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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. Difference between Pneumonia and Bronchitis
Fever with frontal or maxillary tenderness
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

2. Discomfort with abducting the arm past 90 degress
>3.5g of protein per 24hrs
Rotator Cuff tendonitis
With a KOH wet mount preparation
Furucnle

3. Regular bleeding at intervals of less than 21 days
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
Presence of proteinuria on at least two separate ocassion
Polymenorrhea
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

4. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Candida albicans
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

5. What should blood work include for suspected heart failure?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Regular bleeding at intervals of more than 35 days
Warts

6. SE Of Beta blockers?
Rotator Cuff tendonitis
S. aureus- beta hemolytic streptococcus
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Diuretics -BB -CCB -ACEi

7. When is a lumbar puncture contraindicated?
Staphylococcal scalded skin syndrome
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

8. What diagnosis does the 'worse headache of my life' suggest?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
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
Subarachnoid hemorrhage
Less abrupt onset and cessation of palpitations

9. 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.
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
Giardia
Peptic ulcer disease or gastritis
Repeat Pap after infection treated

10. Describe the presentation of myocardial pain?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Peptic ulcer disease or gastritis
With a KOH wet mount preparation
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

11. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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

12. Diarrhea from custard filled pastries
35 (exception for postmenopausal women who have recently been started on HRT)
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
Menorrhagia

13. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Serotypes 16 - 18 - 31 -52 -58
Molluscum contagiosum- pox virus
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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

14. Cycle length variabilty is primarily due to what?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Variability in the time for follicle development during the proliferative phase
Staphylococcal scalded skin syndrome
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

15. Define nephrotic range proteinuria
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
>3.5g of protein per 24hrs
Supraspinatus and bicipital tendons
HPV testing -Pos=colposcopy -Neg=repeat pap smear

16. When should invasive eletrophysiologic study should be considered?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Less than 80 ml of blood
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Adhesive capsulitis (frozen shoulder): most common in middle age women

17. What is benign transient proteinuria?
Upper sternal area burning pain - associated with a productive cough
Common problem that resolves spontaneously and is most often seen in children and young adults
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Diuretics -BB -CCB -ACEi

18. MI - pericardial tamponade - PE - GI bleed - are...
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
Associated with hypotension
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Candida albicans

19. What is the role of FSH in one's menstrual cycle
DM - HTN - DVT - seizures - depression - or anxiety
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Menorrhagia

20. Define the patient population typically affected by orthostatic or postural proteinuria
Serotypes 16 - 18 - 31 -52 -58
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
Pts with palpitations and dizziness - near syncope - or syncope

21. What are the most common viral causes of diarrhea in kids and adults?
Infectious esophagitis
Kids: Rotavirus Adults: Norwalk Virus
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

22. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
Viral infection of the semicircular apparatus
Slow progression of cervical cancer changes -Availability of effective early treatment
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

23. Name the skin lesion: erythema - warmth - edema - pain - fever
Less than 80 ml of blood
Cellulitis
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

24. Isolated - extra pounding beats
Slow progression of cervical cancer changes -Availability of effective early treatment
Colposcopy - Endocervical curettage - and directed cervical biopsy
PVC or Premature atrial contraction (PAC)
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

25. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
24 hour halter
Peptic ulcer disease or gastritis
Albumin; low molecular weight proteins
Analgesic headache

26. Pain in shoulder when throwing - swimming - or serving a tennis ball
Loop diuretics (Check serum K+ levels before drug admin)
Rotator cuff tendonitis
Molluscum contagiosum- pox virus
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

27. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
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
With a KOH wet mount preparation
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
>3.5g of protein per 24hrs

28. What the consequences of decreased cardiac output?
Bence-Jones
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Staphylococcal scalded skin syndrome

29. What are the primary glomerular diseases?
35 (exception for postmenopausal women who have recently been started on HRT)
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

30. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Dehydration - anemia - cardiac causes
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

31. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
24 hour halter
Molluscum contagiosum- pox virus
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Infectious esophagitis

32. How is constipation clinically defined?
Less than 3 stools per week
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
Hgb - Electrolytes - and TSH

33. What test done in PE measures instability of shoulder?
Infectious esophagitis
PE - MI - aortic dissection - pneumothorax
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Lightheadedness - dizziness - syncope

34. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Less abrupt onset and cessation of palpitations
PE - MI - aortic dissection - pneumothorax
Repeat Pap after infection treated

35. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
S. aureus- beta hemolytic streptococcus
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
These patients are associated with low renin states=less likely to respond to medication

36. What type of imaging is need for chronic sinusitis?
Molluscum contagiosum- pox virus
Less abrupt onset and cessation of palpitations
CT
DM - HTN - DVT - seizures - depression - or anxiety

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

38. Pneumonia tx: suitable for healthy adults older than 60
E. Coli O157:H7
Bence-Jones
Acute headache - ataxia - profuse nausea - and vomiting
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

39. What is a markers of CNS vertigo?
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
Generalized Anxiety disorder and panic disorder
Other brainstem or cranial nerve findings
100mg; means patient can be trace protein positive and not be detected

40. What is the Barany maneuver?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
E. Coli O157:H7
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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

41. Describe the presentation of pericardial pain
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

42. Who should have Xray testing for shoulder pain?
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
S. aureus- beta hemolytic streptococcus
Other brainstem or cranial nerve findings

43. 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
Scabies
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Warts
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

44. Describe the presentation tracheobronchitis
24 hour halter
Upper sternal area burning pain - associated with a productive cough
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Furucnle

45. What places women at higher risk of getting cervical cancer?
Cellulitis
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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.

46. What should preconception counseling include?
Acute headache - ataxia - profuse nausea - and vomiting
CBC
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

47. What is the standard tool used for diagnosis of GERD?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
EGD
LH surge triggers ovulation

48. Name some medications that can cause proteinuria
Giardia
100mg; means patient can be trace protein positive and not be detected
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

49. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
S. Aureus
Nonulcer dyspepsia
Wolff-Parkinson-White syndrome
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

50. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Kids: Rotavirus Adults: Norwalk Virus
High blood pressure - focal neurologic defecit - or papilledema
ACEi - ARBS - thiazide diuretics