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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. Shoulder pain with pain radiating to elbow
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Irregular bleeding between cycles
Pancreatitis
Cervical radiculopathy

2. Name the skin lesion: pustule in association with a hair follice
Folliculitis
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Increase; 200 g/day
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

3. SE Of Beta blockers?
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
Increase; 200 g/day
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

4. Name types of laxatives
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
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

5. What is benign transient proteinuria?
ACEi
Common problem that resolves spontaneously and is most often seen in children and young adults
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
DM - HTN - DVT - seizures - depression - or anxiety

6. Cycle length variabilty is primarily due to what?
Less than 80 ml of blood
RBC casts and old to moderate HTN
Variability in the time for follicle development during the proliferative phase
Albumin; low molecular weight proteins

7. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Giardia
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Non-cardiac causes of palpitations
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

8. What is the goal of CHF treatment? What drugs should be used?
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
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
Slow progression of cervical cancer changes -Availability of effective early treatment
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

9. What is afterload?
GERD
Supraspinatus and bicipital tendons
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
ACEi - ARBS - thiazide diuretics

10. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
Acute headache - ataxia - profuse nausea - and vomiting
Serotypes 16 - 18 - 31 -52 -58

11. Predictors of cardiac etiology
Rotator Cuff tendonitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

12. What microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
CT
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
E. Coli O157:H7
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

13. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
BB or CCB - catheter ablation of identified bypass tract
Increase; 200 g/day
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

14. Oligomenorrhea
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Menorrhagia
Regular bleeding at intervals of more than 35 days
>3.5g of protein per 24hrs

15. After treatment of dysplasia - women need Pap smears every...
Less abrupt onset and cessation of palpitations
100mg; means patient can be trace protein positive and not be detected
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
PE - MI - aortic dissection - pneumothorax

16. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
Lightheadedness - dizziness - syncope
Associated with hypotension
Nonulcer dyspepsia

17. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
100mg; means patient can be trace protein positive and not be detected
Lightheadedness - dizziness - 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

18. How is constipation clinically defined?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Warts
Less than 3 stools per week
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

19. What are the 2 psych disorders most commonly associated with palpitations?
Generalized Anxiety disorder and panic disorder
24 hour halter
Cluster headache
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

20. 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.
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Repeat Pap after infection treated
Other brainstem or cranial nerve findings
Infectious esophagitis

21. 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
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
Scabies
Warts
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

22. 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
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
Regular bleeding at intervals of more than 35 days
PE - MI - aortic dissection - pneumothorax

23. What are the indiciations for neuroimaging?
Nonulcer dyspepsia
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

24. Chronic pain and shoulder stiffness with limited motion
Diuretics -BB -CCB -ACEi
Adhesive capsulitis (frozen shoulder): most common in middle age women
Varicella virus
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

25. 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
Other brainstem or cranial nerve findings
Varicella virus
Menorrhagia
Excessive bleeding in amount - duration - or both at irregular intervals

26. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Chest pain during pneumonia or PE
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
E. Coli O157:H7
Infectious esophagitis

27. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Chest pain during pneumonia or PE
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

28. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
Kids: Rotavirus Adults: Norwalk Virus
Possibility of Ischemic colitis
Non-cardiac causes of palpitations

29. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Less than 3 stools per week
Candida albicans
Coronary artery disease/ angina
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

30. What is the Barany maneuver?
Temporal arteritis-biopsy of the temporal artery
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
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
Medication or chemical esophagitis

31. What does the classic ring worm lesion have?
Diuretics -BB -CCB -ACEi
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
A central clear area
Increasing fluid (8 - 8oz glasses of water/day) -fiber

32. Name the diagnosis of heartburn: regurgitation - dysphagia
GERD
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
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

33. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
HIV and syphilis
MSK - pulmonary - GI - or psychological
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

34. What is a markers of CNS vertigo?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Viral gastroenteritis
Other brainstem or cranial nerve findings
HIV and syphilis

35. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
BB or CCB - catheter ablation of identified bypass tract
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

36. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
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
Viral gastroenteritis
Acute headache - ataxia - profuse nausea - and vomiting

37. Metrorrhagia
Less abrupt onset and cessation of palpitations
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Irregular bleeding between cycles

38. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
>150mg per 24hrs
ACEi
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

39. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Loop diuretics (Check serum K+ levels before drug admin)
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Viral infection of the semicircular apparatus
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

40. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Less than 80 ml of blood
Serotypes 16 - 18 - 31 -52 -58
These patients are associated with low renin states=less likely to respond to medication

41. What diagnosis does the 'worse headache of my life' suggest?
Polymenorrhea
Subarachnoid hemorrhage
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Echocardiogram

42. Mainstay treatment for soft tissue inflammation (Shoulder)
Upper sternal area burning pain - associated with a productive cough
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Lightheadedness - dizziness - syncope

43. What occurs after ovulation
Rotator cuff tendonitis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Peptic ulcer disease or gastritis

44. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Pancreatitis
Impetigo
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

45. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
Anticoag with warfarin to prevent thromboembolism
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Supraspinatus and bicipital tendons
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

46. What HPV serotypes are most commonly associated with cervical cancer?
Other brainstem or cranial nerve findings
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
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
Serotypes 16 - 18 - 31 -52 -58

47. MI - pericardial tamponade - PE - GI bleed - are...
Viral infection of the semicircular apparatus
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Associated with hypotension

48. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Bence-Jones

49. What are the most common viral causes of diarrhea in kids and adults?
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Kids: Rotavirus Adults: Norwalk Virus
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

50. What are the symptoms of palpitations?
Lightheadedness - dizziness - syncope
GERD
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Cervical radiculopathy