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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
E. Coli O157:H7
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

2. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Rotator Cuff tendonitis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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

3. What does orthostatic positional changes that bring on dizziness suggest?
ACEi - ARBS - thiazide diuretics
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
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
Dehydration - anemia - cardiac causes

4. What is a markers of CNS vertigo?
Peptic ulcer disease or gastritis
Other brainstem or cranial nerve findings
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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

5. How does systolic vs. diastolic heart failure present on the echocardiogram?
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
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

6. Pneumothorax - sudden sharp chest pain - preceded by viral illness
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
Pleurisy
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Medication or chemical esophagitis

7. When should a patient get a stress test?
Scleroderma/polymyositis with secondary gastroesophageal reflux
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
S. aureus- beta hemolytic streptococcus

8. Difference between Pneumonia and Bronchitis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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

9. What is the role of LH in the menstrual cycle
Analgesic headache
Less abrupt onset and cessation of palpitations
Less than 3 stools per week
LH surge triggers ovulation

10. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
Less than 80 ml of blood
ACEi
PVC or Premature atrial contraction (PAC)

11. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Less than 80 ml of blood
Pleurisy
Pts with palpitations and dizziness - near syncope - or syncope
High blood pressure - focal neurologic defecit - or papilledema

12. Name the diagnosis: transmitted by airborne droplets or vesicular fluid; patients are contagious from 2 days before onset of the rash until all lesions have crusted. The rash has a centripetal distribution - starting at the trunk and spreading to the
Varicella virus
Regular bleeding at intervals of more than 35 days
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
Pancreatitis

13. Pain in shoulder when throwing - swimming - or serving a tennis ball
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Medication or chemical esophagitis
Rotator cuff tendonitis
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

14. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
These patients are associated with low renin states=less likely to respond to medication
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Loop diuretics (Check serum K+ levels before drug admin)

15. Where does the development of abnormal cervical cells begin?
Albumin; low molecular weight proteins
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Impetigo
Squamocolumnar junction=most common site of cervical cancer

16. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
BB or CCB - catheter ablation of identified bypass tract

17. What is an acoustic neuroma?
Cervical radiculopathy
These patients are associated with low renin states=less likely to respond to medication
Cholelithiasis
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

18. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
Cluster headache
Warts
24 hour halter
Coag disorders

19. Shoulder pain with pain radiating to elbow
Less than 3 stools per week
Cervical radiculopathy
Regular bleeding at intervals of more than 35 days
DM - HTN - DVT - seizures - depression - or anxiety

20. Describe the presentation of pericardial pain
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

21. What should blood work include for suspected heart failure?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Loop diuretics (Check serum K+ levels before drug admin)
Less than 80 ml of blood
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

22. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Giardia
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
Nonulcer dyspepsia
Molluscum contagiosum- pox virus

23. MI - pericardial tamponade - PE - GI bleed - are...
Hx: High fever - dyspnea - chills - chest pain - develop hypoxia or cardiopulmonary failure - PE: Abnormal Vital signs (fever - tachypnea - tachycardia) - Lungs (localized rales - bronchial breath sounds - wheezing - signs of consolidation-dullness t
Other brainstem or cranial nerve findings
Associated with hypotension
A 24hr urine protein collection and urine creatinine clearance determination

24. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
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
CBC
Variability in the time for follicle development during the proliferative phase
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

25. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
RBC casts and old to moderate HTN
Non-cardiac causes of palpitations
Pleurisy

26. Name 4 factors that predispose an individual to develop pneumonia.
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Fever with frontal or maxillary tenderness

27. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Albumin; low molecular weight proteins
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
With a KOH wet mount preparation

28. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
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
Bence-Jones

29. How to NSAIDs contribute to gastritis and ulcer formation?
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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
NSAIDs block COX-1 production of prostaglandins that maintain mucosal blood flow - secretion of mucus - and bicarbonate. Without these protective factors - acid-induced inflammation and ulcers my result.
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

30. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
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
S. Aureus
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
S. aureus- beta hemolytic streptococcus

31. How do you define persistent protein uria?
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
Supraspinatus and bicipital tendons
Presence of proteinuria on at least two separate ocassion
Viral gastroenteritis

32. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
>150mg per 24hrs
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

33. What does treatment for migrans include?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Other brainstem or cranial nerve findings
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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

34. History and PE for Pneumonia
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Hx: High fever - dyspnea - chills - chest pain - develop hypoxia or cardiopulmonary failure - PE: Abnormal Vital signs (fever - tachypnea - tachycardia) - Lungs (localized rales - bronchial breath sounds - wheezing - signs of consolidation-dullness t

35. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
CBC
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Possibility of Ischemic colitis
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

36. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
These patients are associated with low renin states=less likely to respond to medication
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Infectious esophagitis

37. What are the secondly causes of glomerular disease?
MSK - pulmonary - GI - or psychological
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

38. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
Pleurisy
S. Aureus
Warts
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

39. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Particulate matter or otoliths may form in the semicircular canal. The otoliths become dislodged and stimulate the sensory hair cells in the semicircular canals - leading to vertigo.
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
These patients are associated with low renin states=less likely to respond to medication
ACEi

40. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Echocardiogram
Colposcopy - Endocervical curettage - and directed cervical biopsy
Streptococci
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

41. What should preconception counseling include?
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
ACEi
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

42. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
Cellulitis
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

43. When does troponin rise following myocardial injury or infarction?
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
Staphylococcal scalded skin syndrome
Coag disorders
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

44. In regards to a Pap smear - What should be done if a patient has cervical inflammation from infections such as Chlamydia or yeast that may cause cells to appear abnormal.
Repeat Pap after infection treated
Pleurisy
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza

45. What are the 2 psych disorders most commonly associated with palpitations?
Warts
Generalized Anxiety disorder and panic disorder
MSK - pulmonary - GI - or psychological
Viral infection of the semicircular apparatus

46. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
Viral infection of the semicircular apparatus
Cervical radiculopathy
ACEi

47. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Non-cardiac causes of palpitations
Intermenstrual bleeding
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Wolff-Parkinson-White syndrome

48. Oligomenorrhea
Hypertension - CAD - valvular heart disease
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
Regular bleeding at intervals of more than 35 days
Cholelithiasis

49. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Increase; 200 g/day
MSK - pulmonary - GI - or psychological
A 24hr urine protein collection and urine creatinine clearance determination

50. Vaccines that should be updated before planned pregnancy
PVC or Premature atrial contraction (PAC)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Non-cardiac causes of palpitations
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

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