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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. Isolated - extra pounding beats
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Albumin; low molecular weight proteins
PVC or Premature atrial contraction (PAC)
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

2. What are the secondly causes of glomerular disease?
PVC or Premature atrial contraction (PAC)
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Scleroderma/polymyositis with secondary gastroesophageal reflux

3. What is an acoustic neuroma?
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
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.
24 hour halter
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

4. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
HIV and syphilis

5. Complete the sentence: pericarditis can cause frictional rub and......
Cervical radiculopathy
HPV
High blood pressure - focal neurologic defecit - or papilledema
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

6. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
MSK - pulmonary - GI - or psychological
Regular bleeding at intervals of more than 35 days
Cluster headache

7. What should preconception counseling include?
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
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
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.
Acute headache - ataxia - profuse nausea - and vomiting

8. 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
EGD
Rotator Cuff tendonitis
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

9. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Varicella virus
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Other brainstem or cranial nerve findings
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

10. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Staphylococcal scalded skin syndrome
Pain
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

11. Vaccines that should be updated before planned pregnancy
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Upper sternal area burning pain - associated with a productive cough
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Analgesic headache

12. 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.
Supraspinatus and bicipital tendons
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Regular bleeding at intervals of more than 35 days
Generalized Anxiety disorder and panic disorder

13. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
Cellulitis
Regular bleeding at intervals of more than 35 days
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

14. What does treatment for migrans include?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
Polymenorrhea
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

15. What are signs of pulmonary congestion?
CBC
Rotator Cuff tendonitis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
HPV testing -Pos=colposcopy -Neg=repeat pap smear

16. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
Rotator Cuff problem
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

17. What is the difference between a Holter monitor or an event monitor?
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
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
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
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

18. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Colposcopy - Endocervical curettage - and directed cervical biopsy
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.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

19. Four muscles of rotator cuff
Non-cardiac causes of palpitations
Squamocolumnar junction=most common site of cervical cancer
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

20. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Echocardiogram
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

21. SE Of Beta blockers?
HIV and syphilis
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Staphylococcal scalded skin syndrome

22. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Adhesive capsulitis (frozen shoulder): most common in middle age women
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Folliculitis

23. What test done in PE measures instability of shoulder?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Subarachnoid hemorrhage
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

24. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
CBC
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

25. What diagnosis does the 'worse headache of my life' suggest?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Subarachnoid hemorrhage
Dehydration - anemia - cardiac causes
Higher filling presure - pulmonary congestion - and decreasd cardiac return

26. How do you define persistent protein uria?
Wolff-Parkinson-White syndrome
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Presence of proteinuria on at least two separate ocassion

27. What is the caUse of Meniere disease? What are the cardinal symptoms?
ACEi - ARBS - thiazide diuretics
Repeat Pap after infection treated
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

28. What is the Barany maneuver?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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
S. aureus- beta hemolytic streptococcus
True

29. Describe the presentation of myocardial pain?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Variability in the time for follicle development during the proliferative phase

30. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Analgesic headache
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.
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

31. What is considered normal blood loss during a menstrual cycle?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Less than 80 ml of blood
>3.5g of protein per 24hrs

32. What is the role of LH in the menstrual cycle
Peptic ulcer disease or gastritis
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
LH surge triggers ovulation
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

33. Menometrorrhagia
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Excessive bleeding in amount - duration - or both at irregular intervals
PE - MI - aortic dissection - pneumothorax
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

34. What are the indiciations for neuroimaging?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Fever with frontal or maxillary tenderness
ACEi - ARBS - thiazide diuretics
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

35. What are the signs of cerebral hemorrhage?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Cholelithiasis
Less than 3 stools per week
Acute headache - ataxia - profuse nausea - and vomiting

36. Where does the development of abnormal cervical cells begin?
Albumin; low molecular weight proteins
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
Squamocolumnar junction=most common site of cervical cancer
Adhesive capsulitis (frozen shoulder): most common in middle age women

37. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Coronary artery disease/ angina
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
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.
MSK - pulmonary - GI - or psychological

38. Name the diagnosis of heartburn: regurgitation - dysphagia
GERD
Bence-Jones
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

39. Name the skin lesion: honey colored crusts
Impetigo
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Subarachnoid hemorrhage

40. What are the symptoms of palpitations?
These patients are associated with low renin states=less likely to respond to medication
Hgb - Electrolytes - and TSH
Lightheadedness - dizziness - syncope
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

41. What are the features of nephrotic syndrome?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Variability in the time for follicle development during the proliferative phase
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
When the patient has symptoms in association with exercise or who describe chest pain or pressure

42. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
HIV and syphilis
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Nonulcer dyspepsia
Viral infection of the semicircular apparatus

43. 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
High blood pressure - focal neurologic defecit - or papilledema
Lightheadedness - dizziness - syncope
Less than 80 ml of blood

44. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Non-cardiac causes of palpitations
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Albumin; low molecular weight proteins

45. Oligomenorrhea
Streptococci
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
With a KOH wet mount preparation
Regular bleeding at intervals of more than 35 days

46. Describe the history and PE of patient presenting with common cold
Cluster headache
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Serotypes 16 - 18 - 31 -52 -58

47. What is the peripheral caUse of vertigo?
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Bence-Jones
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

48. What is the Epley maneuver?
Hgb - Electrolytes - and TSH
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.
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Less abrupt onset and cessation of palpitations

49. History and PE for Pneumonia
Influenza - Rhinovirus - Adenovirus - Parainfluenza
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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
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

50. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Nonulcer dyspepsia
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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