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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. Treatment for supraventricular tachycardias
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
BB or CCB - catheter ablation of identified bypass tract
Analgesic headache
Associated with hypotension

2. Describes what occurs during squamous metaplasia of the cervix.
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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

3. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Polymenorrhea
100mg; means patient can be trace protein positive and not be detected
Fever with frontal or maxillary tenderness

4. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
Slow progression of cervical cancer changes -Availability of effective early treatment
Pain
Squamocolumnar junction=most common site of cervical cancer

5. What is the standard tool used for diagnosis of GERD?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
EGD
CT

6. Name 4 factors that predispose an individual to develop pneumonia.
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Subarachnoid hemorrhage

7. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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
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
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
Lightheadedness - dizziness - syncope

8. What is the role of LH in the menstrual cycle
Warts
Squamocolumnar junction=most common site of cervical cancer
Polymenorrhea
LH surge triggers ovulation

9. What is a markers of CNS vertigo?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Other brainstem or cranial nerve findings
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

10. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
Pain

11. 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.
Cervical radiculopathy
Repeat Pap after infection treated
Rotator cuff tendonitis
DM - HTN - DVT - seizures - depression - or anxiety

12. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
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
Peptic ulcer disease or gastritis
These patients are associated with low renin states=less likely to respond to medication

13. Name the diagnosis of heartburn: severe constant mid abdominal pain
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Pancreatitis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
HPV

14. What is afterload?
Cervical radiculopathy
Candida albicans
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Nonulcer dyspepsia

15. What are signs of pulmonary congestion?
Impetigo
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
>150mg per 24hrs
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

16. 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
True
E. Coli O157:H7
With a KOH wet mount preparation
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

17. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
>150mg per 24hrs
Less than 3 stools per week
Pancreatitis

18. When does troponin rise following myocardial injury or infarction?
Serotypes 16 - 18 - 31 -52 -58
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

19. How are fungal infections diagnosed?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
With a KOH wet mount preparation
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
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

20. Name the diagnosis of heartburn: regurgitation - dysphagia
Cluster headache
Viral gastroenteritis
GERD
Infectious esophagitis

21. What drugs do you use to treat H.pylori + PUD?
HPV
Non-cardiac causes of palpitations
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Possibility of Ischemic colitis

22. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
CT
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Rotator Cuff problem
Loop diuretics (Check serum K+ levels before drug admin)

23. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Diuretics -BB -CCB -ACEi
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

24. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
Polymenorrhea
Hgb - Electrolytes - and TSH
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

25. 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
CT
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Cluster headache
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

26. How is constipation clinically defined?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
RBC casts and old to moderate HTN
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Less than 3 stools per week

27. What the consequences of decreased cardiac output?
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
Increasing fluid (8 - 8oz glasses of water/day) -fiber
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Lightheadedness - dizziness - syncope

28. Why is the pap smear one of the most effective cancer screening tools?
Warts
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

29. Describe the presentation of pericardial pain
Rotator cuff tendonitis
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Less than 3 stools per week

30. What is the goal of CHF treatment? What drugs should be used?
Adhesive capsulitis (frozen shoulder): most common in middle age women
Variability in the time for follicle development during the proliferative phase
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

31. What are the common causes for laryngitis?
Rotator Cuff tendonitis
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
A 24hr urine protein collection and urine creatinine clearance determination

32. What is benign transient proteinuria?
DM - HTN - DVT - seizures - depression - or anxiety
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Common problem that resolves spontaneously and is most often seen in children and young adults
Hgb - Electrolytes - and TSH

33. What is the caUse of Meniere disease? What are the cardinal symptoms?
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Folliculitis
Rotator cuff tendonitis

34. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
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
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
Anticoag with warfarin to prevent thromboembolism
Streptococci

35. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Paroxysmal atrial fibrillation or supraventricular tachycardia
Variability in the time for follicle development during the proliferative phase
Pleurisy

36. Regular bleeding at intervals of less than 21 days
Other brainstem or cranial nerve findings
Polymenorrhea
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Less than 3 stools per week

37. Discomfort with abducting the arm past 90 degress
Kids: Rotavirus Adults: Norwalk Virus
Less abrupt onset and cessation of palpitations
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Rotator Cuff tendonitis

38. What is the peripheral caUse of vertigo?
Supraspinatus and bicipital tendons
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

39. What does treatment for migrans include?
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
Cellulitis
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

40. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
PE - MI - aortic dissection - pneumothorax
HPV
>3.5g of protein per 24hrs

41. What are the features of glomerular nephritis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Coronary artery disease/ angina
RBC casts and old to moderate HTN

42. What is the difference between a Holter monitor or an event monitor?
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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

43. Pneumonia tx: suitable for healthy adults older than 60
Cervical radiculopathy
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

44. Diagnosis of HTN
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Other brainstem or cranial nerve findings
Cellulitis

45. Initial treatment for Rhinosinusitis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Rotator Cuff problem
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

46. What places women at higher risk of getting cervical cancer?
Dehydration - anemia - cardiac causes
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
LH surge triggers ovulation
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

47. Carcinoma in situ is generally referred to a gynecologist and requires ______
24 hour halter
Pancreatitis
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
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

48. Shoulder pain with pain radiating to elbow
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Cervical radiculopathy
Furucnle
S. aureus- beta hemolytic streptococcus

49. What are the symptoms of palpitations?
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
Lightheadedness - dizziness - syncope
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
With a KOH wet mount preparation

50. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Staphylococcal scalded skin syndrome
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin