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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. Define nephrotic range proteinuria
Cervical radiculopathy
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
>3.5g of protein per 24hrs
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

2. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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
Possibility of Ischemic colitis
Medication or chemical esophagitis
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

3. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Cellulitis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Analgesic headache
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

4. Name the diagnosis of heartburn: severe constant mid abdominal pain
Pancreatitis
Squamocolumnar junction=most common site of cervical cancer
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
100mg; means patient can be trace protein positive and not be detected

5. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Rotator Cuff problem
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
ACEi - ARBS - thiazide diuretics

6. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
HPV testing -Pos=colposcopy -Neg=repeat pap smear
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Albumin; low molecular weight proteins
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

7. After treatment of dysplasia - women need Pap smears every...
Generalized Anxiety disorder and panic disorder
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Staphylococcal scalded skin syndrome
Intermenstrual bleeding

8. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Associated with hypotension
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Warts
Cholelithiasis

9. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Streptococci
BB or CCB - catheter ablation of identified bypass tract
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
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.

10. What is afterload?
Anticoag with warfarin to prevent thromboembolism
Lightheadedness - dizziness - syncope
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Chest pain during pneumonia or PE

11. When should invasive eletrophysiologic study should be considered?
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Molluscum contagiosum- pox virus
CBC

12. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Pleurisy
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

13. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
Slow progression of cervical cancer changes -Availability of effective early treatment
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

14. What are the primary glomerular diseases?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
PE - MI - aortic dissection - pneumothorax
Acute headache - ataxia - profuse nausea - and vomiting

15. What drugs do you use to treat H.pylori + PUD?
Supraspinatus and bicipital tendons
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

16. 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
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Repeat Pap after infection treated

17. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Echocardiogram
Bence-Jones

18. What occurs after ovulation
EGD
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Irregular bleeding between cycles

19. What is the next best step if a patient has two or more positive dipstick tests?
DM - HTN - DVT - seizures - depression - or anxiety
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
A 24hr urine protein collection and urine creatinine clearance determination
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

20. 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
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
E. Coli O157:H7
Folliculitis

21. 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
Rotator Cuff problem
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Varicella virus

22. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Possibility of Ischemic colitis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Molluscum contagiosum- pox virus

23. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
>150mg per 24hrs
MSK - pulmonary - GI - or psychological
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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

24. Uterine bleeding between regular cycles
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Repeat Pap after infection treated
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Intermenstrual bleeding

25. Regular bleeding at intervals of less than 21 days
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
Scabies
Polymenorrhea
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

26. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Slow progression of cervical cancer changes -Availability of effective early treatment
HPV
With a KOH wet mount preparation
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

27. Irregular cycles with excessive flow - duration - or both
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Menorrhagia
Less than 80 ml of blood
Lightheadedness - dizziness - syncope

28. Describes what occurs during squamous metaplasia of the cervix.
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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
MSK - pulmonary - GI - or psychological

29. Define the patient population typically affected by orthostatic or postural proteinuria
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
Rotator Cuff problem

30. Diagnosis of HTN
Rotator Cuff problem
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Slow progression of cervical cancer changes -Availability of effective early treatment

31. 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
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
Possibility of Ischemic colitis
Molluscum contagiosum- pox virus
CBC

32. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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

33. When does troponin rise following myocardial injury or infarction?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
CT
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Anticoag with warfarin to prevent thromboembolism

34. Natural history of cervical cancer
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Impetigo

35. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
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
Candida albicans
Molluscum contagiosum- pox virus

36. What are the two common clinical presentations of acute diarrhea?
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Acute headache - ataxia - profuse nausea - and vomiting
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

37. At was quantity does urine dipstick test detect elevated protein?
HPV
High blood pressure - focal neurologic defecit - or papilledema
100mg; means patient can be trace protein positive and not be detected
Adhesive capsulitis (frozen shoulder): most common in middle age women

38. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Echocardiogram
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

39. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Paroxysmal atrial fibrillation or supraventricular tachycardia
Impetigo
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

40. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Loop diuretics (Check serum K+ levels before drug admin)
Pleurisy
E. Coli O157:H7
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

41. Describe the presentation tracheobronchitis
Presence of proteinuria on at least two separate ocassion
Upper sternal area burning pain - associated with a productive cough
CT
Rotator Cuff tendonitis

42. What are the three major risk factors for heart failure?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Hypertension - CAD - valvular heart disease
Subarachnoid hemorrhage
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

43. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Infectious esophagitis
Acute headache - ataxia - profuse nausea - and vomiting

44. Name the diagnosis of heartburn: regurgitation - dysphagia
Pain
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
GERD
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

45. Where does the development of abnormal cervical cells begin?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Analgesic headache
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Squamocolumnar junction=most common site of cervical cancer

46. Define proteinuria
>150mg per 24hrs
Streptococci
Other brainstem or cranial nerve findings
A 24hr urine protein collection and urine creatinine clearance determination

47. Shoulder pain with pain radiating to elbow
Cervical radiculopathy
A central clear area
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
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

48. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

49. Name the skin lesion: pustule in association with a hair follice
Folliculitis
Less abrupt onset and cessation of palpitations
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
Paroxysmal atrial fibrillation or supraventricular tachycardia

50. Treatment for supraventricular tachycardias
100mg; means patient can be trace protein positive and not be detected
BB or CCB - catheter ablation of identified bypass tract
PVC or Premature atrial contraction (PAC)
Serotypes 16 - 18 - 31 -52 -58