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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 places women at higher risk of getting cervical cancer?
HPV
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Paroxysmal atrial fibrillation or supraventricular tachycardia
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

2. What are the symptoms of palpitations?
A 24hr urine protein collection and urine creatinine clearance determination
Slow progression of cervical cancer changes -Availability of effective early treatment
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
Lightheadedness - dizziness - syncope

3. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Giardia
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

4. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Scleroderma/polymyositis with secondary gastroesophageal reflux
Nonulcer dyspepsia
Polymenorrhea

5. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Non-cardiac causes of palpitations
Furucnle
Adhesive capsulitis (frozen shoulder): most common in middle age women
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

6. Pneumonia tx: suitable for healthy adults older than 60
Hypertension - CAD - valvular heart disease
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Less than 3 stools per week
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

7. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Supraspinatus and bicipital tendons
Rotator Cuff problem
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
Rotator cuff tendonitis

8. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
Coag disorders
PE - MI - aortic dissection - pneumothorax
Other brainstem or cranial nerve findings

9. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
A 24hr urine protein collection and urine creatinine clearance determination
Medication or chemical esophagitis

10. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
High blood pressure - focal neurologic defecit - or papilledema
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Chest pain during pneumonia or PE

11. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
35 (exception for postmenopausal women who have recently been started on HRT)
Upper sternal area burning pain - associated with a productive cough
Diuretics -BB -CCB -ACEi
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

12. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
EGD
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Non-cardiac causes of palpitations
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

13. Irregular cycles with excessive flow - duration - or both
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Menorrhagia
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
CBC

14. What should preconception counseling include?
E. Coli O157:H7
Cellulitis
Repeat Pap after infection treated
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

15. 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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

16. What medications can cause heart palpitations?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Adhesive capsulitis (frozen shoulder): most common in middle age women
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

17. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
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
MSK - pulmonary - GI - or psychological
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Temporal arteritis-biopsy of the temporal artery

18. What are the three types of lice?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Candida albicans
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

19. What is the role of LH in the menstrual cycle
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
CBC
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
LH surge triggers ovulation

20. What HPV serotypes are most commonly associated with cervical cancer?
Supraspinatus and bicipital tendons
Serotypes 16 - 18 - 31 -52 -58
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
>3.5g of protein per 24hrs

21. How can GERD (or esophageal motility disorders) lead to chest pain?
Diuretics -BB -CCB -ACEi
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
MSK - pulmonary - GI - or psychological
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

22. What drugs do you use to treat H.pylori + PUD?
Rotator cuff tendonitis
CBC
Infectious esophagitis
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

23. 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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

24. Name the diagnosis of heartburn: severe constant mid abdominal pain
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Temporal arteritis-biopsy of the temporal artery
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Pancreatitis

25. Name the diagnosis: umbilicated skin lesion that is spread by autoinoculation - scratching - or touching a lesion. Discrete 2 to 5 mm slightly umbilicated flesh-colored - dome shaped papules occurring on the face - trunk - axillae - and extremities i
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.
Pain
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Molluscum contagiosum- pox virus

26. What are the secondly causes of glomerular disease?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
CBC
Upper sternal area burning pain - associated with a productive cough
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

27. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
MSK - pulmonary - GI - or psychological
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
HPV

28. Describe the presentation of pneumonia
Cervical radiculopathy
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
MSK - pulmonary - GI - or psychological

29. What occurs after ovulation
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Pancreatitis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

30. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
These patients are associated with low renin states=less likely to respond to medication
Pts with palpitations and dizziness - near syncope - or syncope
ACEi - ARBS - thiazide diuretics
With a KOH wet mount preparation

31. What is the role of FSH in one's menstrual cycle
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Dehydration - anemia - cardiac causes
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

32. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
Streptococci
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Coag disorders

33. Who should have Xray testing for shoulder pain?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
HIV and syphilis
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

34. What is the difference between a Holter monitor or an event monitor?
Rotator Cuff tendonitis
Streptococci
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
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

35. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
Folliculitis
Subarachnoid hemorrhage
Squamocolumnar junction=most common site of cervical cancer

36. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Loop diuretics (Check serum K+ levels before drug admin)
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Hgb - Electrolytes - and TSH
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

37. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
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
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
35 (exception for postmenopausal women who have recently been started on HRT)

38. 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
Furucnle
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Viral gastroenteritis

39. What lab tests are recommended for newly diagnosed hypertensive patients?
Menorrhagia
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Scabies

40. Constipation: What are indications for lab testing?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Slow progression of cervical cancer changes -Availability of effective early treatment
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
100mg; means patient can be trace protein positive and not be detected

41. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Peptic ulcer disease or gastritis
Hypertension - CAD - valvular heart disease
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

42. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
ACEi
Echocardiogram
Viral gastroenteritis
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. Treatment for supraventricular tachycardias
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
BB or CCB - catheter ablation of identified bypass tract
Molluscum contagiosum- pox virus

44. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Increase; 200 g/day
Less abrupt onset and cessation of palpitations
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

45. Menometrorrhagia
Cervical radiculopathy
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Excessive bleeding in amount - duration - or both at irregular intervals

46. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

47. Vaccines that should be updated before planned pregnancy
Excessive bleeding in amount - duration - or both at irregular intervals
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Paroxysmal atrial fibrillation or supraventricular tachycardia

48. 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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
BB or CCB - catheter ablation of identified bypass tract
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

49. What should blood work include for suspected heart failure?
Subarachnoid hemorrhage
Peptic ulcer disease or gastritis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
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

50. Discomfort with abducting the arm past 90 degress
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Adhesive capsulitis (frozen shoulder): most common in middle age women
Hypertension - CAD - valvular heart disease
Rotator Cuff tendonitis