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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. What is the Barany maneuver?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Temporal arteritis-biopsy of the temporal artery
Staphylococcal scalded skin syndrome

2. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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

3. How do you define persistent protein uria?
Serotypes 16 - 18 - 31 -52 -58
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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
Presence of proteinuria on at least two separate ocassion

4. 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
>3.5g of protein per 24hrs
Cluster headache
Subarachnoid hemorrhage
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

5. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
High blood pressure - focal neurologic defecit - or papilledema
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

6. What is the standard tool used for diagnosis of GERD?
EGD
Menorrhagia
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
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

7. What is the caUse of benign positional vertigo?
Upper sternal area burning pain - associated with a productive cough
Pancreatitis
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.
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

8. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Lightheadedness - dizziness - syncope
Medication or chemical esophagitis

9. How is constipation clinically defined?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Less than 3 stools per week
Peptic ulcer disease or gastritis
Anticoag with warfarin to prevent thromboembolism

10. How can GERD (or esophageal motility disorders) lead to chest pain?
Increase; 200 g/day
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

11. 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)
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
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

12. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Pts with palpitations and dizziness - near syncope - or syncope
Wolff-Parkinson-White syndrome
A 24hr urine protein collection and urine creatinine clearance determination

13. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Impetigo
Hypertension - CAD - valvular heart disease
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Tension headache

14. Difference between Pneumonia and Bronchitis
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
Kids: Rotavirus Adults: Norwalk Virus
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

15. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Rotator Cuff tendonitis
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

16. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
PE - MI - aortic dissection - pneumothorax
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
Staphylococcal scalded skin syndrome
Adhesive capsulitis (frozen shoulder): most common in middle age women

17. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Upper sternal area burning pain - associated with a productive cough
Chest pain during pneumonia or PE
DM - HTN - DVT - seizures - depression - or anxiety
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

18. What is the role of LH in the menstrual cycle
Hypertension - CAD - valvular heart disease
LH surge triggers ovulation
Streptococci
Colposcopy - Endocervical curettage - and directed cervical biopsy

19. What medications can cause heart palpitations?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Pancreatitis
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
Colposcopy - Endocervical curettage - and directed cervical biopsy

20. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Excessive bleeding in amount - duration - or both at irregular intervals
Infectious esophagitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

21. How does CHF present on X-ray?
S. aureus- beta hemolytic streptococcus
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
These patients are associated with low renin states=less likely to respond to medication
E. Coli O157:H7

22. Describe the presentation tracheobronchitis
Wolff-Parkinson-White syndrome
Possibility of Ischemic colitis
PE - MI - aortic dissection - pneumothorax
Upper sternal area burning pain - associated with a productive cough

23. What are the three types of lice?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Coronary artery disease/ angina
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Echocardiogram

24. Name 4 factors that predispose an individual to develop pneumonia.
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Lightheadedness - dizziness - syncope

25. Regular bleeding at intervals of less than 21 days
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Menorrhagia
Polymenorrhea
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

26. What are the signs of cerebral hemorrhage?
Varicella virus
Polymenorrhea
These patients are associated with low renin states=less likely to respond to medication
Acute headache - ataxia - profuse nausea - and vomiting

27. 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
Varicella virus
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
PVC or Premature atrial contraction (PAC)

28. When should invasive eletrophysiologic study should be considered?
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
Adhesive capsulitis (frozen shoulder): most common in middle age women
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

29. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Less abrupt onset and cessation of palpitations
These patients are associated with low renin states=less likely to respond to medication
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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

30. What should preconception counseling include?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
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
Associated with hypotension

31. Why is the pap smear one of the most effective cancer screening tools?
Rotator Cuff tendonitis
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
Slow progression of cervical cancer changes -Availability of effective early treatment
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

32. Who should have Xray testing for shoulder pain?
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Acute headache - ataxia - profuse nausea - and vomiting
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

33. Cycle length variabilty is primarily due to what?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Adhesive capsulitis (frozen shoulder): most common in middle age women
Variability in the time for follicle development during the proliferative phase
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

34. What are the 2 psych disorders most commonly associated with palpitations?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Generalized Anxiety disorder and panic disorder
HIV and syphilis
Fever with frontal or maxillary tenderness

35. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Acute headache - ataxia - profuse nausea - and vomiting
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Cholelithiasis

36. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Polymenorrhea
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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
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

37. Name the skin lesion: erythema - warmth - edema - pain - fever
Candida albicans
Cervical radiculopathy
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
Cellulitis

38. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Anticoag with warfarin to prevent thromboembolism
High blood pressure - focal neurologic defecit - or papilledema
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
Non-cardiac causes of palpitations

39. 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
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Warts
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

40. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Molluscum contagiosum- pox virus
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Diuretics -BB -CCB -ACEi

41. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
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
Staphylococcal scalded skin syndrome
Fever with frontal or maxillary tenderness

42. History for Acute bronchitis
PVC or Premature atrial contraction (PAC)
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
CT
Cluster headache

43. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
HIV and syphilis
Irregular bleeding between cycles
Polymenorrhea

44. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
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
Adhesive capsulitis (frozen shoulder): most common in middle age women
Presence of proteinuria on at least two separate ocassion

45. Pain in shoulder when throwing - swimming - or serving a tennis ball
Pts with palpitations and dizziness - near syncope - or syncope
24 hour halter
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Rotator cuff tendonitis

46. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Anticoag with warfarin to prevent thromboembolism
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Viral gastroenteritis

47. What are the symptoms of palpitations?
Lightheadedness - dizziness - syncope
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.
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 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

48. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Warts
MSK - pulmonary - GI - or psychological

49. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Giardia
Viral infection of the semicircular apparatus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

50. MI - pericardial tamponade - PE - GI bleed - are...
Pancreatitis
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Associated with hypotension
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal