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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. What is an acoustic neuroma?
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Intermenstrual bleeding

2. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Wolff-Parkinson-White syndrome
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.
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

3. At was quantity does urine dipstick test detect elevated protein?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
100mg; means patient can be trace protein positive and not be detected
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Candida albicans

4. Vaccines that should be updated before planned pregnancy
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

5. Diarrhea from custard filled pastries
S. Aureus
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Lightheadedness - dizziness - syncope

6. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Nonulcer dyspepsia
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

7. Name the diagnosis of heartburn: regurgitation - dysphagia
Presence of proteinuria on at least two separate ocassion
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
CT
GERD

8. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
CBC
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

9. Mainstay treatment for soft tissue inflammation (Shoulder)
DM - HTN - DVT - seizures - depression - or anxiety
Varicella virus
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

10. Four muscles of rotator cuff
Temporal arteritis-biopsy of the temporal artery
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Coronary artery disease/ angina

11. How to NSAIDs contribute to gastritis and ulcer formation?
Warts
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.
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

12. What is the caUse of Meniere disease? What are the cardinal symptoms?
Cholelithiasis
S. Aureus
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

13. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Viral gastroenteritis
Analgesic headache

14. Describe the presentation of myocardial pain?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Hgb - Electrolytes - and TSH
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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

15. Regular bleeding at intervals of less than 21 days
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Staphylococcal scalded skin syndrome
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Polymenorrhea

16. What type of imaging is need for chronic sinusitis?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
CT
Less abrupt onset and cessation of palpitations
PE - MI - aortic dissection - pneumothorax

17. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
RBC casts and old to moderate HTN
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
100mg; means patient can be trace protein positive and not be detected
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

18. What should blood work include for suspected heart failure?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Associated with hypotension
Folliculitis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

19. What is considered normal blood loss during a menstrual cycle?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
EGD
Pancreatitis
Less than 80 ml of blood

20. 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
Repeat Pap after infection treated
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
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

21. Uterine bleeding between regular cycles
Cluster headache
Intermenstrual bleeding
Lightheadedness - dizziness - syncope
Associated with hypotension

22. 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
Scabies
Fever with frontal or maxillary tenderness
Menorrhagia
100mg; means patient can be trace protein positive and not be detected

23. What is the role of FSH in one's menstrual cycle
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Associated with hypotension
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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

24. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
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.
Rotator Cuff problem
Common problem that resolves spontaneously and is most often seen in children and young adults
PE - MI - aortic dissection - pneumothorax

25. Constipation: What are indications for lab testing?
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
Furucnle
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

26. How do you define persistent protein uria?
Candida albicans
These patients are associated with low renin states=less likely to respond to medication
Presence of proteinuria on at least two separate ocassion
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

27. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Infectious esophagitis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Adhesive capsulitis (frozen shoulder): most common in middle age women
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

28. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Hgb - Electrolytes - and TSH
With a KOH wet mount preparation
Diuretics -BB -CCB -ACEi
Supraspinatus and bicipital tendons

29. 1+ protein level on urine dipstick usually represents how much protein in the urine?
True
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
S. aureus- beta hemolytic streptococcus
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

30. Name the skin lesion: pustule in association with a hair follice
True
Folliculitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Viral infection of the semicircular apparatus

31. What are the two common clinical presentations of acute diarrhea?
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
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
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

32. Name types of laxatives
Pancreatitis
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Diuretics -BB -CCB -ACEi
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

33. History and PE for Pneumonia
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Supraspinatus and bicipital tendons
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

34. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Streptococci
Squamocolumnar junction=most common site of cervical cancer
Kids: Rotavirus Adults: Norwalk Virus

35. What are the symptoms of palpitations?
Cellulitis
Lightheadedness - dizziness - syncope
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
Pleurisy

36. 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
Increase; 200 g/day
Excessive bleeding in amount - duration - or both at irregular intervals
Bence-Jones
Varicella virus

37. When does troponin rise following myocardial injury or infarction?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Scabies
MSK - pulmonary - GI - or psychological
Echocardiogram

38. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Nonulcer dyspepsia
Acute headache - ataxia - profuse nausea - and vomiting
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

39. What are the physical exam signs of CHF?
Infectious esophagitis
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
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
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

40. 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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
24 hour halter
True
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

41. Cycle length variabilty is primarily due to what?
Slow progression of cervical cancer changes -Availability of effective early treatment
Variability in the time for follicle development during the proliferative phase
High blood pressure - focal neurologic defecit - or papilledema
Medication or chemical esophagitis

42. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
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
Cholelithiasis
Streptococci
Generalized Anxiety disorder and panic disorder

43. What is the standard tool used for diagnosis of GERD?
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
EGD
Other brainstem or cranial nerve findings
Cervical radiculopathy

44. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Lightheadedness - dizziness - syncope
Variability in the time for follicle development during the proliferative phase

45. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
A 24hr urine protein collection and urine creatinine clearance determination
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
ACEi

46. Pneumonia tx: suitable for healthy adults less than 60
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
HPV
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

47. What diagnosis does the 'worse headache of my life' suggest?
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
PVC or Premature atrial contraction (PAC)
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
Subarachnoid hemorrhage

48. Describe the presentation of pneumonia
PE - MI - aortic dissection - pneumothorax
S. Aureus
Generalized Anxiety disorder and panic disorder
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

49. What are the signs of malignant hypertension?
Slow progression of cervical cancer changes -Availability of effective early treatment
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
High blood pressure - focal neurologic defecit - or papilledema

50. Where does the development of abnormal cervical cells begin?
35 (exception for postmenopausal women who have recently been started on HRT)
Scabies
Squamocolumnar junction=most common site of cervical cancer
Warts