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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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
Temporal arteritis-biopsy of the temporal artery

2. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Colposcopy - Endocervical curettage - and directed cervical biopsy
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Folliculitis

3. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

4. What places women at higher risk of getting cervical cancer?
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: 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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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

5. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
True
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Echocardiogram

6. 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
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
Varicella virus
Chest pain during pneumonia or PE
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

7. What is the Barany maneuver?
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
Echocardiogram
Scabies
Excessive bleeding in amount - duration - or both at irregular intervals

8. History for Sinusitis

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9. What should preconception counseling include?
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
Temporal arteritis-biopsy of the temporal artery
Less than 3 stools per week
Pts with palpitations and dizziness - near syncope - or syncope

10. Treatment for supraventricular tachycardias
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
BB or CCB - catheter ablation of identified bypass tract
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
EGD

11. What are the two common clinical presentations of acute diarrhea?
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
CT
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

12. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Temporal arteritis-biopsy of the temporal artery
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.

13. Name the diagnosis of heartburn: regurgitation - dysphagia
Polymenorrhea
Furucnle
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
GERD

14. How can GERD (or esophageal motility disorders) lead to chest pain?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
CBC
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

15. 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.
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Less than 80 ml of blood
Repeat Pap after infection treated
Influenza - Rhinovirus - Adenovirus - Parainfluenza

16. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
RBC casts and old to moderate HTN
S. Aureus

17. What is a markers of CNS vertigo?
CT
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.
Other brainstem or cranial nerve findings
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

18. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
ACEi - ARBS - thiazide diuretics
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

19. What are the most common causes for the common cold?
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
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
A 24hr urine protein collection and urine creatinine clearance determination
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

20. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Slow progression of cervical cancer changes -Availability of effective early treatment
DM - HTN - DVT - seizures - depression - or anxiety
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
RBC casts and old to moderate HTN

21. Chronic pain and shoulder stiffness with limited motion
Less than 80 ml of blood
Adhesive capsulitis (frozen shoulder): most common in middle age women
Less than 3 stools per week
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

22. How does CHF present on X-ray?
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
Viral infection of the semicircular apparatus
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

23. Describe the presentation tracheobronchitis
ACEi - ARBS - thiazide diuretics
Upper sternal area burning pain - associated with a productive cough
Adhesive capsulitis (frozen shoulder): most common in middle age women
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

24. Regular bleeding at intervals of less than 21 days
Subarachnoid hemorrhage
Polymenorrhea
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
When the patient has symptoms in association with exercise or who describe chest pain or pressure

25. What type of imaging is need for chronic sinusitis?
CT
DM - HTN - DVT - seizures - depression - or anxiety
Analgesic headache
When the patient has symptoms in association with exercise or who describe chest pain or pressure

26. Name the skin lesion: pustule in association with a hair follice
Polymenorrhea
Presence of proteinuria on at least two separate ocassion
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Folliculitis

27. What are symptoms are CHF?
Less than 3 stools per week
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Wolff-Parkinson-White syndrome
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

28. What is the role of FSH in one's menstrual cycle
Less than 3 stools per week
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Dehydration - anemia - cardiac causes
CBC

29. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

30. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Cholelithiasis
Less abrupt onset and cessation of palpitations

31. 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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

32. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Chest pain during pneumonia or PE
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
PE - MI - aortic dissection - pneumothorax

33. What is considered normal blood loss during a menstrual cycle?
Impetigo
Less than 80 ml of blood
Streptococci
Pts with palpitations and dizziness - near syncope - or syncope

34. What is the next best step if a patient has two or more positive dipstick tests?
Possibility of Ischemic colitis
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
A 24hr urine protein collection and urine creatinine clearance determination

35. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Rotator Cuff problem
E. Coli O157:H7
HPV
>150mg per 24hrs

36. Metrorrhagia
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
Infectious esophagitis
Coronary artery disease/ angina
Irregular bleeding between cycles

37. What should blood work include for suspected heart failure?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Irregular bleeding between cycles
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

38. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Infectious esophagitis
Menorrhagia
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

39. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
35 (exception for postmenopausal women who have recently been started on HRT)

40. How are fungal infections diagnosed?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
With a KOH wet mount preparation
Polymenorrhea
>150mg per 24hrs

41. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

42. When does troponin rise following myocardial injury or infarction?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Coag disorders
These patients are associated with low renin states=less likely to respond to medication
When the patient has symptoms in association with exercise or who describe chest pain or pressure

43. What are the features of glomerular nephritis
High blood pressure - focal neurologic defecit - or papilledema
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
RBC casts and old to moderate HTN
Repeat Pap after infection treated

44. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Dehydration - anemia - cardiac causes
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
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

45. What are the primary glomerular diseases?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Increase; 200 g/day
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

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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Warts
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Acute headache - ataxia - profuse nausea - and vomiting

47. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Giardia
Squamocolumnar junction=most common site of cervical cancer
Cholelithiasis

48. MI - pericardial tamponade - PE - GI bleed - are...
Associated with hypotension
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.
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

49. When is a lumbar puncture contraindicated?
HPV
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Peptic ulcer disease or gastritis
These patients are associated with low renin states=less likely to respond to medication

50. What are the common causes for laryngitis?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Excessive bleeding in amount - duration - or both at irregular intervals
Coag disorders
Influenza - Rhinovirus - Adenovirus - Parainfluenza