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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. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Pleurisy
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

2. How does CHF present on X-ray?
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
24 hour halter
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
100mg; means patient can be trace protein positive and not be detected

3. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Diuretics -BB -CCB -ACEi
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. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
DM - HTN - DVT - seizures - depression - or anxiety
Diuretics -BB -CCB -ACEi

5. When should a patient get a stress test?
Supraspinatus and bicipital tendons
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
Impetigo
When the patient has symptoms in association with exercise or who describe chest pain or pressure

6. Pneumonia tx: suitable for healthy adults less than 60
Analgesic headache
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

7. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
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

8. What does orthostatic positional changes that bring on dizziness suggest?
Temporal arteritis-biopsy of the temporal artery
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
Dehydration - anemia - cardiac causes
Cervical radiculopathy

9. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Rotator cuff tendonitis
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

10. Cycle length variabilty is primarily due to what?
Infectious esophagitis
Variability in the time for follicle development during the proliferative phase
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Coronary artery disease/ angina

11. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Scabies
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

12. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
Nonulcer dyspepsia
A 24hr urine protein collection and urine creatinine clearance determination
DM - HTN - DVT - seizures - depression - or anxiety

13. Carcinoma in situ is generally referred to a gynecologist and requires ______
Increase; 200 g/day
Associated with hypotension
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
Folliculitis

14. 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
Molluscum contagiosum- pox virus
A central clear area
Other brainstem or cranial nerve findings
35 (exception for postmenopausal women who have recently been started on HRT)

15. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Cervical radiculopathy
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Candida albicans

16. History and PE for Pneumonia
Regular bleeding at intervals of more than 35 days
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
Pancreatitis
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

17. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Loop diuretics (Check serum K+ levels before drug admin)
S. Aureus
Pts with palpitations and dizziness - near syncope - or syncope

18. What is the goal of CHF treatment? What drugs should be used?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Hgb - Electrolytes - and TSH
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
Impetigo

19. What drugs do you use to treat H.pylori + PUD?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
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.

20. 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
Common problem that resolves spontaneously and is most often seen in children and young adults
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

21. What are the signs of malignant hypertension?
Molluscum contagiosum- pox virus
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
High blood pressure - focal neurologic defecit - or papilledema
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

22. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Slow progression of cervical cancer changes -Availability of effective early treatment
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.
Viral gastroenteritis

23. Pain in shoulder when throwing - swimming - or serving a tennis ball
Rotator Cuff problem
Rotator cuff tendonitis
Pts with palpitations and dizziness - near syncope - or syncope
DM - HTN - DVT - seizures - depression - or anxiety

24. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Less than 3 stools per week
100mg; means patient can be trace protein positive and not be detected

25. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
DM - HTN - DVT - seizures - depression - or anxiety
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

26. Menometrorrhagia
CBC
Excessive bleeding in amount - duration - or both at irregular intervals
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Folliculitis

27. Where does the development of abnormal cervical cells begin?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Cervical radiculopathy
Squamocolumnar junction=most common site of cervical cancer
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

28. 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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Scabies
Cluster headache
Wolff-Parkinson-White syndrome

29. Define the patient population typically affected by orthostatic or postural proteinuria
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Tension headache
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: 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

30. 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
Echocardiogram
Cluster headache
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Folliculitis

31. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Repeat Pap after infection treated
BB or CCB - catheter ablation of identified bypass tract
Scleroderma/polymyositis with secondary gastroesophageal reflux

32. Diagnostic Evaluation of Abnoraml vaginal bleeding
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Coronary artery disease/ angina
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
Possibility of Ischemic colitis

33. Lab testing for heart palpitation
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Other brainstem or cranial nerve findings
Hgb - Electrolytes - and TSH
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

34. Name 4 factors that predispose an individual to develop pneumonia.
Cervical radiculopathy
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

35. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Associated with hypotension
Influenza - Rhinovirus - Adenovirus - Parainfluenza
PE - MI - aortic dissection - pneumothorax
S. aureus- beta hemolytic streptococcus

36. What are the features of glomerular nephritis
GERD
RBC casts and old to moderate HTN
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
S. Aureus

37. What is the next best step if a patient has two or more positive dipstick tests?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Scleroderma/polymyositis with secondary gastroesophageal reflux
A 24hr urine protein collection and urine creatinine clearance determination
HPV testing -Pos=colposcopy -Neg=repeat pap smear

38. Regular bleeding at intervals of less than 21 days
GERD
Temporal arteritis-biopsy of the temporal artery
True
Polymenorrhea

39. What is the caUse of Meniere disease? What are the cardinal symptoms?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Viral infection of the semicircular apparatus
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Bence-Jones

40. What lab tests are recommended for newly diagnosed hypertensive patients?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Staphylococcal scalded skin syndrome
100mg; means patient can be trace protein positive and not be detected
Analgesic headache

41. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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

42. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Impetigo
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Generalized Anxiety disorder and panic disorder
ACEi

43. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
ACEi - ARBS - thiazide diuretics
Hgb - Electrolytes - and TSH
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

44. History for Acute bronchitis
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.
Higher filling presure - pulmonary congestion - and decreasd cardiac return
BB or CCB - catheter ablation of identified bypass tract
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

45. What test done in PE measures instability of shoulder?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

46. Constipation: What are indications for lab testing?
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

47. Name the skin lesion: pustule in association with a hair follice
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
>150mg per 24hrs
Folliculitis
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

48. Describe the presentation of angina?
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
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

49. What should be considered in younger patients with menorrhagia
Coag disorders
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
High blood pressure - focal neurologic defecit - or papilledema
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

50. What HPV serotypes are most commonly associated with cervical cancer?
Associated with hypotension
>150mg per 24hrs
Serotypes 16 - 18 - 31 -52 -58
Bulk forming: Psyllium - Methycellulose - Polycarbophil