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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. Mainstay treatment for soft tissue inflammation (Shoulder)
Cervical radiculopathy
Acute headache - ataxia - profuse nausea - and 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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

2. 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
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
S. aureus- beta hemolytic streptococcus
Chest pain during pneumonia or PE
Molluscum contagiosum- pox virus

3. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Furucnle
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Viral gastroenteritis
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.

4. What is the caUse of benign positional vertigo?
35 (exception for postmenopausal women who have recently been started on HRT)
When the patient has symptoms in association with exercise or who describe chest pain or pressure
LH surge triggers ovulation
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.

5. Define proteinuria
Regular bleeding at intervals of more than 35 days
>150mg per 24hrs
Common problem that resolves spontaneously and is most often seen in children and young adults
PE - MI - aortic dissection - pneumothorax

6. Things that need to be included in history of shoulder pain
Warts
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

7. Name the diagnosis: transmitted by airborne droplets or vesicular fluid; patients are contagious from 2 days before onset of the rash until all lesions have crusted. The rash has a centripetal distribution - starting at the trunk and spreading to the
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Varicella virus
Excessive bleeding in amount - duration - or both at irregular intervals

8. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
A central clear area
DM - HTN - DVT - seizures - depression - or anxiety
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

9. What are signs of pulmonary congestion?
Coronary artery disease/ angina
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Impetigo

10. PE for a patient getting an abnormal vaginal bleeding work up
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Hypertension - CAD - valvular heart disease
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

11. SE Of Beta blockers?
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
Molluscum contagiosum- pox virus
LH surge triggers ovulation
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

12. Metrorrhagia
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
GERD
Associated with hypotension
Irregular bleeding between cycles

13. What is the Barany maneuver?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Fever with frontal or maxillary tenderness

14. Pneumonia tx: suitable for healthy adults less than 60
Generalized Anxiety disorder and panic disorder
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
CT
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

15. Prenatal visit schedule for low-risk pregnancies
Less than 3 stools per week
A central clear area
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
With a KOH wet mount preparation

16. What are the signs of acute sinusitis?
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
Other brainstem or cranial nerve findings
Fever with frontal or maxillary tenderness

17. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
True
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Less abrupt onset and cessation of palpitations

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

19. After treatment of dysplasia - women need Pap smears every...
Subarachnoid hemorrhage
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Higher filling presure - pulmonary congestion - and decreasd cardiac return

20. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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
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

21. Menometrorrhagia
E. Coli O157:H7
Excessive bleeding in amount - duration - or both at irregular intervals
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

22. What should preconception counseling include?
Intermenstrual bleeding
Less than 3 stools per week
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
Menorrhagia

23. Why is the pap smear one of the most effective cancer screening tools?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Slow progression of cervical cancer changes -Availability of effective early treatment

24. Tx of chronic or intermittent afibs
Anticoag with warfarin to prevent thromboembolism
PVC or Premature atrial contraction (PAC)
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

25. Name the diagnosis of heartburn: regurgitation - dysphagia
1)Promoting Na+retention 2) Promoting hypertrophy and hyperplasia of vascular smooth muscles through its mitogenic properties 3) Modifying ion transport - leading to increase in intracellular Ca2+ 4) Sympathetic activation
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
GERD

26. What is an acoustic neuroma?
Warts
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

27. How are fungal infections diagnosed?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
With a KOH wet mount preparation
Adhesive capsulitis (frozen shoulder): most common in middle age women

28. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Kids: Rotavirus Adults: Norwalk Virus
Viral gastroenteritis
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
Less abrupt onset and cessation of palpitations

29. How does systolic vs. diastolic heart failure present on the echocardiogram?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
>3.5g of protein per 24hrs
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

30. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Non-cardiac causes of palpitations
Staphylococcal scalded skin syndrome
A 24hr urine protein collection and urine creatinine clearance determination
Wolff-Parkinson-White syndrome

31. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear

32. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Diuretics -BB -CCB -ACEi
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Regular bleeding at intervals of more than 35 days

33. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Rotator Cuff tendonitis
Tension headache
Impetigo
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

34. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Less than 80 ml of blood

35. What does treatment for migrans include?
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
Scabies
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

36. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Medication or chemical esophagitis
Dehydration - anemia - cardiac causes
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Bulk forming: Psyllium - Methycellulose - Polycarbophil

37. name the 4 emergent causes of chest pain
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
Less abrupt onset and cessation of palpitations
PE - MI - aortic dissection - pneumothorax
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

38. Describe the presentation of angina?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
Cholelithiasis
Increase; 200 g/day

39. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Furucnle
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

40. How can GERD (or esophageal motility disorders) lead to chest pain?
Tension headache
Polymenorrhea
Nonulcer dyspepsia
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

41. How is constipation clinically defined?
Less than 3 stools per week
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
PE - MI - aortic dissection - pneumothorax

42. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
Streptococci
Echocardiogram
Kids: Rotavirus Adults: Norwalk Virus

43. Who should have Xray testing for shoulder pain?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Acute headache - ataxia - profuse nausea - and vomiting
Cellulitis

44. What is considered normal blood loss during a menstrual cycle?
Loop diuretics (Check serum K+ levels before drug admin)
Albumin; low molecular weight proteins
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Less than 80 ml of blood

45. What are the two common clinical presentations of acute diarrhea?
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

46. What are the indiciations for neuroimaging?
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
Menorrhagia
Folliculitis

47. 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.
Repeat Pap after infection treated
CT
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

48. What are the most common causes for the common cold?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Repeat Pap after infection treated
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

49. History for Acute bronchitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Molluscum contagiosum- pox virus

50. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
BB or CCB - catheter ablation of identified bypass tract
MSK - pulmonary - GI - or psychological
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
Diuretics -BB -CCB -ACEi