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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. 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
Folliculitis
Fever with frontal or maxillary tenderness
GERD

2. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
With a KOH wet mount preparation
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Adhesive capsulitis (frozen shoulder): most common in middle age women
Infectious esophagitis

3. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Increase; 200 g/day

4. 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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
A 24hr urine protein collection and urine creatinine clearance determination

5. What is the standard tool used for diagnosis of GERD?
Pancreatitis
EGD
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Bence-Jones

6. What is a markers of CNS vertigo?
Rotator cuff tendonitis
Other brainstem or cranial nerve findings
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Cellulitis

7. What are the indiciations for neuroimaging?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
>3.5g of protein per 24hrs
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
Streptococci

8. What are the two common clinical presentations of acute diarrhea?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
CBC

9. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
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
Viral infection of the semicircular apparatus
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

10. Why is the pap smear one of the most effective cancer screening tools?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Slow progression of cervical cancer changes -Availability of effective early treatment
Folliculitis

11. What type of imaging is need for chronic sinusitis?
CT
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
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

12. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Slow progression of cervical cancer changes -Availability of effective early treatment
Peptic ulcer disease or gastritis

13. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
High blood pressure - focal neurologic defecit - or papilledema
HPV
RBC casts and old to moderate HTN
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

14. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

15. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
MSK - pulmonary - GI - or psychological
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Staphylococcal scalded skin syndrome
Rotator Cuff tendonitis

16. What is the mechanism of action for stimulant agents in treating constipation?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Loop diuretics (Check serum K+ levels before drug admin)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Temporal arteritis-biopsy of the temporal artery

17. Initial treatment for Rhinosinusitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Loop diuretics (Check serum K+ levels before drug admin)

18. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Candida albicans
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

19. Describes what occurs during squamous metaplasia of the cervix.
Cervical radiculopathy
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

20. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
HPV
GERD

21. How do you know if heart palpitations are due to stimulant or medication use?
Infectious esophagitis
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Less abrupt onset and cessation of palpitations

22. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
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
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

23. 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.
Viral infection of the semicircular apparatus
Repeat Pap after infection treated
Anticoag with warfarin to prevent thromboembolism
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

24. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
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
ACEi - ARBS - thiazide diuretics
A central clear area

25. Shoulder pain with pain radiating to elbow
Fever with frontal or maxillary tenderness
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Cervical radiculopathy

26. What are the secondly causes of glomerular disease?
Streptococci
Acute headache - ataxia - profuse nausea - and vomiting
Candida albicans
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

27. What is the role of FSH in one's menstrual cycle
Generalized Anxiety disorder and panic disorder
>150mg per 24hrs
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
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

28. What are the 2 psych disorders most commonly associated with palpitations?
Giardia
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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
Generalized Anxiety disorder and panic disorder

29. Pneumonia tx: suitable for healthy adults less than 60
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

30. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
PVC or Premature atrial contraction (PAC)
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

31. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
PVC or Premature atrial contraction (PAC)
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
Subarachnoid hemorrhage
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

32. MI - pericardial tamponade - PE - GI bleed - are...
ACEi
Common problem that resolves spontaneously and is most often seen in children and young adults
Nonulcer dyspepsia
Associated with hypotension

33. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Generalized Anxiety disorder and panic disorder
Cervical radiculopathy
Giardia
Folliculitis

34. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
Warts
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

35. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
ACEi
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
Intermenstrual bleeding

36. What should be considered in younger patients with menorrhagia
Cholelithiasis
Common problem that resolves spontaneously and is most often seen in children and young adults
Coag disorders
Temporal arteritis-biopsy of the temporal artery

37. Pneumothorax - sudden sharp chest pain - preceded by viral illness
CT
Pleurisy
ACEi
Warts

38. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
A 24hr urine protein collection and urine creatinine clearance determination
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

39. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
When the patient has symptoms in association with exercise or who describe chest pain or pressure
MSK - pulmonary - GI - or psychological
CBC

40. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
GERD
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

41. History for Sinusitis

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42. What is the goal of CHF treatment? What drugs should be used?
Giardia
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
Bence-Jones
Less than 3 stools per week

43. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
>150mg per 24hrs
A 24hr urine protein collection and urine creatinine clearance determination
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

44. Complete the sentence: pericarditis can cause frictional rub and......
BB or CCB - catheter ablation of identified bypass tract
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Cellulitis

45. Pain in shoulder when throwing - swimming - or serving a tennis ball
When the patient has symptoms in association with exercise or who describe chest pain or pressure
HIV and syphilis
Rotator cuff tendonitis
S. Aureus

46. What is considered normal blood loss during a menstrual cycle?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Scleroderma/polymyositis with secondary gastroesophageal reflux
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Less than 80 ml of blood

47. When should invasive eletrophysiologic study should be considered?
Coronary artery disease/ angina
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Hypertension - CAD - valvular heart disease
Supraspinatus and bicipital tendons

48. Describe the presentation of pericardial pain
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Loop diuretics (Check serum K+ levels before drug admin)
Hypertension - CAD - valvular heart disease
Associated with hypotension

49. Uterine bleeding between regular cycles
Repeat Pap after infection treated
Intermenstrual bleeding
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

50. How to NSAIDs contribute to gastritis and ulcer formation?
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.
Albumin; low molecular weight proteins
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Scabies