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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. Cycle length variabilty is primarily due to what?
Wolff-Parkinson-White syndrome
Variability in the time for follicle development during the proliferative phase
Serotypes 16 - 18 - 31 -52 -58
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

2. Prenatal visit schedule for low-risk pregnancies
HPV
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
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.
Impetigo

3. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Infectious esophagitis
Temporal arteritis-biopsy of the temporal artery
Serotypes 16 - 18 - 31 -52 -58

4. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Non-cardiac causes of palpitations
Warts
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Loop diuretics (Check serum K+ levels before drug admin)

5. 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)
Streptococci
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

6. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
Influenza - Rhinovirus - Adenovirus - Parainfluenza
100mg; means patient can be trace protein positive and not be detected
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

7. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
DM - HTN - DVT - seizures - depression - or anxiety
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
Supraspinatus and bicipital tendons
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

8. What are the most common viral causes of diarrhea in kids and adults?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Less than 3 stools per week
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.
Kids: Rotavirus Adults: Norwalk Virus

9. What are the 2 psych disorders most commonly associated with palpitations?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Generalized Anxiety disorder and panic disorder
Irregular bleeding between cycles

10. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
BB or CCB - catheter ablation of identified bypass tract

11. How does CHF present on X-ray?
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
Less than 80 ml of blood
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

12. What is the preload?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Varicella virus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

13. Four muscles of rotator cuff
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Candida albicans
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

14. Regular bleeding at intervals of less than 21 days
Wolff-Parkinson-White syndrome
Polymenorrhea
Less than 80 ml of blood
Viral infection of the semicircular apparatus

15. Describe the presentation of pericardial pain
Pleurisy
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
MSK - pulmonary - GI - or psychological
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

16. Menometrorrhagia
Echocardiogram
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Excessive bleeding in amount - duration - or both at irregular intervals
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

17. What is the Barany maneuver?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Cellulitis

18. How is constipation clinically defined?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Less than 3 stools per week
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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

19. What test done in PE measures instability of shoulder?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
E. Coli O157:H7
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

20. What are the features of glomerular nephritis
RBC casts and old to moderate HTN
PE - MI - aortic dissection - pneumothorax
Analgesic headache
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

21. How are fungal infections diagnosed?
Less than 3 stools per week
Excessive bleeding in amount - duration - or both at irregular intervals
With a KOH wet mount preparation
Non-cardiac causes of palpitations

22. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Polymenorrhea

23. What is the caUse of Meniere disease? What are the cardinal symptoms?
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Less than 80 ml of blood
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

24. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Loop diuretics (Check serum K+ levels before drug admin)
Analgesic headache
Excessive bleeding in amount - duration - or both at irregular intervals

25. Diarrhea from custard filled pastries
GERD
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
S. Aureus

26. Define the patient population typically affected by orthostatic or postural proteinuria
Rotator Cuff tendonitis
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
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
Nonulcer dyspepsia

27. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
LH surge triggers ovulation
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Less than 80 ml of blood
Infectious esophagitis

28. Pneumonia tx: suitable for healthy adults less than 60
Folliculitis
Associated with hypotension
Cholelithiasis
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

29. What should be considered in younger patients with menorrhagia
Coag disorders
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Viral gastroenteritis
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

30. Oligomenorrhea
Scabies
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Regular bleeding at intervals of more than 35 days
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

31. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Giardia
S. aureus- beta hemolytic streptococcus
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Scleroderma/polymyositis with secondary gastroesophageal reflux

32. How to NSAIDs contribute to gastritis and ulcer formation?
100mg; means patient can be trace protein positive and not be detected
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
HPV
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.

33. What does treatment for migrans include?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Polymenorrhea
Warts
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 for Acute bronchitis
Less than 3 stools per week
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Medication or chemical esophagitis
ACEi

35. Who should have Xray testing for shoulder pain?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Coag disorders
Rotator Cuff tendonitis

36. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Lightheadedness - dizziness - syncope
Cholelithiasis
Presence of proteinuria on at least two separate ocassion
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

37. 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
Rotator Cuff problem
E. Coli O157:H7
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
True

38. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
DM - HTN - DVT - seizures - depression - or anxiety
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
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.

39. Constipation: What are indications for lab testing?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
ACEi - ARBS - thiazide diuretics
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

40. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
100mg; means patient can be trace protein positive and not be detected
Lightheadedness - dizziness - syncope
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

41. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

42. What are the signs of cerebral hemorrhage?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Dehydration - anemia - cardiac causes
Acute headache - ataxia - profuse nausea - and vomiting
Irregular bleeding between cycles

43. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
E. Coli O157:H7
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Adhesive capsulitis (frozen shoulder): most common in middle age women
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

44. When does troponin rise following myocardial injury or infarction?
Kids: Rotavirus Adults: Norwalk Virus
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
When the patient has symptoms in association with exercise or who describe chest pain or pressure

45. Clinical Manifestations of HTN
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
EGD

46. What is the role of LH in the menstrual cycle
With a KOH wet mount preparation
LH surge triggers ovulation
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Temporal arteritis-biopsy of the temporal artery

47. Isolated - extra pounding beats
RBC casts and old to moderate HTN
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
PVC or Premature atrial contraction (PAC)
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

48. What are the primary glomerular diseases?
Impetigo
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
MSK - pulmonary - GI - or psychological
Subarachnoid hemorrhage

49. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Paroxysmal atrial fibrillation or supraventricular tachycardia
CT
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
Viral infection of the semicircular apparatus

50. Describe the presentation tracheobronchitis
Supraspinatus and bicipital tendons
S. Aureus
Upper sternal area burning pain - associated with a productive cough
Pancreatitis