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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. Four muscles of rotator cuff
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Subarachnoid hemorrhage
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Squamocolumnar junction=most common site of cervical cancer

2. 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
Hypertension - CAD - valvular heart disease
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.
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Varicella virus

3. 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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Other brainstem or cranial nerve findings
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
True

4. patients with herpes zoster may experience what symptom before the rash appear?
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Pain
LH surge triggers ovulation
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

5. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
Associated with hypotension
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Chest pain during pneumonia or PE

6. Pain in shoulder when throwing - swimming - or serving a tennis ball
35 (exception for postmenopausal women who have recently been started on HRT)
Rotator cuff tendonitis
Supraspinatus and bicipital tendons
Viral gastroenteritis

7. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
ACEi
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

8. Difference between Pneumonia and Bronchitis
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
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Presence of proteinuria on at least two separate ocassion
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

9. 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
A 24hr urine protein collection and urine creatinine clearance determination
RBC casts and old to moderate HTN
Molluscum contagiosum- pox virus
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

10. What is an acoustic neuroma?
Pleurisy
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
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

11. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
E. Coli O157:H7
ACEi - ARBS - thiazide diuretics
Anticoag with warfarin to prevent thromboembolism
Medication or chemical esophagitis

12. Describe the history and PE of patient presenting with common cold
Chest pain during pneumonia or PE
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
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
Rotator cuff tendonitis

13. When should a patient get a stress test?
MSK - pulmonary - GI - or psychological
Chest pain during pneumonia or PE
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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

14. Why don't ACEi work well for the elderly and African Americans when treating HTN?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Infectious esophagitis
These patients are associated with low renin states=less likely to respond to medication
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.

15. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
GERD
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Hgb - Electrolytes - and TSH
Wolff-Parkinson-White syndrome

16. Uterine bleeding between regular cycles
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Intermenstrual bleeding
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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

17. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Paroxysmal atrial fibrillation or supraventricular tachycardia
PVC or Premature atrial contraction (PAC)

18. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Anticoag with warfarin to prevent thromboembolism
Possibility of Ischemic colitis

19. What medications can cause heart palpitations?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Varicella virus
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
Viral gastroenteritis

20. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Slow progression of cervical cancer changes -Availability of effective early treatment
Repeat Pap after infection treated

21. Discomfort with abducting the arm past 90 degress
Anticoag with warfarin to prevent thromboembolism
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Rotator Cuff tendonitis
LH surge triggers ovulation

22. Describe the presentation of myocardial pain?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Non-cardiac causes of palpitations

23. Vaccines that should be updated before planned pregnancy
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
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.

24. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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.
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

25. What is the peripheral caUse of vertigo?
With a KOH wet mount preparation
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
Excessive bleeding in amount - duration - or both at irregular intervals

26. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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
Coronary artery disease/ angina
Cholelithiasis

27. What are the two common clinical presentations of acute diarrhea?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Loop diuretics (Check serum K+ levels before drug admin)
Generalized Anxiety disorder and panic disorder
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

28. Pneumonia tx: suitable for healthy adults older than 60
Other brainstem or cranial nerve findings
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Non-cardiac causes of palpitations
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

29. What is the difference between a Holter monitor or an event monitor?
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.
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

30. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
EGD
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.
DM - HTN - DVT - seizures - depression - or anxiety
24 hour halter

31. Name the skin lesion: pustule in association with a hair follice
True
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.
Folliculitis
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

32. 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
MSK - pulmonary - GI - or psychological
Warts
Scabies
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

33. What are the signs of acute sinusitis?
Presence of proteinuria on at least two separate ocassion
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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Fever with frontal or maxillary tenderness

34. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Menorrhagia
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
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

35. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Staphylococcal scalded skin syndrome
ACEi - ARBS - thiazide diuretics
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
Increase; 200 g/day

36. What is a markers of CNS vertigo?
Chest pain during pneumonia or PE
Other brainstem or cranial nerve findings
Pancreatitis
Lightheadedness - dizziness - syncope

37. MI - pericardial tamponade - PE - GI bleed - are...
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Associated with hypotension
ACEi - ARBS - thiazide diuretics
Regular bleeding at intervals of more than 35 days

38. When does troponin rise following myocardial injury or infarction?
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Varicella virus
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

39. 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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Analgesic headache
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

40. What HPV serotypes are most commonly associated with cervical cancer?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Serotypes 16 - 18 - 31 -52 -58
ACEi - ARBS - thiazide diuretics
DM - HTN - DVT - seizures - depression - or anxiety

41. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

42. Pneumonia tx: suitable for healthy adults less than 60
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Non-cardiac causes of palpitations
PE - MI - aortic dissection - pneumothorax
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

43. Name the diagnosis of heartburn: regurgitation - dysphagia
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
PE - MI - aortic dissection - pneumothorax
Supraspinatus and bicipital tendons
GERD

44. Diarrhea from custard filled pastries
Repeat Pap after infection treated
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
S. Aureus
When the patient has symptoms in association with exercise or who describe chest pain or pressure

45. What is considered normal blood loss during a menstrual cycle?
Hypertension - CAD - valvular heart disease
Irregular bleeding between cycles
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
Less than 80 ml of blood

46. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
With a KOH wet mount preparation
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

47. How can GERD (or esophageal motility disorders) lead to chest pain?
Slow progression of cervical cancer changes -Availability of effective early treatment
Medication or chemical esophagitis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

48. PE for a patient getting an abnormal vaginal bleeding work up
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
100mg; means patient can be trace protein positive and not be detected
PE - MI - aortic dissection - pneumothorax

49. 1+ protein level on urine dipstick usually represents how much protein in the urine?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Impetigo
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

50. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Kids: Rotavirus Adults: Norwalk Virus
EGD
Pleurisy
Nonulcer dyspepsia