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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. Why is the pap smear one of the most effective cancer screening tools?
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Slow progression of cervical cancer changes -Availability of effective early treatment
Viral infection of the semicircular apparatus

2. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
S. Aureus
Adhesive capsulitis (frozen shoulder): most common in middle age women
ACEi
True

3. What occurs after ovulation
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Viral infection of the semicircular apparatus
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

4. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Candida albicans
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Wolff-Parkinson-White syndrome

5. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
A 24hr urine protein collection and urine creatinine clearance determination
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Peptic ulcer disease or gastritis
Hgb - Electrolytes - and TSH

6. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Staphylococcal scalded skin syndrome
Viral infection of the semicircular apparatus
Medication or chemical esophagitis
Colposcopy - Endocervical curettage - and directed cervical biopsy

7. Describe the presentation of pericardial pain
Cholelithiasis
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Rotator Cuff tendonitis

8. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
LH surge triggers ovulation
Echocardiogram
DM - HTN - DVT - seizures - depression - or anxiety

9. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Slow progression of cervical cancer changes -Availability of effective early treatment
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

10. Define proteinuria
Other brainstem or cranial nerve findings
>150mg per 24hrs
Fever with frontal or maxillary tenderness
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

11. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Albumin; low molecular weight proteins

12. What are the three types of lice?
Coronary artery disease/ angina
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Increasing fluid (8 - 8oz glasses of water/day) -fiber
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

13. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
PE - MI - aortic dissection - pneumothorax
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

14. Name some medications that can cause proteinuria
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
A 24hr urine protein collection and urine creatinine clearance determination
Analgesic headache
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

15. What HPV serotypes are most commonly associated with cervical cancer?
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
Serotypes 16 - 18 - 31 -52 -58
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

16. What is the role of LH in the menstrual cycle
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Subarachnoid hemorrhage
Pts with palpitations and dizziness - near syncope - or syncope
LH surge triggers ovulation

17. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Furucnle
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
Diuretics -BB -CCB -ACEi
Streptococci

18. What should preconception counseling include?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Acute headache - ataxia - profuse nausea - and vomiting
Pancreatitis
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

19. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
HPV
BB or CCB - catheter ablation of identified bypass tract
Other brainstem or cranial nerve findings

20. What is the role of FSH in one's menstrual cycle
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Cluster headache
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Molluscum contagiosum- pox virus

21. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
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
Medication or chemical esophagitis
Cellulitis

22. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
RBC casts and old to moderate HTN
CBC
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

23. What are the signs of acute sinusitis?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
LH surge triggers ovulation
Dehydration - anemia - cardiac causes
Fever with frontal or maxillary tenderness

24. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
HPV testing -Pos=colposcopy -Neg=repeat pap smear

25. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Echocardiogram
Colposcopy - Endocervical curettage - and directed cervical biopsy
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

26. What places women at higher risk of getting cervical cancer?
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
Coronary artery disease/ angina
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
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

27. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Lightheadedness - dizziness - syncope

28. Clinical Manifestations of HTN
Tension headache
Infectious esophagitis
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Irregular bleeding between cycles

29. What are the indiciations for neuroimaging?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

30. Name the diagnosis of heartburn: severe constant mid abdominal pain
Pancreatitis
Pleurisy
PVC or Premature atrial contraction (PAC)
When the patient has symptoms in association with exercise or who describe chest pain or pressure

31. What is the caUse of benign positional vertigo?
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
Non-cardiac causes of palpitations
Less than 3 stools per week
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.

32. What are the secondly causes of glomerular disease?
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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

33. Vaccines that should be updated before planned pregnancy
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
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
RBC casts and old to moderate HTN

34. At was quantity does urine dipstick test detect elevated protein?
100mg; means patient can be trace protein positive and not be detected
Fever with frontal or maxillary tenderness
Albumin; low molecular weight proteins
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

35. Initial treatment for Rhinosinusitis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Rotator Cuff problem
Bence-Jones
Scleroderma/polymyositis with secondary gastroesophageal reflux

36. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
Temporal arteritis-biopsy of the temporal artery

37. 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.
Anticoag with warfarin to prevent thromboembolism
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Supraspinatus and bicipital tendons
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

38. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Wolff-Parkinson-White syndrome
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Candida albicans

39. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Viral gastroenteritis
Coag disorders

40. What is the mechanism of action for stimulant agents in treating constipation?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Dehydration - anemia - cardiac causes
Viral infection of the semicircular apparatus
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

41. 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
Scabies
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Increasing fluid (8 - 8oz glasses of water/day) -fiber

42. Pneumonia tx: suitable for healthy adults less than 60
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Temporal arteritis-biopsy of the temporal artery
Pleurisy

43. Define the patient population typically affected by orthostatic or postural proteinuria
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Tension headache
HPV
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

44. HIgh risk pregnant patients should be evaluated for ____ and ____
HIV and syphilis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Diuretics -BB -CCB -ACEi
Hypertension - CAD - valvular heart disease

45. Lab testing for heart palpitation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Hgb - Electrolytes - and TSH
Common problem that resolves spontaneously and is most often seen in children and young adults

46. Describes what occurs during squamous metaplasia of the cervix.
Folliculitis
Cholelithiasis
Molluscum contagiosum- pox virus
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

47. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Acute headache - ataxia - profuse nausea - and vomiting
Excessive bleeding in amount - duration - or both at irregular intervals
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Variability in the time for follicle development during the proliferative phase

48. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Temporal arteritis-biopsy of the temporal artery
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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

49. What are signs of pulmonary congestion?
Cholelithiasis
Possibility of Ischemic colitis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

50. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Excessive bleeding in amount - duration - or both at irregular intervals
Pts with palpitations and dizziness - near syncope - or syncope
HIV and syphilis
Chest pain during pneumonia or PE