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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. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
24 hour halter
Irregular bleeding between cycles

2. What is the role of LH in the menstrual cycle
Irregular bleeding between cycles
LH surge triggers ovulation
Other brainstem or cranial nerve findings
Less than 3 stools per week

3. What are the three major risk factors for heart failure?
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
Hypertension - CAD - valvular heart disease
Albumin; low molecular weight proteins
Cellulitis

4. What should preconception counseling include?
EGD
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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

5. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Scleroderma/polymyositis with secondary gastroesophageal reflux
HPV
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

6. Name types of laxatives
Acute headache - ataxia - profuse nausea - and vomiting
HPV testing -Pos=colposcopy -Neg=repeat pap smear
PVC or Premature atrial contraction (PAC)
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

7. Pain in shoulder when throwing - swimming - or serving a tennis ball
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Rotator cuff tendonitis
Pts with palpitations and dizziness - near syncope - or syncope
High blood pressure - focal neurologic defecit - or papilledema

8. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Scabies
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
MSK - pulmonary - GI - or psychological
Slow progression of cervical cancer changes -Availability of effective early treatment

9. Things that need to be included in history of shoulder pain
EGD
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
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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

10. History and PE for Pneumonia
Streptococci
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
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
Cluster headache

11. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Pts with palpitations and dizziness - near syncope - or syncope
Repeat Pap after infection treated
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
Scabies

12. What should blood work include for suspected heart failure?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Possibility of Ischemic colitis
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Echocardiogram

13. Describe the presentation tracheobronchitis
Coronary artery disease/ angina
Upper sternal area burning pain - associated with a productive cough
>3.5g of protein per 24hrs
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

14. Diarrhea from custard filled pastries
Bulk forming: Psyllium - Methycellulose - Polycarbophil
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Impetigo
S. Aureus

15. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Regular bleeding at intervals of more than 35 days
Streptococci
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Squamocolumnar junction=most common site of cervical cancer

16. Describe the presentation of pericardial pain
Wolff-Parkinson-White syndrome
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

17. Describe the presentation of pneumonia
Supraspinatus and bicipital tendons
Scabies
These patients are associated with low renin states=less likely to respond to medication
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

18. What is benign transient proteinuria?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Common problem that resolves spontaneously and is most often seen in children and young adults
LH surge triggers ovulation
Scabies

19. What are symptoms are CHF?
HIV and syphilis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Hgb - Electrolytes - and TSH
Cellulitis

20. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Cholelithiasis
With a KOH wet mount preparation
HPV
S. aureus- beta hemolytic streptococcus

21. What is the preload?
Pts with palpitations and dizziness - near syncope - or syncope
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

22. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
S. Aureus
Analgesic headache
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
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

23. Clinical Manifestations of HTN
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Rotator Cuff tendonitis
Albumin; low molecular weight proteins
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

24. What is the Epley maneuver?
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
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
CT

25. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

26. What are the signs of malignant hypertension?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Squamocolumnar junction=most common site of cervical cancer
Excessive bleeding in amount - duration - or both at irregular intervals
High blood pressure - focal neurologic defecit - or papilledema

27. What is the peripheral caUse of vertigo?
Cervical radiculopathy
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Staphylococcal scalded skin syndrome
24 hour halter

28. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Generalized Anxiety disorder and panic disorder
Rotator Cuff tendonitis
Paroxysmal atrial fibrillation or supraventricular tachycardia
Increase; 200 g/day

29. What drugs do you use to treat H.pylori + PUD?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Nonulcer dyspepsia
Bence-Jones

30. What diagnosis does the 'worse headache of my life' suggest?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Subarachnoid hemorrhage
S. aureus- beta hemolytic streptococcus
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

31. 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
HPV
Cluster headache
Cellulitis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

32. Name the skin lesion: honey colored crusts
Excessive bleeding in amount - duration - or both at irregular intervals
Warts
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Impetigo

33. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Nonulcer dyspepsia
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
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
Slow progression of cervical cancer changes -Availability of effective early treatment

34. What is a markers of CNS vertigo?
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
Other brainstem or cranial nerve findings
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Albumin; low molecular weight proteins

35. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Dehydration - anemia - cardiac causes
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Viral gastroenteritis

36. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
CBC
HIV and syphilis

37. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Presence of proteinuria on at least two separate ocassion
Infectious esophagitis
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

38. Why don't ACEi work well for the elderly and African Americans when treating HTN?
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
These patients are associated with low renin states=less likely to respond to medication
BB or CCB - catheter ablation of identified bypass tract
E. Coli O157:H7

39. Prenatal visit schedule for low-risk pregnancies
GERD
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
HPV
Viral gastroenteritis

40. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Echocardiogram
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Pleurisy

41. What are the most common viral causes of diarrhea in kids and adults?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Excessive bleeding in amount - duration - or both at irregular intervals
Kids: Rotavirus Adults: Norwalk Virus

42. Diagnostic Evaluation of Abnoraml vaginal bleeding
Furucnle
Rotator Cuff tendonitis
Coronary artery disease/ angina
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

43. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
S. aureus- beta hemolytic streptococcus
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

44. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
NSAIDs block COX-1 production of prostaglandins that maintain mucosal blood flow - secretion of mucus - and bicarbonate. Without these protective factors - acid-induced inflammation and ulcers my result.
>150mg per 24hrs
Scabies

45. Define the patient population typically affected by orthostatic or postural proteinuria
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
Other brainstem or cranial nerve findings
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

46. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Streptococci
Scleroderma/polymyositis with secondary gastroesophageal reflux
Loop diuretics (Check serum K+ levels before drug admin)
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

47. 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.
Presence of proteinuria on at least two separate ocassion
Furucnle
Supraspinatus and bicipital tendons
Echocardiogram

48. Regular bleeding at intervals of less than 21 days
Intermenstrual bleeding
Tension headache
Polymenorrhea
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

49. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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
HPV

50. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Pts with palpitations and dizziness - near syncope - or syncope
Increase; 200 g/day
Higher filling presure - pulmonary congestion - and decreasd cardiac return