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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 is the Barany maneuver?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
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
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

2. Irregular cycles with excessive flow - duration - or both
Repeat Pap after infection treated
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology
Menorrhagia
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

3. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Chest pain during pneumonia or PE
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
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

4. What should blood work include for suspected heart failure?
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

5. What are the indiciations for neuroimaging?
Increase; 200 g/day
Furucnle
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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

6. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Rotator Cuff problem
Analgesic headache

7. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Irregular bleeding between cycles
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
CBC

8. Uterine bleeding between regular cycles
MSK - pulmonary - GI - or psychological
Rotator Cuff tendonitis
Intermenstrual bleeding
Serotypes 16 - 18 - 31 -52 -58

9. What are the symptoms of palpitations?
Less abrupt onset and cessation of palpitations
Lightheadedness - dizziness - syncope
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
When the patient has symptoms in association with exercise or who describe chest pain or pressure

10. Things that need to be included in history of shoulder pain
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Squamocolumnar junction=most common site of cervical cancer
Irregular bleeding between cycles
Dehydration - anemia - cardiac causes

11. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Staphylococcal scalded skin syndrome
Infectious esophagitis
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
Rotator cuff tendonitis

12. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Giardia
Rotator Cuff tendonitis
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
S. aureus- beta hemolytic streptococcus

13. What are the signs of cerebral hemorrhage?
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.
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
Acute headache - ataxia - profuse nausea - and vomiting
Pancreatitis

14. Clinical Manifestations of HTN
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Dehydration - anemia - cardiac causes

15. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Influenza - Rhinovirus - Adenovirus - Parainfluenza
24 hour halter
Colposcopy - Endocervical curettage - and directed cervical biopsy
Pleurisy

16. What type of imaging is need for chronic sinusitis?
CT
Medication or chemical esophagitis
Pts with palpitations and dizziness - near syncope - or syncope
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

17. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
EGD
With a KOH wet mount preparation
Menorrhagia

18. 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.
Albumin; low molecular weight proteins
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Tension headache
Staphylococcal scalded skin syndrome

19. What medications can cause heart palpitations?
A 24hr urine protein collection and urine creatinine clearance determination
Bence-Jones
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
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

20. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Candida albicans
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
Squamocolumnar junction=most common site of cervical cancer
Echocardiogram

21. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Medication or chemical esophagitis
Polymenorrhea
Pain
Peptic ulcer disease or gastritis

22. What test done in PE measures instability of shoulder?
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

23. What is the peripheral caUse of vertigo?
Pancreatitis
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
HPV

24. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

25. History for Acute bronchitis
Pancreatitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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
Peptic ulcer disease or gastritis

26. Name some medications that can cause proteinuria
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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.
S. Aureus

27. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
LH surge triggers ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Non-cardiac causes of palpitations
CBC

28. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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

29. What should preconception counseling include?
CBC
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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

30. What are the most common causes for the common cold?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Squamocolumnar junction=most common site of cervical cancer
Excessive bleeding in amount - duration - or both at irregular intervals
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

31. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Viral infection of the semicircular apparatus
Regular bleeding at intervals of more than 35 days
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
CBC

32. Name the skin lesion: honey colored crusts
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.
Hypertension - CAD - valvular heart disease
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Impetigo

33. SE Of Beta blockers?
Lightheadedness - dizziness - syncope
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
>3.5g of protein per 24hrs

34. Predictors of cardiac etiology
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

35. Shoulder pain with pain radiating to elbow
Cervical radiculopathy
HPV
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

36. What occurs after ovulation
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
CT
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

37. When should a patient get a stress test?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Irregular bleeding between cycles
Cluster headache

38. Where does the development of abnormal cervical cells begin?
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
Squamocolumnar junction=most common site of cervical cancer
Coronary artery disease/ angina
Analgesic headache

39. Define proteinuria
>150mg per 24hrs
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
HIV and syphilis

40. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
ACEi

41. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Streptococci
Staphylococcal scalded skin syndrome
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

42. What lab tests are recommended for newly diagnosed hypertensive patients?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Hypertension - CAD - valvular heart disease

43. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
EGD
Possibility of Ischemic colitis
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

44. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Temporal arteritis-biopsy of the temporal artery
Adhesive capsulitis (frozen shoulder): most common in middle age women
Pts with palpitations and dizziness - near syncope - or syncope
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

45. 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
Associated with hypotension
PVC or Premature atrial contraction (PAC)
Cellulitis
Warts

46. 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
Hgb - Electrolytes - and TSH
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
Molluscum contagiosum- pox virus
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

47. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Less abrupt onset and cessation of palpitations
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
DM - HTN - DVT - seizures - depression - or anxiety

48. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
100mg; means patient can be trace protein positive and not be detected
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
PE - MI - aortic dissection - pneumothorax

49. Carcinoma in situ is generally referred to a gynecologist and requires ______
Cervical radiculopathy
Supraspinatus and bicipital tendons
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
100mg; means patient can be trace protein positive and not be detected

50. 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
Staphylococcal scalded skin syndrome
Scabies
Impetigo
Nonulcer dyspepsia