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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
Albumin; low molecular weight proteins
BB or CCB - catheter ablation of identified bypass tract
Paroxysmal atrial fibrillation or supraventricular tachycardia
Anticoag with warfarin to prevent thromboembolism

2. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
E. Coli O157:H7
Non-cardiac causes of palpitations
Albumin; low molecular weight proteins
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

3. What are the three types of lice?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
RBC casts and old to moderate HTN
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Fever with frontal or maxillary tenderness

4. Clinical Manifestations of HTN
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
Repeat Pap after infection treated
Chest pain during pneumonia or PE
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

5. When should a patient get a stress test?
Subarachnoid hemorrhage
Echocardiogram
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

6. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Candida albicans
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

7. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Possibility of Ischemic colitis
24 hour halter
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

8. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Possibility of Ischemic colitis
ACEi - ARBS - thiazide diuretics
Regular bleeding at intervals of more than 35 days

9. Mainstay treatment for soft tissue inflammation (Shoulder)
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Loop diuretics (Check serum K+ levels before drug admin)
Staphylococcal scalded skin syndrome

10. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
Adhesive capsulitis (frozen shoulder): most common in middle age women
35 (exception for postmenopausal women who have recently been started on HRT)
100mg; means patient can be trace protein positive and not be detected
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

11. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Echocardiogram
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

12. 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
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
Molluscum contagiosum- pox virus
CT
Paroxysmal atrial fibrillation or supraventricular tachycardia

13. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Peptic ulcer disease or gastritis
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Chest pain during pneumonia or PE
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

14. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Loop diuretics (Check serum K+ levels before drug admin)
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Wolff-Parkinson-White syndrome
When the patient has symptoms in association with exercise or who describe chest pain or pressure

15. Describe the presentation of angina?
Medication or chemical esophagitis
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
ACEi - ARBS - thiazide diuretics
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

16. Regular bleeding at intervals of less than 21 days
E. Coli O157:H7
Polymenorrhea
Viral gastroenteritis
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

17. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
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
Temporal arteritis-biopsy of the temporal artery
Viral infection of the semicircular apparatus
Increasing fluid (8 - 8oz glasses of water/day) -fiber

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

19. Difference between Pneumonia and Bronchitis
Irregular bleeding between cycles
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
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

20. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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

21. What does orthostatic positional changes that bring on dizziness suggest?
Acute headache - ataxia - profuse nausea - and vomiting
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Scleroderma/polymyositis with secondary gastroesophageal reflux
Dehydration - anemia - cardiac causes

22. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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

23. History for Sinusitis

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24. 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
Fever with frontal or maxillary tenderness
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Cluster headache
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.

25. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
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
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.

26. History for Acute bronchitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
HIV and syphilis
Supraspinatus and bicipital tendons
Repeat Pap after infection treated

27. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Temporal arteritis-biopsy of the temporal artery
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Impetigo
Rotator cuff tendonitis

28. Menometrorrhagia
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
Excessive bleeding in amount - duration - or both at irregular intervals
Temporal arteritis-biopsy of the temporal artery
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

29. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Analgesic headache
Pleurisy
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

30. 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
Varicella virus
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Upper sternal area burning pain - associated with a productive cough
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

31. MI - pericardial tamponade - PE - GI bleed - are...
Associated with hypotension
High blood pressure - focal neurologic defecit - or papilledema
S. Aureus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

32. What are the signs of cerebral hemorrhage?
Fever with frontal or maxillary tenderness
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
E. Coli O157:H7
Acute headache - ataxia - profuse nausea - and vomiting

33. Name the diagnosis of heartburn: severe constant mid abdominal pain
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Pancreatitis
Influenza - Rhinovirus - Adenovirus - Parainfluenza

34. Describe the presentation of myocardial pain?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Scabies
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

35. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Impetigo
Varicella virus
Cholelithiasis

36. What are the indiciations for neuroimaging?
Non-cardiac causes of palpitations
Temporal arteritis-biopsy of the temporal artery
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
Regular bleeding at intervals of more than 35 days

37. What drugs do you use to treat H.pylori + PUD?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

38. Diagnosis of HTN
Nonulcer dyspepsia
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Adhesive capsulitis (frozen shoulder): most common in middle age women
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

39. What is a markers of CNS vertigo?
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
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
Other brainstem or cranial nerve findings
Temporal arteritis-biopsy of the temporal artery

40. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
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.
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
Bence-Jones
Furucnle

41. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Nonulcer dyspepsia
Scabies
Hgb - Electrolytes - and TSH

42. 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
Hgb - Electrolytes - and TSH
Loop diuretics (Check serum K+ levels before drug admin)
Slow progression of cervical cancer changes -Availability of effective early treatment

43. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
HIV and syphilis
Rotator Cuff problem
Acute headache - ataxia - profuse nausea - and vomiting
Streptococci

44. Prenatal visit schedule for low-risk pregnancies
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Associated with hypotension
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
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

45. What are the signs of malignant hypertension?
Analgesic headache
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
Non-cardiac causes of palpitations
High blood pressure - focal neurologic defecit - or papilledema

46. 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
Pts with palpitations and dizziness - near syncope - or syncope
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
Generalized Anxiety disorder and panic disorder

47. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Less than 80 ml of blood
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

48. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
PE - MI - aortic dissection - pneumothorax
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Streptococci

49. HIgh risk pregnant patients should be evaluated for ____ and ____
ACEi - ARBS - thiazide diuretics
Pts with palpitations and dizziness - near syncope - or syncope
HIV and syphilis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

50. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Subarachnoid hemorrhage
LH surge triggers ovulation
Wolff-Parkinson-White syndrome
Infectious esophagitis