Family Medicine EOR ExamQuestions
and answer
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
_____of respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial
tamponade, PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. -
correct answer-Differential Diagnosis
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: maternal HTN, smoking, cocaine, multiples,
PROM, inherited thrombophilia. Labs: decreased fibrinogen, decreased platelets - correct
answer-painful vaginal bleeding.
____is a surgical emergency. RF: previous c/s, prior uterine surgery, hyperstimulation w
oxytocin, trauma, parity >4. - correct answer-Uterine rupture
____ is bleeding from umbilical cord resulting in loss of fetal blood. - correct answer-Vasa
previa
,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 do you apply to a jellyfish sting? - correct answer-acetic acid or vinegar
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
____ is injury to a ligament. Graded I-III (complete). - correct answer-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 answer-Ottawa ankle
rules
____ = tearing of muscle or tendon fibers caused by excessive stretch during vigorous
activity. Graded I-IV (complete). - correct answer-Strain
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
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
____ 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 > ____. While closely monitoring, use clonidine, nifedipine,
captopril, or labetalol. - correct answer-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
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
INGESTED HARMFUL SUBSTANCES CHART - correct answer-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
answer-Orbital Cellulitis
What is a concern from a globe fracture? - correct answer-muscle entrapment
____ of orbital cellulitis are subperiostal abscess, cavernous sinus thrombosis, hearing loss,
septicemia, meningitis, optic nerve damage, blindness. - correct answer-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
answer-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 answer-Contact
dermatitis
and answer
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
_____of respiratory arrest includes ACS, acute heart failure, arrhythmia, pericardial
tamponade, PE, PNA, COPD, asthma, angioedema, anaphylaxis, CO poisoning, trauma. -
correct answer-Differential Diagnosis
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: maternal HTN, smoking, cocaine, multiples,
PROM, inherited thrombophilia. Labs: decreased fibrinogen, decreased platelets - correct
answer-painful vaginal bleeding.
____is a surgical emergency. RF: previous c/s, prior uterine surgery, hyperstimulation w
oxytocin, trauma, parity >4. - correct answer-Uterine rupture
____ is bleeding from umbilical cord resulting in loss of fetal blood. - correct answer-Vasa
previa
,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 do you apply to a jellyfish sting? - correct answer-acetic acid or vinegar
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
____ is injury to a ligament. Graded I-III (complete). - correct answer-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 answer-Ottawa ankle
rules
____ = tearing of muscle or tendon fibers caused by excessive stretch during vigorous
activity. Graded I-IV (complete). - correct answer-Strain
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
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
____ 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 > ____. While closely monitoring, use clonidine, nifedipine,
captopril, or labetalol. - correct answer-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
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
INGESTED HARMFUL SUBSTANCES CHART - correct answer-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
answer-Orbital Cellulitis
What is a concern from a globe fracture? - correct answer-muscle entrapment
____ of orbital cellulitis are subperiostal abscess, cavernous sinus thrombosis, hearing loss,
septicemia, meningitis, optic nerve damage, blindness. - correct answer-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
answer-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 answer-Contact
dermatitis
