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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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. Discomfort with abducting the arm past 90 degress
LH surge triggers ovulation
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Rotator Cuff tendonitis
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

2. What is afterload?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Presence of proteinuria on at least two separate ocassion
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
High blood pressure - focal neurologic defecit - or papilledema

3. What are symptoms are CHF?
Cervical radiculopathy
Kids: Rotavirus Adults: Norwalk Virus
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Generalized Anxiety disorder and panic disorder

4. Define nephrotic range proteinuria
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
>3.5g of protein per 24hrs
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Tension headache

5. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Possibility of Ischemic colitis

6. 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
Diuretics -BB -CCB -ACEi
Scabies
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

7. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
When the patient has symptoms in association with exercise or who describe chest pain or pressure
PE - MI - aortic dissection - pneumothorax

8. What should preconception counseling include?
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
Staphylococcal scalded skin syndrome
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
Hypertension - CAD - valvular heart disease

9. What is the caUse of benign positional vertigo?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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.

10. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

11. 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
RBC casts and old to moderate HTN
Rotator cuff tendonitis
LH surge triggers ovulation

12. Chronic pain and shoulder stiffness with limited motion
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Adhesive capsulitis (frozen shoulder): most common in middle age women
HPV
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

13. Shoulder pain with pain radiating to elbow
Peptic ulcer disease or gastritis
MSK - pulmonary - GI - or psychological
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
Cervical radiculopathy

14. Name some medications that can cause proteinuria
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
True
Folliculitis
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

15. Who should have Xray testing for shoulder pain?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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

16. How does systolic vs. diastolic heart failure present on the echocardiogram?
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
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
Rotator Cuff tendonitis
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

17. 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.
Wolff-Parkinson-White syndrome
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Presence of proteinuria on at least two separate ocassion
Tension headache

18. Carcinoma in situ is generally referred to a gynecologist and requires ______
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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

19. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
>150mg per 24hrs
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Varicella virus
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

20. How are fungal infections diagnosed?
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
With a KOH wet mount preparation
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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

21. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
BB or CCB - catheter ablation of identified bypass tract
Molluscum contagiosum- pox virus
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

22. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Coag disorders
Fever with frontal or maxillary tenderness

23. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Possibility of Ischemic colitis
Staphylococcal scalded skin syndrome
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
BB or CCB - catheter ablation of identified bypass tract

24. Name types of laxatives
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

25. Why is the pap smear one of the most effective cancer screening tools?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Slow progression of cervical cancer changes -Availability of effective early treatment
Less than 3 stools per week
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

26. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Streptococci
Repeat Pap after infection treated

27. Define the patient population typically affected by orthostatic or postural proteinuria
A 24hr urine protein collection and urine creatinine clearance determination
Wolff-Parkinson-White syndrome
24 hour halter
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

28. Oligomenorrhea
Lightheadedness - dizziness - syncope
Candida albicans
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Regular bleeding at intervals of more than 35 days

29. What is the Epley maneuver?
Pancreatitis
Upper sternal area burning pain - associated with a productive cough
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.
Tension headache

30. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ 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
GERD
Scleroderma/polymyositis with secondary gastroesophageal reflux
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

31. What occurs after ovulation
Diuretics -BB -CCB -ACEi
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Adhesive capsulitis (frozen shoulder): most common in middle age women
Acute headache - ataxia - profuse nausea - and vomiting

32. What are the features of nephrotic syndrome?
>150mg per 24hrs
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
ACEi - ARBS - thiazide diuretics
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

33. name the 4 emergent causes of chest pain
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Scabies
PE - MI - aortic dissection - pneumothorax
Loop diuretics (Check serum K+ levels before drug admin)

34. What are the signs of acute sinusitis?
GERD
Fever with frontal or maxillary tenderness
Less than 80 ml of blood
True

35. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Tension headache
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
LH surge triggers ovulation

36. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
True
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
Viral infection of the semicircular apparatus

37. Describes what occurs during squamous metaplasia of the cervix.
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Rotator cuff tendonitis
Cluster headache

38. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

39. 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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
These patients are associated with low renin states=less likely to respond to medication
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

40. 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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Medication or chemical esophagitis
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. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Variability in the time for follicle development during the proliferative phase
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
PVC or Premature atrial contraction (PAC)

42. Describe the presentation of angina?
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.
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
Scabies
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

43. 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
Warts
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Staphylococcal scalded skin syndrome
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

44. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
Lightheadedness - dizziness - syncope
Generalized Anxiety disorder and panic disorder
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

45. How is constipation clinically defined?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
EGD
Less than 3 stools per week
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

46. History for Acute bronchitis
Diuretics -BB -CCB -ACEi
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
E. Coli O157:H7

47. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
CBC
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Candida albicans
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

48. Pain in shoulder when throwing - swimming - or serving a tennis ball
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Rotator cuff tendonitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Pain

49. 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
DM - HTN - DVT - seizures - depression - or anxiety
Staphylococcal scalded skin syndrome
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Molluscum contagiosum- pox virus

50. What are the most common causes for the common cold?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Hypertension - CAD - valvular heart disease
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.