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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.
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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. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
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
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
Wolff-Parkinson-White syndrome
S. aureus- beta hemolytic streptococcus

2. 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
PVC or Premature atrial contraction (PAC)
Loop diuretics (Check serum K+ levels before drug admin)
Warts
Varicella virus

3. What medications can cause heart palpitations?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Fever with frontal or maxillary tenderness
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

4. 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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Coronary artery disease/ angina
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

5. Diarrhea from custard filled pastries
Candida albicans
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
S. Aureus
Influenza - Rhinovirus - Adenovirus - Parainfluenza

6. 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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Medication or chemical esophagitis
Irregular bleeding between cycles

7. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Fever with frontal or maxillary tenderness
Viral gastroenteritis
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

8. Define nephrotic range proteinuria
Less than 3 stools per week
>3.5g of protein per 24hrs
Anticoag with warfarin to prevent thromboembolism
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

9. Prenatal visit schedule for low-risk pregnancies
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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

10. 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
GERD
Medication or chemical esophagitis
E. Coli O157:H7
Variability in the time for follicle development during the proliferative phase

11. patients with herpes zoster may experience what symptom before the rash appear?
Pain
Folliculitis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

12. Irregular cycles with excessive flow - duration - or both
Adhesive capsulitis (frozen shoulder): most common in middle age women
Analgesic headache
Menorrhagia
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

13. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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

14. Pneumonia tx: suitable for healthy adults older than 60
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Peptic ulcer disease or gastritis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
HIV and syphilis

15. Metrorrhagia
BB or CCB - catheter ablation of identified bypass tract
Irregular bleeding between cycles
Varicella virus
RBC casts and old to moderate HTN

16. Name the type of headache: mild to moderate intensity; located in the bilateral occipital-frontal areas; dull or band-like; lasts for hours; often assoc. with stress.
Folliculitis
Less than 80 ml of blood
Tension headache
Influenza - Rhinovirus - Adenovirus - Parainfluenza

17. Name the skin lesion: erythema - warmth - edema - pain - fever
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
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.
Cellulitis
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

18. What is the caUse of Meniere disease? What are the cardinal symptoms?
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
Candida albicans
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

19. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
ACEi - ARBS - thiazide diuretics
S. aureus- beta hemolytic streptococcus

20. What HPV serotypes are most commonly associated with cervical cancer?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Presence of proteinuria on at least two separate ocassion
Serotypes 16 - 18 - 31 -52 -58
Squamocolumnar junction=most common site of cervical cancer

21. What is an acoustic neuroma?
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
Molluscum contagiosum- pox virus
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
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

22. Treatment for supraventricular tachycardias
S. Aureus
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
BB or CCB - catheter ablation of identified bypass tract

23. What places women at higher risk of getting cervical cancer?
Coronary artery disease/ angina
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Intermenstrual bleeding

24. What are the features of glomerular nephritis
Cholelithiasis
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
RBC casts and old to moderate HTN
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

25. What is the Epley maneuver?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Molluscum contagiosum- pox virus
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.
Diuretics -BB -CCB -ACEi

26. MI - pericardial tamponade - PE - GI bleed - are...
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Associated with hypotension
Bulk forming: Psyllium - Methycellulose - Polycarbophil

27. What are the signs of acute sinusitis?
Rotator cuff tendonitis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Fever with frontal or maxillary tenderness
HIV and syphilis

28. 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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Pts with palpitations and dizziness - near syncope - or syncope

29. 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
Supraspinatus and bicipital tendons
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
A 24hr urine protein collection and urine creatinine clearance determination

30. Describe the presentation of angina?
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
Other brainstem or cranial nerve findings
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

31. Name the skin lesion: honey colored crusts
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Less than 3 stools per week
Streptococci
Impetigo

32. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Common problem that resolves spontaneously and is most often seen in children and young adults
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

33. History for Sinusitis

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34. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Supraspinatus and bicipital tendons
Furucnle
Giardia
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

35. Name the diagnosis of heartburn: regurgitation - dysphagia
Rotator Cuff problem
GERD
MSK - pulmonary - GI - or psychological
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.

36. Menometrorrhagia
Repeat Pap after infection treated
Regular bleeding at intervals of more than 35 days
Excessive bleeding in amount - duration - or both at irregular intervals
A 24hr urine protein collection and urine creatinine clearance determination

37. What does orthostatic positional changes that bring on dizziness suggest?
Dehydration - anemia - cardiac causes
Less than 80 ml of blood
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
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

38. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Chest pain during pneumonia or PE
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Upper sternal area burning pain - associated with a productive cough

39. What occurs after ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Lightheadedness - dizziness - syncope
HPV
CT

40. Discomfort with abducting the arm past 90 degress
Adhesive capsulitis (frozen shoulder): most common in middle age women
35 (exception for postmenopausal women who have recently been started on HRT)
Rotator Cuff tendonitis
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

41. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
Pleurisy
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

42. What are symptoms are CHF?
Kids: Rotavirus Adults: Norwalk Virus
Pain
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

43. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
These patients are associated with low renin states=less likely to respond to medication
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

44. What is the Barany maneuver?
Acute headache - ataxia - profuse nausea - and vomiting
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
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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. Pneumonia tx: suitable for healthy adults less than 60
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Infectious esophagitis
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

46. After treatment of dysplasia - women need Pap smears every...
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Less than 80 ml of blood
Streptococci
Infectious esophagitis

47. PE for a patient getting an abnormal vaginal bleeding work up
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
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

48. What is benign transient proteinuria?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Giardia
Common problem that resolves spontaneously and is most often seen in children and young adults
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

49. Isolated - extra pounding beats
Adhesive capsulitis (frozen shoulder): most common in middle age women
Pts with palpitations and dizziness - near syncope - or syncope
PVC or Premature atrial contraction (PAC)
Folliculitis

50. Define proteinuria
GERD
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
>150mg per 24hrs
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