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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 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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

2. What test done in PE measures instability of shoulder?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

3. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Supraspinatus and bicipital tendons
With a KOH wet mount preparation
Paroxysmal atrial fibrillation or supraventricular tachycardia

4. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Molluscum contagiosum- pox virus
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Tension headache

5. What should blood work include for suspected heart failure?
Loop diuretics (Check serum K+ levels before drug admin)
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

6. Initial treatment for Rhinosinusitis
Pain
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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
Infectious esophagitis

7. What are the two common clinical presentations of acute diarrhea?
Temporal arteritis-biopsy of the temporal artery
Higher filling presure - pulmonary congestion - and decreasd cardiac return
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Slow progression of cervical cancer changes -Availability of effective early treatment

8. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
Less than 3 stools per week
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
ACEi - ARBS - thiazide diuretics

9. Why is the pap smear one of the most effective cancer screening tools?
Varicella virus
High blood pressure - focal neurologic defecit - or papilledema
Slow progression of cervical cancer changes -Availability of effective early treatment
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.

10. What are the three types of lice?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Slow progression of cervical cancer changes -Availability of effective early treatment
35 (exception for postmenopausal women who have recently been started on HRT)
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

11. 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
Polymenorrhea
S. Aureus
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

12. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Rotator Cuff problem
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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
Kids: Rotavirus Adults: Norwalk Virus

13. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
LH surge triggers ovulation
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

14. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Subarachnoid hemorrhage
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Anticoag with warfarin to prevent thromboembolism

15. History for Acute bronchitis
Hypertension - CAD - valvular heart disease
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
>3.5g of protein per 24hrs

16. Who should have Xray testing for shoulder pain?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

17. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
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
35 (exception for postmenopausal women who have recently been started on HRT)
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

18. What is the preload?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

19. Prenatal visit schedule for low-risk pregnancies
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
Hgb - Electrolytes - and TSH
Kids: Rotavirus Adults: Norwalk Virus
Higher filling presure - pulmonary congestion - and decreasd cardiac return

20. What drugs do you use to treat H.pylori + PUD?
Less abrupt onset and cessation of palpitations
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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

21. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
HIV and syphilis
Peptic ulcer disease or gastritis
Loop diuretics (Check serum K+ levels before drug admin)
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

22. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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.
Possibility of Ischemic colitis
Viral gastroenteritis

23. What is a markers of CNS vertigo?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
BB or CCB - catheter ablation of identified bypass tract
Other brainstem or cranial nerve findings
100mg; means patient can be trace protein positive and not be detected

24. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Analgesic headache

25. Cycle length variabilty is primarily due to what?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Anticoag with warfarin to prevent thromboembolism
Variability in the time for follicle development during the proliferative phase

26. Complete the sentence: pericarditis can cause frictional rub and......
Rotator cuff tendonitis
Pancreatitis
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

27. Diagnosis of HTN
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
RBC casts and old to moderate HTN
Infectious esophagitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

28. What are the signs of cerebral hemorrhage?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Menorrhagia
Acute headache - ataxia - profuse nausea - and vomiting
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

29. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Fever with frontal or maxillary tenderness

30. What are the three major risk factors for heart failure?
Lightheadedness - dizziness - syncope
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Viral infection of the semicircular apparatus
Hypertension - CAD - valvular heart disease

31. What is the goal of CHF treatment? What drugs should be used?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
LH surge triggers ovulation
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
Intermenstrual bleeding

32. Diarrhea from custard filled pastries
S. Aureus
Pts with palpitations and dizziness - near syncope - or syncope
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.
Staphylococcal scalded skin syndrome

33. What is the Epley maneuver?
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.
Serotypes 16 - 18 - 31 -52 -58
LH surge triggers ovulation
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

34. At was quantity does urine dipstick test detect elevated protein?
Coronary artery disease/ angina
100mg; means patient can be trace protein positive and not be detected
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

35. What are the primary glomerular diseases?
Cluster headache
Molluscum contagiosum- pox virus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
LH surge triggers ovulation

36. Lab testing for heart palpitation
Echocardiogram
These patients are associated with low renin states=less likely to respond to medication
Hgb - Electrolytes - and TSH
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

37. Oligomenorrhea
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Kids: Rotavirus Adults: Norwalk Virus
Regular bleeding at intervals of more than 35 days
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

38. What is the role of FSH in one's menstrual cycle
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
Analgesic headache
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.
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

39. How are fungal infections diagnosed?
Squamocolumnar junction=most common site of cervical cancer
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
With a KOH wet mount preparation
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

40. Define nephrotic range proteinuria
Irregular bleeding between cycles
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Common problem that resolves spontaneously and is most often seen in children and young adults
>3.5g of protein per 24hrs

41. What should be considered in younger patients with menorrhagia
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Coag disorders
Pts with palpitations and dizziness - near syncope - or syncope
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

42. PE for a patient getting an abnormal vaginal bleeding work up
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Possibility of Ischemic colitis
HIV and syphilis

43. What are the symptoms of palpitations?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Adhesive capsulitis (frozen shoulder): most common in middle age women
Lightheadedness - dizziness - syncope
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

44. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
EGD
Variability in the time for follicle development during the proliferative phase
CBC
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

45. HIgh risk pregnant patients should be evaluated for ____ and ____
A central clear area
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.
HIV and syphilis
Folliculitis

46. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
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
HIV and syphilis
Polymenorrhea

47. Name 4 factors that predispose an individual to develop pneumonia.
Associated with hypotension
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Loop diuretics (Check serum K+ levels before drug admin)
Higher filling presure - pulmonary congestion - and decreasd cardiac return

48. What is considered normal blood loss during a menstrual cycle?
Less abrupt onset and cessation of palpitations
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
HPV
Less than 80 ml of blood

49. What is an acoustic neuroma?
Lightheadedness - dizziness - syncope
ACEi
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Jugular venous distension: elevated venous pressures -PMI is displaced laterally and downward: cardiomegaly -bibasilar rales -third and fourth heart sounds: fluid overloaded - stiff ventricles -murmurs: valvular pathology -hepatomegaly: right sided

50. Name the diagnosis: a fertilized female mite burrow through the stratum corneum to being a 30 day life cycle of egg laying and deposition of fecal matter. After the eggs have hatched - the mites can migrate to other areas such as the finger webs - wr
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Scabies
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid