is an open PTX treated? - correct answer 3 sided occlusive dressing for flutter valve effect &
chest tube
(VERIFIED ANSWERS)
URGENT CARE: Respiratory arrest has a multitude of causes including pulmonary, cardiac, neurologic,
toxic/metabolic, etc. Name some. - correct answer 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 answer Stridor,
inspiratory stridor, expiratory stridor; Wheezing; crackles & rales
Ddx for _____respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial tamponade,
PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. - correct answer respiratory
arrest
D/D for ____ includes DKA, hypoglycemia, UTI, sepsis, drug overdose, stroke, and seizure. - correct
answer deteriorating mental status or unconscious patient
D/D for ____ includes appendicitis, pancreatitis, PID, obstruction, AAA, perforated viscous, diverticulitis,
mesenteric ischemia, or infarction. - correct answer acute abdomen
What is the treatment for allergic reaction? immediate & subsequent? - correct answer 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 answer 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 answer 4 cc LR per % body burned per
kg body weight --- insert 2 large bore IV's into unburned skin
Placenta previa presents with ____. - correct answer painless vaginal bleeding.
Placenta abruption presents with ____.
RF:
Labs: - correct answer painful vaginal bleeding.
RF: maternal HTN, smoking, cocaine, multiples, PROM, inherited thrombophilia.
,FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
Labs: decreased fibrinogen, decreased platelets
Uterine rupture is a _____
RF: - correct answer surgical emergency.
RF: previous c/s, prior uterine surgery, hyperstimulation w oxytocin, trauma, parity >4.
Vasa Previa - correct answer bleeding from umbilical cord resulting in loss of fetal blood.
With a black widow bite, what can be used for muscle spasms & rigidity? What about antivenom? -
correct answer diazepam, calcium gluconate, robaxin;
use antivenom judiciously
Which pit viper snake has the most potent vemom: rattlesnake, cottonmouth, or copperhead? - correct
answer rattlesnake
What's the classic triad of foreign body aspiration? - correct answer generalized wheezing
cough
diminished breath sounds
Explain the Salter-Harris classification of growth plate injuries? - correct answer I - Straight
II - Above
III - Lower
IV - Through
V - Ram
Sprain - correct answer injury to a ligament. Graded I-III (complete).
Ottawa Ankle Rules - correct answer 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
Strain - correct answer tearing of muscle or tendon fibers caused by excessive stretch during vigorous
activity. Graded I-IV (complete).
ST Elevations in II, III, aVF - correct answer Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6 - correct answer lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5 - correct answer Anterioseptal MI, left anterior descending artery
ST Elevations in V1, V2 - correct answer posterior wall MI, posterior descending artery
No nitroglycerin in which type of MI? - correct answer inferior wall MI bc of possible hypotension
,FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
What are the pre hospital treatments for ACS? - correct answer 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
answer 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 answer
bare metal - 30d-12m
drug eluting - >/=12mon
What meds should a patient go home with after ACS? - correct answer 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 answer Myoglobin
Cardiac Markers: _____is the test of choice and appears 2-6 hours after MI and stays elevated for 5-10
days. - correct answer Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated for 2-4 days. Specific to heart
muscle. - correct answer 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 answer 12 hours; 30 minutes; 90 minutes
If a patient has nondiagnostic changes in ST segment or T wave, consider what? - correct answer serial
cardiac markers -- repeat EKGs
All patients should be on _____treatment for the 1st year after MI, then ____ indefinitely. - correct
answer dual antiplatelet for 1st year; then ASA indefinitely
, FAMILY MEDICINE EOR EXAM ACTUAL EXAM 480 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS)
____ develops in 10-20% of anterior MI's; ST elevation present 4-8 weeks post MI & pulging scar is
diagnostic. - correct answer LV aneurysm
In what patients should a "silent MI" be a concern? - correct answer elderly, women, DM
ST elevation progresses to ____ which is a sign of dead muscle. - correct answer Q waves
Hypertensive urgency is a bp > ____.
Tx - correct answer bp>220/110
While closely monitoring, use clonidine, nifedipine, captopril, or labetalol.
Hypertensive ____ is severe elevation with evidence of rapidly progressive end organ damage --
encephalopathy, nephropathy, pulmonary edema etc.
Tx: Decrease 10-20% in 1st hour, 5-10% over next 23 hours to target <160/100.
Use IV meds. bp diastolic >170 - correct answer hypertensive emergency
In acute phase of ____, bp is only lowered to <185/110 (if reperfusion candidate) or <220/120 (if non
reperfusion candidate). - correct answer ischemic stroke
PE: a negative ____ test rules out PE. What is the gold standard for PE dx? - correct answer d dimer
test; angiography
PERC score criteria (HADCLOTS) used to rule out need for further imagin w PE. - correct answer 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 answer Wells criteria
Tension pneumothorax is treated w ____ at 2nd intercostal space, mid-clavicular line. - correct answer
needle decompression & chest tube; hypotension, tracheal deviation, elevated jugular venous pressure
How is an open PTX treated? - correct answer 3 sided occlusive dressing for flutter valve effect &
chest tube
