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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 HPV serotypes are most commonly associated with cervical cancer?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
>3.5g of protein per 24hrs
Associated with hypotension
Serotypes 16 - 18 - 31 -52 -58

2. Describe the presentation of angina?
Variability in the time for follicle development during the proliferative phase
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
Loop diuretics (Check serum K+ levels before drug admin)
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

3. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
ACEi - ARBS - thiazide diuretics
PE - MI - aortic dissection - pneumothorax
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
Streptococci

4. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Giardia
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Paroxysmal atrial fibrillation or supraventricular tachycardia

5. 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
Increase; 200 g/day
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
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

6. Carcinoma in situ is generally referred to a gynecologist and requires ______
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
Echocardiogram
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

7. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Loop diuretics (Check serum K+ levels before drug admin)
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
S. aureus- beta hemolytic streptococcus

8. How are fungal infections diagnosed?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
CT
With a KOH wet mount preparation

9. Define proteinuria
>150mg per 24hrs
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
True
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

10. Who should have Xray testing for shoulder pain?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Albumin; low molecular weight proteins
Pain
Supraspinatus and bicipital tendons

11. PE for a patient getting an abnormal vaginal bleeding work up
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Temporal arteritis-biopsy of the temporal artery
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
True

12. MI - pericardial tamponade - PE - GI bleed - are...
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Associated with hypotension
Wolff-Parkinson-White syndrome
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

13. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Polymenorrhea

14. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
High blood pressure - focal neurologic defecit - or papilledema
Medication or chemical esophagitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

15. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Tension headache
>150mg per 24hrs
Echocardiogram
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

16. What lab tests are recommended for newly diagnosed hypertensive patients?
Loop diuretics (Check serum K+ levels before drug admin)
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Viral gastroenteritis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

17. 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
E. Coli O157:H7
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

18. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Impetigo
Scabies
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

19. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
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
Repeat Pap after infection treated

20. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Rotator Cuff tendonitis
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
CBC

21. Name some medications that can cause proteinuria
Intermenstrual bleeding
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Regular bleeding at intervals of more than 35 days

22. What is the next best step if a patient has two or more positive dipstick tests?
A 24hr urine protein collection and urine creatinine clearance determination
Diuretics -BB -CCB -ACEi
Acute headache - ataxia - profuse nausea - and vomiting
Cervical radiculopathy

23. What are the three types of lice?
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Wolff-Parkinson-White syndrome

24. 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.
Upper sternal area burning pain - associated with a productive cough
Possibility of Ischemic colitis
Repeat Pap after infection treated
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

25. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
CT
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Less than 3 stools per week
Nonulcer dyspepsia

26. How does systolic vs. diastolic heart failure present on the echocardiogram?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Polymenorrhea
Viral infection of the semicircular apparatus

27. SE Of Beta blockers?
With a KOH wet mount preparation
S. Aureus
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

28. Pneumonia tx: suitable for healthy adults less than 60
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.
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
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

29. After treatment of dysplasia - women need Pap smears every...
Supraspinatus and bicipital tendons
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Regular bleeding at intervals of more than 35 days
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

30. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
These patients are associated with low renin states=less likely to respond to medication
A 24hr urine protein collection and urine creatinine clearance determination
Coronary artery disease/ angina

31. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Impetigo
Pts with palpitations and dizziness - near syncope - or syncope
Regular bleeding at intervals of more than 35 days
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

32. HIgh risk pregnant patients should be evaluated for ____ and ____
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
Hypertension - CAD - valvular heart disease
HIV and syphilis
Rotator cuff tendonitis

33. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
HPV testing -Pos=colposcopy -Neg=repeat pap smear

34. What should blood work include for suspected heart failure?
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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

35. What are the secondly causes of glomerular disease?
Intermenstrual bleeding
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

36. Name the skin lesion: honey colored crusts
Analgesic headache
>150mg per 24hrs
Impetigo
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

37. Name the diagnosis of heartburn: severe constant mid abdominal pain
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Pancreatitis
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

38. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
RBC casts and old to moderate HTN
Analgesic headache
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Staphylococcal scalded skin syndrome

39. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Albumin; low molecular weight proteins
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. When should invasive eletrophysiologic study should be considered?
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
PVC or Premature atrial contraction (PAC)
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

41. What is the Epley maneuver?
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.
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Non-cardiac causes of palpitations
Bence-Jones

42. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Analgesic headache
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Paroxysmal atrial fibrillation or supraventricular tachycardia

43. Mainstay treatment for soft tissue inflammation (Shoulder)
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Infectious esophagitis
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

44. What are the features of glomerular nephritis
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
Upper sternal area burning pain - associated with a productive cough
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
RBC casts and old to moderate HTN

45. What is afterload?
Temporal arteritis-biopsy of the temporal artery
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.
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Non-cardiac causes of palpitations

46. What diagnosis does the 'worse headache of my life' suggest?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Pts with palpitations and dizziness - near syncope - or syncope
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Subarachnoid hemorrhage

47. Define nephrotic range proteinuria
S. Aureus
>3.5g of protein per 24hrs
Pleurisy
A 24hr urine protein collection and urine creatinine clearance determination

48. Uterine bleeding between regular cycles
Intermenstrual bleeding
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
MSK - pulmonary - GI - or psychological

49. What are the primary glomerular diseases?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
EGD
Streptococci

50. 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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Pleurisy