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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. 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
Rotator Cuff problem
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Varicella virus
Other brainstem or cranial nerve findings

2. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Furucnle
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Serotypes 16 - 18 - 31 -52 -58

3. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
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
Temporal arteritis-biopsy of the temporal artery
DM - HTN - DVT - seizures - depression - or anxiety
Wolff-Parkinson-White syndrome

4. Define the patient population typically affected by orthostatic or postural proteinuria
HIV and syphilis
Supraspinatus and bicipital tendons
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return

5. What are the two common clinical presentations of acute diarrhea?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

6. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
Intermenstrual bleeding
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Pts with palpitations and dizziness - near syncope - or syncope

7. History for Sinusitis

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8. What are the most common viral causes of diarrhea in kids and adults?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Kids: Rotavirus Adults: Norwalk Virus

9. Cycle length variabilty is primarily due to what?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Variability in the time for follicle development during the proliferative phase
S. aureus- beta hemolytic streptococcus
Loop diuretics (Check serum K+ levels before drug admin)

10. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
HPV testing -Pos=colposcopy -Neg=repeat pap smear

11. Describe the history and PE of patient presenting with common cold
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

12. What is a markers of CNS vertigo?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Less than 80 ml of blood
Other brainstem or cranial nerve findings
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

13. 1+ protein level on urine dipstick usually represents how much protein in the urine?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Impetigo
Echocardiogram
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

14. How does systolic vs. diastolic heart failure present on the echocardiogram?
Cervical radiculopathy
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
Nonulcer dyspepsia
True

15. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Rotator Cuff tendonitis
Generalized Anxiety disorder and panic disorder
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Paroxysmal atrial fibrillation or supraventricular tachycardia

16. Name 4 factors that predispose an individual to develop pneumonia.
Furucnle
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

17. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Hypertension - CAD - valvular heart disease
Bence-Jones
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

18. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Rotator Cuff tendonitis
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Intermenstrual bleeding

19. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Upper sternal area burning pain - associated with a productive cough
Giardia
Albumin; low molecular weight proteins
Bulk forming: Psyllium - Methycellulose - Polycarbophil

20. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
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 (exception for postmenopausal women who have recently been started on HRT)
Varicella virus
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

21. What is benign transient proteinuria?
Common problem that resolves spontaneously and is most often seen in children and young adults
Coronary artery disease/ angina
Pain
Generalized Anxiety disorder and panic disorder

22. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
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
Chest pain during pneumonia or PE
BB or CCB - catheter ablation of identified bypass tract
S. aureus- beta hemolytic streptococcus

23. What are the signs of cerebral hemorrhage?
BB or CCB - catheter ablation of identified bypass tract
Furucnle
Acute headache - ataxia - profuse nausea - and vomiting
These patients are associated with low renin states=less likely to respond to medication

24. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Staphylococcal scalded skin syndrome
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
CT
E. Coli O157:H7

25. Chronic pain and shoulder stiffness with limited motion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
High blood pressure - focal neurologic defecit - or papilledema
PVC or Premature atrial contraction (PAC)

26. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Wolff-Parkinson-White syndrome
Temporal arteritis-biopsy of the temporal artery
Viral infection of the semicircular apparatus
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

27. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Staphylococcal scalded skin syndrome
Folliculitis
Hgb - Electrolytes - and TSH
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

28. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
GERD
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Adhesive capsulitis (frozen shoulder): most common in middle age women
ACEi - ARBS - thiazide diuretics

29. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Other brainstem or cranial nerve findings

30. What are the features of glomerular nephritis
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
RBC casts and old to moderate HTN
Furucnle
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

31. What are signs of pulmonary congestion?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Irregular bleeding between cycles
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

32. What does orthostatic positional changes that bring on dizziness suggest?
Dehydration - anemia - cardiac causes
HPV
True
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

33. What is an acoustic neuroma?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Adhesive capsulitis (frozen shoulder): most common in middle age women
Cervical radiculopathy
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

34. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Hypertension - CAD - valvular heart disease
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

35. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
A 24hr urine protein collection and urine creatinine clearance determination
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

36. Mainstay treatment for soft tissue inflammation (Shoulder)
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Presence of proteinuria on at least two separate ocassion

37. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
Common problem that resolves spontaneously and is most often seen in children and young adults
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
CBC

38. What is the role of FSH in one's menstrual cycle
Coronary artery disease/ angina
Influenza - Rhinovirus - Adenovirus - Parainfluenza
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

39. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
Lightheadedness - dizziness - syncope
Medication or chemical esophagitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

40. What is considered normal blood loss during a menstrual cycle?
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
Squamocolumnar junction=most common site of cervical cancer
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.
Less than 80 ml of blood

41. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
Pts with palpitations and dizziness - near syncope - or syncope
Less than 3 stools per week
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

42. Oligomenorrhea
Bence-Jones
Regular bleeding at intervals of more than 35 days
HPV
Presence of proteinuria on at least two separate ocassion

43. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

44. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Non-cardiac causes of palpitations
Hgb - Electrolytes - and TSH
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Increase; 200 g/day

45. Name the diagnosis of heartburn: severe constant mid abdominal pain
Giardia
Pancreatitis
Other brainstem or cranial nerve findings
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

46. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
EGD
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

47. What are the 2 psych disorders most commonly associated with palpitations?
S. aureus- beta hemolytic streptococcus
Generalized Anxiety disorder and panic disorder
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.
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

48. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
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
Less abrupt onset and cessation of palpitations
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Coronary artery disease/ angina

49. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Pts with palpitations and dizziness - near syncope - or syncope
PE - MI - aortic dissection - pneumothorax

50. What is the next best step if a patient has two or more positive dipstick tests?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
MSK - pulmonary - GI - or psychological
A 24hr urine protein collection and urine creatinine clearance determination
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed