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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. What does the classic ring worm lesion have?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Peptic ulcer disease or gastritis
A central clear area
Infectious esophagitis

2. What does treatment for migrans include?
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Genetic screening - medical assessment for chronic diseases - screening for infectious diseases - and updating of immunizations - advice on proper nutrition and exercise - help with quitting unhealthy habits - and advice on avoiding environmental haz
High blood pressure - focal neurologic defecit - or papilledema
Triptans - ergotamine - DHE (emergency); prophylaxis- beta blockeres - tricyclic antidepressants - CCBs - anticonvulsants - serotonin antagonists - MAOIs; avoidance of stress - alcohol - caffeine - tyramine (red wine and cheese) - nitrates (cured mea

3. How do you define persistent protein uria?
Generalized Anxiety disorder and panic disorder
Presence of proteinuria on at least two separate ocassion
Reduce symptoms - prevent complications - improve survival-diuretics - ACE inhibitors (slow progression of heart failure - decrease the number of hospitalizations and decrease mortality) - beta blockers (decrease mortality and sudden death) - spirono
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

4. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Acute headache - ataxia - profuse nausea - and vomiting
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Colposcopy - Endocervical curettage - and directed cervical biopsy
DM - HTN - DVT - seizures - depression - or anxiety

5. How does systolic vs. diastolic heart failure present on the echocardiogram?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Systolic dysfunction- ejection fraction is reduced to less than 45% - diastolic dysfunction- ejection fraction is preserved or high; use doppler techniques- abnormal flow across the mitral valve
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

6. At was quantity does urine dipstick test detect elevated protein?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Stabilize on oxygen - nitroglycerin - morphine for pain - aspirin (to decrease mortality by 20%) - clopidogrel or ticolodipine. (beta blockers - heparin - nitrates - ACEi - thrombolytics (if <75 with ST segment elevation - and a history consistent wi
100mg; means patient can be trace protein positive and not be detected

7. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
True
Supraspinatus and bicipital tendons
Cluster headache
Hx: Scratchy throat - runny nose - nasal congestion - rhinorrhea - malaise - fever - hoarsenss - cough - low grade fever - headache PE: Swollen red nasal mucosa - fever - purulent discharge - facial tenderness

8. Things that need to be included in history of shoulder pain
100mg; means patient can be trace protein positive and not be detected
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Dehydration - anemia - cardiac causes
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

9. What microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
E. Coli O157:H7
ACEi
High blood pressure - focal neurologic defecit - or papilledema

10. What is the role of FSH in one's menstrual cycle
CT
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

11. Mainstay treatment for soft tissue inflammation (Shoulder)
ACEi - ARBS - thiazide diuretics
E. Coli O157:H7
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Varicella virus

12. Name the diagnosis of heartburn: severe constant mid abdominal pain
Pancreatitis
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

13. What type of imaging is need for chronic sinusitis?
Analgesic headache
S. aureus- beta hemolytic streptococcus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
CT

14. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
PE - MI - aortic dissection - pneumothorax
Polymenorrhea
Non-cardiac causes of palpitations

15. What should be considered in younger patients with menorrhagia
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
RBC casts and old to moderate HTN
Squamocolumnar junction=most common site of cervical cancer
Coag disorders

16. Natural history of cervical cancer
HPV
Supraspinatus and bicipital tendons
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Medication or chemical esophagitis

17. What is the preload?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
True
Less than 80 ml of blood

18. What are the signs of malignant hypertension?
Pap Smear (unless recent normal pap) -CBC -Pregnancy test -Ultrasound if uterus is enlarged -Cervical culture in patients high risk of infection -Thyroid test and testing for systemic diseases
High blood pressure - focal neurologic defecit - or papilledema
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology
Colposcopy - Endocervical curettage - and directed cervical biopsy

19. What is the caUse of Meniere disease? What are the cardinal symptoms?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Slow progression of cervical cancer changes -Availability of effective early treatment
Bronchitis: Antecedent URI - Cough - No or low-grade fever - clear lungs or coarse rhonchi - Normal CXR Pneumonia: Acute onset of cough - fever - and tachypnea - chest pain - leukocytosis - pulmonary infiltrate on CXR

