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Family Medicine Shelf
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Subjects
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health-sciences
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family-medicine
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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. History for Acute bronchitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Candida albicans
LH surge triggers ovulation
Common problem that resolves spontaneously and is most often seen in children and young adults
2. 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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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
Excessive bleeding in amount - duration - or both at irregular intervals
Scabies
3. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Infectious esophagitis
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Coronary artery disease/ angina
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
4. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
5. At was quantity does urine dipstick test detect elevated protein?
Viral gastroenteritis
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
100mg; means patient can be trace protein positive and not be detected
Menorrhagia
6. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
>3.5g of protein per 24hrs
Excessive bleeding in amount - duration - or both at irregular intervals
Loop diuretics (Check serum K+ levels before drug admin)
7. Name the skin lesion: pustule in association with a hair follice
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Echocardiogram
Folliculitis
8. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Albumin; low molecular weight proteins
Viral gastroenteritis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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
9. What are the indiciations for neuroimaging?
Giardia
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Intermenstrual bleeding
10. What diagnosis does the 'worse headache of my life' suggest?
Increase; 200 g/day
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Subarachnoid hemorrhage
Repeat Pap after infection treated
11. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Temporal arteritis-biopsy of the temporal artery
Giardia
CBC
Pain
12. How do you know if heart palpitations are due to stimulant or medication use?
Subarachnoid hemorrhage
Less abrupt onset and cessation of palpitations
Increasing fluid (8 - 8oz glasses of water/day) -fiber
ACEi - ARBS - thiazide diuretics
13. What are the features of glomerular nephritis
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Repeat Pap after infection treated
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
RBC casts and old to moderate HTN
14. 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
Less than 3 stools per week
Varicella virus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
15. Define proteinuria
Cervical radiculopathy
>150mg per 24hrs
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
16. Shoulder pain with pain radiating to elbow
A central clear area
Presence of proteinuria on at least two separate ocassion
Cervical radiculopathy
Infectious esophagitis
17. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Cholelithiasis
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.
ACEi - ARBS - thiazide diuretics
18. Irregular cycles with excessive flow - duration - or both
Menorrhagia
24 hour halter
Infectious esophagitis
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
19. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
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
Coag disorders
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
20. How can GERD (or esophageal motility disorders) lead to chest pain?
HIV and syphilis
Colposcopy - Endocervical curettage - and directed cervical biopsy
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
21. Name the skin lesion: erythema - warmth - edema - pain - fever
Infectious esophagitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Cellulitis
22. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Scleroderma/polymyositis with secondary gastroesophageal reflux
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
DM - HTN - DVT - seizures - depression - or anxiety
23. 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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Scleroderma/polymyositis with secondary gastroesophageal reflux
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
True
24. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Presence of proteinuria on at least two separate ocassion
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
25. Describe the presentation of pericardial pain
Streptococci
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
26. Lab testing for heart palpitation
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Hgb - Electrolytes - and TSH
Scabies
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
27. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
HIV and syphilis
A central clear area
Warts
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
28. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
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
Menorrhagia
HIV and syphilis
Staphylococcal scalded skin syndrome
29. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
ACEi
Variability in the time for follicle development during the proliferative phase
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
30. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Paroxysmal atrial fibrillation or supraventricular tachycardia
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Tension headache
31. When is a lumbar puncture contraindicated?
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.
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Cellulitis
32. MI - pericardial tamponade - PE - GI bleed - are...
Wolff-Parkinson-White syndrome
Serotypes 16 - 18 - 31 -52 -58
Menorrhagia
Associated with hypotension
33. What should be considered in younger patients with menorrhagia
HPV
Rotator Cuff tendonitis
Coag disorders
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
34. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Adhesive capsulitis (frozen shoulder): most common in middle age women
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Intermenstrual bleeding
MSK - pulmonary - GI - or psychological
35. What are the primary glomerular diseases?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
RBC casts and old to moderate HTN
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
36. When should invasive eletrophysiologic study should be considered?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
LH surge triggers ovulation
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
37. What are the signs of cerebral hemorrhage?
Acute headache - ataxia - profuse nausea - and vomiting
Varicella virus
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
Generalized Anxiety disorder and panic disorder
38. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Infectious esophagitis
Less than 3 stools per week
39. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
These patients are associated with low renin states=less likely to respond to medication
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
40. Why is the pap smear one of the most effective cancer screening tools?
Slow progression of cervical cancer changes -Availability of effective early treatment
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
Subarachnoid hemorrhage
41. Oligomenorrhea
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Regular bleeding at intervals of more than 35 days
These patients are associated with low renin states=less likely to respond to medication
Wolff-Parkinson-White syndrome
42. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Varicella virus
Infectious esophagitis
HPV
43. What is the standard tool used for diagnosis of GERD?
EGD
Scabies
Coag disorders
>150mg per 24hrs
44. Mainstay treatment for soft tissue inflammation (Shoulder)
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
DM - HTN - DVT - seizures - depression - or anxiety
45. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Chest pain during pneumonia or PE
Scabies
BB or CCB - catheter ablation of identified bypass tract
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
46. When should a patient get a stress test?
Regular bleeding at intervals of more than 35 days
Anticoag with warfarin to prevent thromboembolism
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
47. Four muscles of rotator cuff
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
Less than 80 ml of blood
Candida albicans
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
48. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
Nonulcer dyspepsia
Excessive bleeding in amount - duration - or both at irregular intervals
Cervical radiculopathy
Supraspinatus and bicipital tendons
49. Clinical Manifestations of HTN
Folliculitis
Peptic ulcer disease or gastritis
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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.
50. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Less than 80 ml of blood
HPV
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