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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.
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. 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
Common problem that resolves spontaneously and is most often seen in children and young adults
Bence-Jones
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Warts

2. What diagnosis does the 'worse headache of my life' suggest?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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
Subarachnoid hemorrhage

3. History for Sinusitis

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4. Mainstay treatment for soft tissue inflammation (Shoulder)
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
1)Promoting Na+retention 2) Promoting hypertrophy and hyperplasia of vascular smooth muscles through its mitogenic properties 3) Modifying ion transport - leading to increase in intracellular Ca2+ 4) Sympathetic activation
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Kids: Rotavirus Adults: Norwalk Virus

5. What should blood work include for suspected heart failure?
Echocardiogram
Coronary artery disease/ angina
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

6. What are the features of glomerular nephritis
Hypertension - CAD - valvular heart disease
RBC casts and old to moderate HTN
Peptic ulcer disease or gastritis
Excessive bleeding in amount - duration - or both at irregular intervals

7. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Regular bleeding at intervals of more than 35 days
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
Common problem that resolves spontaneously and is most often seen in children and young adults

8. What are the signs of acute sinusitis?
Fever with frontal or maxillary tenderness
LH surge triggers ovulation
Less abrupt onset and cessation of palpitations
Intermenstrual bleeding

9. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Streptococci
E. Coli O157:H7
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
CBC

10. Chronic pain and shoulder stiffness with limited motion
Irregular bleeding between cycles
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Adhesive capsulitis (frozen shoulder): most common in middle age women
Polymenorrhea

11. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Viral gastroenteritis
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Increase; 200 g/day

12. After treatment of dysplasia - women need Pap smears every...
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Cholelithiasis
CT
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

13. Predictors of cardiac etiology
MSK - pulmonary - GI - or psychological
Less abrupt onset and cessation of palpitations
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

14. When should a patient get a stress test?
CBC
Colposcopy - Endocervical curettage - and directed cervical biopsy
ACEi
When the patient has symptoms in association with exercise or who describe chest pain or pressure

15. What is an acoustic neuroma?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

16. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

17. Four muscles of rotator cuff
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
These patients are associated with low renin states=less likely to respond to medication
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

18. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Non-cardiac causes of palpitations
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Fever with frontal or maxillary tenderness

19. What should be considered in younger patients with menorrhagia
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Analgesic headache
Increase; 200 g/day
Coag disorders

20. Uterine bleeding between regular cycles
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
ACEi - ARBS - thiazide diuretics
Intermenstrual bleeding
Impetigo

21. What are the 2 psych disorders most commonly associated with palpitations?
Generalized Anxiety disorder and panic disorder
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
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
Chest pain during pneumonia or PE

22. What are the primary glomerular diseases?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
Adhesive capsulitis (frozen shoulder): most common in middle age women

23. Initial treatment for Rhinosinusitis
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
>150mg per 24hrs
Scabies
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

24. How is constipation clinically defined?
Menorrhagia
Less than 3 stools per week
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
PVC or Premature atrial contraction (PAC)

25. 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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
>3.5g of protein per 24hrs
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

26. Diagnosis of HTN
Non-cardiac causes of palpitations
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Peptic ulcer disease or gastritis

27. How are fungal infections diagnosed?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Generalized Anxiety disorder and panic disorder
Serotypes 16 - 18 - 31 -52 -58
With a KOH wet mount preparation

28. Describe the presentation of pneumonia
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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
Peptic ulcer disease or gastritis
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

29. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
DM - HTN - DVT - seizures - depression - or anxiety
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

30. 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
E. Coli O157:H7
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
High blood pressure - focal neurologic defecit - or papilledema
MSK - pulmonary - GI - or psychological

31. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
True
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Less than 3 stools per week
RBC casts and old to moderate HTN

32. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Candida albicans
These patients are associated with low renin states=less likely to respond to medication
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Peptic ulcer disease or gastritis

33. What should preconception counseling include?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Slow progression of cervical cancer changes -Availability of effective early treatment

34. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Increase; 200 g/day
Repeat Pap after infection treated

35. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
RBC casts and old to moderate HTN
Medication or chemical esophagitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Possibility of Ischemic colitis

36. How do you define persistent protein uria?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Bence-Jones
Presence of proteinuria on at least two separate ocassion
Varicella virus

37. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
ACEi - ARBS - thiazide diuretics
Hypertension - CAD - valvular heart disease
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

38. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Echocardiogram
Adhesive capsulitis (frozen shoulder): most common in middle age women
Upper sternal area burning pain - associated with a productive cough

39. What HPV serotypes are most commonly associated with cervical cancer?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Medication or chemical esophagitis
Serotypes 16 - 18 - 31 -52 -58

40. Complete the sentence: pericarditis can cause frictional rub and......
Analgesic headache
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Polymenorrhea

41. Natural history of cervical cancer
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Folliculitis
Wolff-Parkinson-White syndrome
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

42. Name some medications that can cause proteinuria
Staphylococcal scalded skin syndrome
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Serotypes 16 - 18 - 31 -52 -58

43. Describe the presentation of pericardial pain
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Polymenorrhea
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

44. What test done in PE measures instability of shoulder?
Streptococci
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Nonulcer dyspepsia
Less than 3 stools per week

45. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Diuretics -BB -CCB -ACEi
1)Promoting Na+retention 2) Promoting hypertrophy and hyperplasia of vascular smooth muscles through its mitogenic properties 3) Modifying ion transport - leading to increase in intracellular Ca2+ 4) Sympathetic activation
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

46. Discomfort with abducting the arm past 90 degress
Cellulitis
Presence of proteinuria on at least two separate ocassion
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Rotator Cuff tendonitis

47. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Folliculitis
Bulk forming: Psyllium - Methycellulose - Polycarbophil
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

48. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
ACEi - ARBS - thiazide diuretics
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Cholelithiasis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

49. What does the classic ring worm lesion have?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
A central clear area
CBC
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

50. What are the two common clinical presentations of acute diarrhea?
Squamocolumnar junction=most common site of cervical cancer
Warts
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Possibility of Ischemic colitis