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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
PVC or Premature atrial contraction (PAC)
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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

2. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Streptococci
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
Peptic ulcer disease or gastritis

3. What type of imaging is need for chronic sinusitis?
With a KOH wet mount preparation
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
CT
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

4. What diagnosis does the 'worse headache of my life' suggest?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
PVC or Premature atrial contraction (PAC)
Subarachnoid hemorrhage
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

5. Shoulder pain with pain radiating to elbow
Paroxysmal atrial fibrillation or supraventricular tachycardia
Cervical radiculopathy
Common problem that resolves spontaneously and is most often seen in children and young adults
Less than 3 stools per week

6. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Less abrupt onset and cessation of palpitations
Pts with palpitations and dizziness - near syncope - or syncope
S. Aureus
Less than 3 stools per week

7. 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
Rotator Cuff tendonitis
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Scabies
Regular bleeding at intervals of more than 35 days

8. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
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
Pts with palpitations and dizziness - near syncope - or syncope
PVC or Premature atrial contraction (PAC)
Viral infection of the semicircular apparatus

9. What is considered normal blood loss during a menstrual cycle?
Slow progression of cervical cancer changes -Availability of effective early treatment
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Scabies
Less than 80 ml of blood

10. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
DM - HTN - DVT - seizures - depression - or anxiety
Presence of proteinuria on at least two separate ocassion
High blood pressure - focal neurologic defecit - or papilledema
Cluster headache

11. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Temporal arteritis-biopsy of the temporal artery
35 (exception for postmenopausal women who have recently been started on HRT)

12. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Diuretics -BB -CCB -ACEi
When the patient has symptoms in association with exercise or who describe chest pain or pressure

13. 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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Pleurisy
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
Varicella virus

14. Lab testing for heart palpitation
Slow progression of cervical cancer changes -Availability of effective early treatment
Hgb - Electrolytes - and TSH
Subarachnoid hemorrhage
Scabies

15. What are the secondly causes of glomerular disease?
Associated with hypotension
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
PE - MI - aortic dissection - pneumothorax

16. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
S. aureus- beta hemolytic streptococcus
Variability in the time for follicle development during the proliferative phase

17. What lab tests are recommended for newly diagnosed hypertensive patients?
CT
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Echocardiogram
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

18. Constipation: What are indications for lab testing?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Less than 3 stools per week
Paroxysmal atrial fibrillation or supraventricular tachycardia
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

19. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
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
Giardia
Excessive bleeding in amount - duration - or both at irregular intervals
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

20. What should be considered in younger patients with menorrhagia
Coag disorders
Infectious esophagitis
Less abrupt onset and cessation of palpitations
Tension headache

21. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Candida albicans
Serotypes 16 - 18 - 31 -52 -58
Bulk forming: Psyllium - Methycellulose - Polycarbophil
S. aureus- beta hemolytic streptococcus

22. Name some medications that can cause proteinuria
Regular bleeding at intervals of more than 35 days
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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.

23. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
With a KOH wet mount preparation
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

24. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Hgb - Electrolytes - and TSH
Scleroderma/polymyositis with secondary gastroesophageal reflux

25. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Increase; 200 g/day
Supraspinatus and bicipital tendons
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Pleurisy

26. How is constipation clinically defined?
GERD
Viral infection of the semicircular apparatus
Less than 3 stools per week
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

27. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Menorrhagia
HPV
Lightheadedness - dizziness - syncope
Peptic ulcer disease or gastritis

28. Diagnosis of HTN
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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.
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
>150mg per 24hrs

29. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Pain
Furucnle
CBC

30. What occurs after ovulation
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
Repeat Pap after infection treated
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

31. What is a markers of CNS vertigo?
RBC casts and old to moderate HTN
S. aureus- beta hemolytic streptococcus
Other brainstem or cranial nerve findings
24 hour halter

32. What is the caUse of benign positional vertigo?
Impetigo
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
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.
CT

33. Describe the presentation tracheobronchitis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
>3.5g of protein per 24hrs
Upper sternal area burning pain - associated with a productive cough
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

34. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
Dehydration - anemia - cardiac causes
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
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

35. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Scabies
Nonulcer dyspepsia
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

36. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Wolff-Parkinson-White syndrome
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. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Pain
Coag disorders
DM - HTN - DVT - seizures - depression - or anxiety

38. Diarrhea from custard filled pastries
S. Aureus
Coag disorders
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Presence of proteinuria on at least two separate ocassion

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.
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Repeat Pap after infection treated
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.
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

40. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Possibility of Ischemic colitis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

41. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
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
S. Aureus

42. What medications can cause heart palpitations?
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Menorrhagia

43. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
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
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
Diuretics -BB -CCB -ACEi
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

44. Pneumonia tx: suitable for healthy adults less than 60
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Albumin; low molecular weight proteins

45. Name the diagnosis of heartburn: regurgitation - dysphagia
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Loop diuretics (Check serum K+ levels before drug admin)
A central clear area
GERD

46. Four muscles of rotator cuff
Albumin; low molecular weight proteins
Higher filling presure - pulmonary congestion - and decreasd cardiac return
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

47. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
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.
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Other brainstem or cranial nerve findings

48. Isolated - extra pounding beats
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
MSK - pulmonary - GI - or psychological
PVC or Premature atrial contraction (PAC)
Varicella virus

49. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Paroxysmal atrial fibrillation or supraventricular tachycardia

50. Menometrorrhagia
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Cluster headache
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Excessive bleeding in amount - duration - or both at irregular intervals