20. What are symptoms are CHF?
The patient is seated with the head turned to the right and is quickly lowered to the supine position with the head over the edge of the examination table 30 degrees below horizontal. The test is then repeated with the head turned to the left. The te
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Warts
Affects 60% of patients with asymptomatic proteinuria; patients are usually <30 - secrete less than 2g protein/day: proteinuria occurs in the upright - but not supine position

21. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Rotator Cuff problem
Cervical radiculopathy
Irregular bleeding between cycles

22. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
24 hour halter
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Diuretics -BB -CCB -ACEi

23. What is benign transient proteinuria?
Systolic dysfunction- ejection fraction is reduced to less than 45% - diastolic dysfunction- ejection fraction is preserved or high; use doppler techniques- abnormal flow across the mitral valve
Giardia
Colposcopy - Endocervical curettage - and directed cervical biopsy
Common problem that resolves spontaneously and is most often seen in children and young adults

24. What is the next best step if a patient has two or more positive dipstick tests?
Hx: Onset of menarche and duration and frequency of the menstrual period - Bleeding pattern - hx of liver - renal - thyroid disease - Use of anticoags - oral contraception - hormone replacement - ROS: weight change - hirsutism (indicating PCOS=LH:FSH
LH surge triggers ovulation
A 24hr urine protein collection and urine creatinine clearance determination
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

25. Diarrhea is defined as an ____ in stool weight to more than ____g per day
ACEi
Increase; 200 g/day
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

26. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
A 24hr urine protein collection and urine creatinine clearance determination
Stabilize on oxygen - nitroglycerin - morphine for pain - aspirin (to decrease mortality by 20%) - clopidogrel or ticolodipine. (beta blockers - heparin - nitrates - ACEi - thrombolytics (if <75 with ST segment elevation - and a history consistent wi

27. Pneumonia tx: suitable for healthy adults less than 60
Adhesive capsulitis (frozen shoulder): most common in middle age women
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Genetic screening - medical assessment for chronic diseases - screening for infectious diseases - and updating of immunizations - advice on proper nutrition and exercise - help with quitting unhealthy habits - and advice on avoiding environmental haz

28. MI - pericardial tamponade - PE - GI bleed - are...
Dysfunctional Uterine bleeding: caused by hormonal imbalances from a functionally abnormal hypothalamic-pitu-ovarian axis resulting in abnormal follicle development and anovulation (metorrhagia) -Corpus luteum does not develop=progesterone-deficient
Associated with hypotension
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
When the patient has symptoms in association with exercise or who describe chest pain or pressure

29. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Preconception visit: up to 1 yr before conception -1st prenatal visit: 6-8wks after missed menses -Every 4 wks: up to 28 wks gestational age -Every 2 wks: up to 36 weeks gestational age -Every week: until delivery
W/in 4hrs and peaks 24hrs; it is important to obtain serial markers since the first set of cardiac markers are negative in 25 - 50% of patients with an acute MI
Pancreatitis

30. Uterine bleeding between regular cycles
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
PE - MI - aortic dissection - pneumothorax
Intermenstrual bleeding
Pap Smear (unless recent normal pap) -CBC -Pregnancy test -Ultrasound if uterus is enlarged -Cervical culture in patients high risk of infection -Thyroid test and testing for systemic diseases

31. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Reduce symptoms - prevent complications - improve survival-diuretics - ACE inhibitors (slow progression of heart failure - decrease the number of hospitalizations and decrease mortality) - beta blockers (decrease mortality and sudden death) - spirono
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
Echocardiogram
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

32. Name the skin lesion: honey colored crusts
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Bronchitis: Antecedent URI - Cough - No or low-grade fever - clear lungs or coarse rhonchi - Normal CXR Pneumonia: Acute onset of cough - fever - and tachypnea - chest pain - leukocytosis - pulmonary infiltrate on CXR
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Impetigo

