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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. What is the role of LH in the menstrual cycle
Pain
Pancreatitis
LH surge triggers ovulation
HPV testing -Pos=colposcopy -Neg=repeat pap smear

2. 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
Cluster headache
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
S. aureus- beta hemolytic streptococcus

3. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

4. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
DM - HTN - DVT - seizures - depression - or anxiety
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

5. When is a lumbar puncture contraindicated?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Less than 3 stools per week
Scabies

6. 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.
CBC
Lightheadedness - dizziness - syncope
Repeat Pap after infection treated
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

7. Uterine bleeding between regular cycles
Less abrupt onset and cessation of palpitations
Adhesive capsulitis (frozen shoulder): most common in middle age women
Intermenstrual bleeding
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

8. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
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
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

9. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
Other brainstem or cranial nerve findings
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
E. Coli O157:H7

10. SE Of Beta blockers?
EGD
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

11. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
LH surge triggers ovulation
Infectious esophagitis
>3.5g of protein per 24hrs
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

12. Describe the history and PE of patient presenting with common cold
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
CBC
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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

13. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
>3.5g of protein per 24hrs
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Rotator Cuff problem
MSK - pulmonary - GI - or psychological

14. 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
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

15. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
LH surge triggers ovulation
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
HPV testing -Pos=colposcopy -Neg=repeat pap smear

16. What is the mechanism of action for stimulant agents in treating constipation?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

17. What are the signs of cerebral hemorrhage?
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.
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Acute headache - ataxia - profuse nausea - and vomiting

18. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
These patients are associated with low renin states=less likely to respond to medication
RBC casts and old to moderate HTN
Increase; 200 g/day

19. 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
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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
ACEi - ARBS - thiazide diuretics

20. Pain in shoulder when throwing - swimming - or serving a tennis ball
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Rotator cuff tendonitis
Hypertension - CAD - valvular heart disease

21. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Viral infection of the semicircular apparatus
Colposcopy - Endocervical curettage - and directed cervical biopsy

22. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
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
HPV
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

23. What are the symptoms of palpitations?
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
Menorrhagia
Lightheadedness - dizziness - syncope
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

24. Diagnosis of HTN
Anticoag with warfarin to prevent thromboembolism
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Possibility of Ischemic colitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

25. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Squamocolumnar junction=most common site of cervical cancer
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Coronary artery disease/ angina

26. Regular bleeding at intervals of less than 21 days
Supraspinatus and bicipital tendons
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Polymenorrhea
Colposcopy - Endocervical curettage - and directed cervical biopsy

27. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Staphylococcal scalded skin syndrome
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Cervical radiculopathy

28. What does the classic ring worm lesion have?
Impetigo
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
A central clear area
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

29. How to NSAIDs contribute to gastritis and ulcer formation?
Albumin; low molecular weight proteins
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.
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
Staphylococcal scalded skin syndrome

30. What are the features of glomerular nephritis
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
HPV testing -Pos=colposcopy -Neg=repeat pap smear
RBC casts and old to moderate HTN

31. Name the skin lesion: honey colored crusts
Hypertension - CAD - valvular heart disease
Pain
Lightheadedness - dizziness - syncope
Impetigo

32. What lab tests are recommended for newly diagnosed hypertensive patients?
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
CBC

33. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Temporal arteritis-biopsy of the temporal artery
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
Excessive bleeding in amount - duration - or both at irregular intervals
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

34. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Possibility of Ischemic colitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Increase; 200 g/day

35. Define the patient population typically affected by orthostatic or postural proteinuria
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
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
Subarachnoid hemorrhage

36. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
E. Coli O157:H7
ACEi - ARBS - thiazide diuretics
Less than 3 stools per week
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

37. What medications can cause heart palpitations?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
CBC
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

38. What are the most common viral causes of diarrhea in kids and adults?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Wolff-Parkinson-White syndrome
Kids: Rotavirus Adults: Norwalk Virus
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

39. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Serotypes 16 - 18 - 31 -52 -58
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.
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

40. Diarrhea from custard filled pastries
Subarachnoid hemorrhage
S. Aureus
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

41. What is the standard tool used for diagnosis of GERD?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
EGD
HIV and syphilis
Giardia

42. How are fungal infections diagnosed?
Polymenorrhea
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
Viral infection of the semicircular apparatus

43. Clinical Manifestations of HTN
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
Analgesic headache
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

44. What is the Barany maneuver?
Presence of proteinuria on at least two separate ocassion
Hypertension - CAD - valvular heart disease
>3.5g of protein per 24hrs
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

45. MI - pericardial tamponade - PE - GI bleed - are...
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
Associated with hypotension
DM - HTN - DVT - seizures - depression - or anxiety
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.

46. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bence-Jones
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
S. aureus- beta hemolytic streptococcus
Cervical radiculopathy

47. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Cellulitis

48. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

49. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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

50. What should be considered in younger patients with menorrhagia
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Dehydration - anemia - cardiac causes
Coag disorders
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