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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. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
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
Viral gastroenteritis
LH surge triggers ovulation

2. What are the features of glomerular nephritis
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Cholelithiasis
Serotypes 16 - 18 - 31 -52 -58
RBC casts and old to moderate HTN

3. Name the skin lesion: honey colored crusts
Impetigo
These patients are associated with low renin states=less likely to respond to medication
CBC
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

4. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Pain

5. History for Acute bronchitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
HIV and syphilis
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

6. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Folliculitis
Medication or chemical esophagitis
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

7. What is the Epley maneuver?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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.
BB or CCB - catheter ablation of identified bypass tract

8. Natural history of cervical cancer
Hgb - Electrolytes - and TSH
S. Aureus
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

9. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Adhesive capsulitis (frozen shoulder): most common in middle age women

10. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
A 24hr urine protein collection and urine creatinine clearance determination

11. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
MSK - pulmonary - GI - or psychological
Streptococci
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Giardia

12. What is the standard tool used for diagnosis of GERD?
Upper sternal area burning pain - associated with a productive cough
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Anticoag with warfarin to prevent thromboembolism
EGD

13. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
GERD
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.
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

14. What is the caUse of Meniere disease? What are the cardinal symptoms?
Acute headache - ataxia - profuse nausea - and vomiting
BB or CCB - catheter ablation of identified bypass tract
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Adhesive capsulitis (frozen shoulder): most common in middle age women

15. Name the diagnosis: umbilicated skin lesion that is spread by autoinoculation - scratching - or touching a lesion. Discrete 2 to 5 mm slightly umbilicated flesh-colored - dome shaped papules occurring on the face - trunk - axillae - and extremities i
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Molluscum contagiosum- pox virus
GERD
Impetigo

16. What is afterload?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Pain
Anticoag with warfarin to prevent thromboembolism

17. What are the 2 psych disorders most commonly associated with palpitations?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Anticoag with warfarin to prevent thromboembolism
Generalized Anxiety disorder and panic disorder
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

18. 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
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Excessive bleeding in amount - duration - or both at irregular intervals

19. What are the common causes for laryngitis?
Coag disorders
Echocardiogram
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

20. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Coag disorders
Giardia
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Colposcopy - Endocervical curettage - and directed cervical biopsy

21. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Irregular bleeding between cycles
>3.5g of protein per 24hrs
ACEi - ARBS - thiazide diuretics

22. Name types of laxatives
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Rotator Cuff tendonitis

23. What are signs of pulmonary congestion?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

24. What does orthostatic positional changes that bring on dizziness suggest?
Subarachnoid hemorrhage
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Dehydration - anemia - cardiac causes
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

25. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

26. Name the diagnosis of heartburn: regurgitation - dysphagia
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
GERD

27. 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.
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Peptic ulcer disease or gastritis
Supraspinatus and bicipital tendons

28. Chronic pain and shoulder stiffness with limited motion
RBC casts and old to moderate HTN
Adhesive capsulitis (frozen shoulder): most common in middle age women
>3.5g of protein per 24hrs
EGD

29. Describe the presentation tracheobronchitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Rotator Cuff problem
A 24hr urine protein collection and urine creatinine clearance determination
Upper sternal area burning pain - associated with a productive cough

30. What are the three major risk factors for heart failure?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Hypertension - CAD - valvular heart disease
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
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

31. Define the patient population typically affected by orthostatic or postural proteinuria
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
Serotypes 16 - 18 - 31 -52 -58
Impetigo

32. Treatment for supraventricular tachycardias
100mg; means patient can be trace protein positive and not be detected
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
BB or CCB - catheter ablation of identified bypass tract
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

33. How is constipation clinically defined?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Paroxysmal atrial fibrillation or supraventricular tachycardia
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Less than 3 stools per week

34. When should invasive eletrophysiologic study should be considered?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Irregular bleeding between cycles
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Possibility of Ischemic colitis

35. MI - pericardial tamponade - PE - GI bleed - are...
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Associated with hypotension
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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. What test done in PE measures instability of shoulder?
Menorrhagia
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

37. Irregular cycles with excessive flow - duration - or both
>3.5g of protein per 24hrs
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Diuretics -BB -CCB -ACEi
Menorrhagia

38. What are the most common viral causes of diarrhea in kids and adults?
Analgesic headache
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Kids: Rotavirus Adults: Norwalk Virus
Variability in the time for follicle development during the proliferative phase

39. What the consequences of decreased cardiac output?
Subarachnoid hemorrhage
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
True
CBC

40. PE for a patient getting an abnormal vaginal bleeding work up
Pain
Non-cardiac causes of palpitations
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

41. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Presence of proteinuria on at least two separate ocassion
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Nonulcer dyspepsia

42. Prenatal visit schedule for low-risk pregnancies
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
Temporal arteritis-biopsy of the temporal artery
24 hour halter
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

43. What are the two common clinical presentations of acute diarrhea?
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
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

44. 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.
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Menorrhagia
Repeat Pap after infection treated

45. Pneumothorax - sudden sharp chest pain - preceded by viral illness
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.
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Pleurisy

46. Isolated - extra pounding beats
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.
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
PVC or Premature atrial contraction (PAC)
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

47. Difference between Pneumonia and Bronchitis
ACEi
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
Temporal arteritis-biopsy of the temporal artery
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

48. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
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
Rotator cuff tendonitis
Non-cardiac causes of palpitations
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

49. Uterine bleeding between regular cycles
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
Intermenstrual bleeding
ACEi
24 hour halter

50. How are fungal infections diagnosed?
Intermenstrual bleeding
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
With a KOH wet mount preparation