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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. Clinical Manifestations of HTN
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
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
Cervical radiculopathy
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

2. 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 tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
These patients are associated with low renin states=less likely to respond to medication
Molluscum contagiosum- pox virus
Wolff-Parkinson-White syndrome

3. What are the symptoms of palpitations?
Lightheadedness - dizziness - syncope
Folliculitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

4. Pain in shoulder when throwing - swimming - or serving a tennis ball
CBC
S. aureus- beta hemolytic streptococcus
Rotator cuff tendonitis
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

5. 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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

6. Diarrhea from custard filled pastries
S. Aureus
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Diuretics -BB -CCB -ACEi

7. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Kids: Rotavirus Adults: Norwalk Virus
Albumin; low molecular weight proteins
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Polymenorrhea

8. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Possibility of Ischemic colitis
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
Medication or chemical esophagitis

9. Why don't ACEi work well for the elderly and African Americans when treating HTN?
35 (exception for postmenopausal women who have recently been started on HRT)
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
These patients are associated with low renin states=less likely to respond to medication
MSK - pulmonary - GI - or psychological

10. When is a lumbar puncture contraindicated?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Supraspinatus and bicipital tendons
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

11. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Paroxysmal atrial fibrillation or supraventricular tachycardia
Coronary artery disease/ angina
Staphylococcal scalded skin syndrome
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

12. 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
Wolff-Parkinson-White syndrome
Cluster headache
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

13. Treatment for supraventricular tachycardias
EGD
Serotypes 16 - 18 - 31 -52 -58
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
BB or CCB - catheter ablation of identified bypass tract

14. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
ACEi - ARBS - thiazide diuretics
Staphylococcal scalded skin syndrome
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
ACEi

15. Diagnostic Evaluation of Abnoraml vaginal bleeding
Chest pain during pneumonia or PE
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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

16. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
24 hour halter
Loop diuretics (Check serum K+ levels before drug admin)
Supraspinatus and bicipital tendons

17. Name the skin lesion: honey colored crusts
Common problem that resolves spontaneously and is most often seen in children and young adults
Kids: Rotavirus Adults: Norwalk Virus
E. Coli O157:H7
Impetigo

18. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
HPV
ACEi
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

19. What the consequences of decreased cardiac output?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Giardia
Activation of the RAAS - increased levels of catecholamines - secretion of atrial natriuretic hormone -This leads to vasoconstriction - fluid retention - increased afterload - which further inhibits cardiac output -late changes are mycoardial and vas
High blood pressure - focal neurologic defecit - or papilledema

20. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Chest pain during pneumonia or PE
HPV
Non-cardiac causes of palpitations
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

21. What does the classic ring worm lesion have?
Kids: Rotavirus Adults: Norwalk Virus
A central clear area
Fever with frontal or maxillary tenderness
Associated with hypotension

22. What are the signs of cerebral hemorrhage?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Acute headache - ataxia - profuse nausea - and vomiting
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

23. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
When the patient has symptoms in association with exercise or who describe chest pain or pressure
RBC casts and old to moderate HTN

24. What is the caUse of Meniere disease? What are the cardinal symptoms?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Common problem that resolves spontaneously and is most often seen in children and young adults
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

25. How do you define persistent protein uria?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Presence of proteinuria on at least two separate ocassion
Infectious esophagitis
CBC

26. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Pain
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

27. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Hypertension - CAD - valvular heart disease
Rotator Cuff problem
Other brainstem or cranial nerve findings
Influenza - Rhinovirus - Adenovirus - Parainfluenza

28. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Medication or chemical esophagitis
Pain
Echocardiogram
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

29. Describe the presentation of pneumonia
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
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

30. Tx of chronic or intermittent afibs
Supraspinatus and bicipital tendons
Anticoag with warfarin to prevent thromboembolism
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.
Upper sternal area burning pain - associated with a productive cough

31. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Polymenorrhea
Chest pain during pneumonia or PE
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

32. SE Of Beta blockers?
A central clear area
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
Furucnle
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

33. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Candida albicans
DM - HTN - DVT - seizures - depression - or anxiety
Furucnle

34. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
Squamocolumnar junction=most common site of cervical cancer

35. Describe the presentation of angina?
Cluster headache
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
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
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

36. What is afterload?
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Infectious esophagitis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

37. What HPV serotypes are most commonly associated with cervical cancer?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
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
Serotypes 16 - 18 - 31 -52 -58

38. 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
Analgesic headache
Scabies
Viral infection of the semicircular apparatus
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

39. Chronic pain and shoulder stiffness with limited motion
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
Giardia
100mg; means patient can be trace protein positive and not be detected
Adhesive capsulitis (frozen shoulder): most common in middle age women

40. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
Lightheadedness - dizziness - syncope
Impetigo
Diuretics -BB -CCB -ACEi

41. 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
Warts
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Rotator Cuff tendonitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

42. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Serotypes 16 - 18 - 31 -52 -58
Staphylococcal scalded skin syndrome
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Loop diuretics (Check serum K+ levels before drug admin)

43. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Kids: Rotavirus Adults: Norwalk Virus
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
Pancreatitis

44. Cycle length variabilty is primarily due to what?
Variability in the time for follicle development during the proliferative phase
Less abrupt onset and cessation of palpitations
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
MSK - pulmonary - GI - or psychological

45. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Fever with frontal or maxillary tenderness
High blood pressure - focal neurologic defecit - or papilledema
Peptic ulcer disease or gastritis
Furucnle

46. 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
Impetigo
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
E. Coli O157:H7
Analgesic headache

47. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bence-Jones
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Colposcopy - Endocervical curettage - and directed cervical biopsy
Slow progression of cervical cancer changes -Availability of effective early treatment

48. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Wolff-Parkinson-White syndrome
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
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

49. Natural history of cervical cancer
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
A 24hr urine protein collection and urine creatinine clearance determination
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
Scleroderma/polymyositis with secondary gastroesophageal reflux

50. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Non-cardiac causes of palpitations
These patients are associated with low renin states=less likely to respond to medication