33. Carcinoma in situ is generally referred to a gynecologist and requires ______
Non-cardiac causes of palpitations
100mg; means patient can be trace protein positive and not be detected
Varicella virus
Conization (or LEEP): removeal of a portion of the cervix and thus patients are at risk of preterm labor - incompetent cervix - or cervical stenosis in future pregnancies

34. How do you know if heart palpitations are due to stimulant or medication use?
Serotypes 16 - 18 - 31 -52 -58
Diuretics -BB -CCB -ACEi
Viral infection of the semicircular apparatus
Less abrupt onset and cessation of palpitations

35. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
Molluscum contagiosum- pox virus
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
CT

36. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Less than 3 stools per week
Pts with palpitations and dizziness - near syncope - or syncope
BB or CCB - catheter ablation of identified bypass tract
Typically brought on exercise - eating - emotional excitement; pain lasts 5 - 15mins - disappears with nitroglycerin or at rest; if the pain lasts <1 or >30mins it should not be considered anginal

37. Why is the pap smear one of the most effective cancer screening tools?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Slow progression of cervical cancer changes -Availability of effective early treatment
Intermenstrual bleeding
Hx: Onset of menarche and duration and frequency of the menstrual period - Bleeding pattern - hx of liver - renal - thyroid disease - Use of anticoags - oral contraception - hormone replacement - ROS: weight change - hirsutism (indicating PCOS=LH:FSH

38. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Molluscum contagiosum- pox virus
S. aureus- beta hemolytic streptococcus
HSV1: oral HSV2: genital -primary infection: transmitted by respiratory droplets or by direct contact with an active lesion or infected secretions -secondary phase: reactivation of the latent virus from dorsal root ganglia -grouped vesicles on an ery
Chest pain during pneumonia or PE

39. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
High blood pressure - focal neurologic defecit - or papilledema
ACEi - ARBS - thiazide diuretics
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology

40. Cycle length variabilty is primarily due to what?
Variability in the time for follicle development during the proliferative phase
Coag disorders
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Muscular chest pain (inflammation or overuse pf chest wall muscles); costochondral joint (reproduced on palpation and patient may not want to take a deep breath in); rib fractures

41. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Associated with hypotension
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Bence-Jones

42. Oligomenorrhea
CBC
Increase; 200 g/day
Regular bleeding at intervals of more than 35 days
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas

43. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Increase; 200 g/day
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Peptic ulcer disease or gastritis

44. History for Acute bronchitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Cholelithiasis
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
When the patient has symptoms in association with exercise or who describe chest pain or pressure

45. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Typically brought on exercise - eating - emotional excitement; pain lasts 5 - 15mins - disappears with nitroglycerin or at rest; if the pain lasts <1 or >30mins it should not be considered anginal
Dysfunctional Uterine bleeding: caused by hormonal imbalances from a functionally abnormal hypothalamic-pitu-ovarian axis resulting in abnormal follicle development and anovulation (metorrhagia) -Corpus luteum does not develop=progesterone-deficient
Subarachnoid hemorrhage
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

46. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
PVC or Premature atrial contraction (PAC)
Streptococci
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Intermenstrual bleeding

47. History for Sinusitis

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48. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
High blood pressure - focal neurologic defecit - or papilledema
Holter monitor: 24 hours - detect an arrhythmia; patient keeps a log of symptoms Event monitor: can be carried for 30 days or more and are patient activated at the time of symptoms; event recroding ca nbe transmitted by telephone to a monitoring symp
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

49. Difference between Pneumonia and Bronchitis
RBC casts and old to moderate HTN
It is a test for BPV. Rotate the patients through a series of positions in an attempt to relocate the debris in the semicircular canal into the vestibule of the labyrinth.
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Bronchitis: Antecedent URI - Cough - No or low-grade fever - clear lungs or coarse rhonchi - Normal CXR Pneumonia: Acute onset of cough - fever - and tachypnea - chest pain - leukocytosis - pulmonary infiltrate on CXR

50. What are the signs of cerebral hemorrhage?
Acute headache - ataxia - profuse nausea - and vomiting
24 hour halter
PVC or Premature atrial contraction (PAC)
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas