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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 are the signs of acute sinusitis?
Rotator Cuff problem
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Fever with frontal or maxillary tenderness

2. Describe the presentation of myocardial pain?
Cluster headache
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Infectious esophagitis
Bulk forming: Psyllium - Methycellulose - Polycarbophil

3. Prenatal visit schedule for low-risk pregnancies
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
Cluster headache
With a KOH wet mount preparation
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

4. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
100mg; means patient can be trace protein positive and not be detected
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
EGD

5. Name 4 factors that predispose an individual to develop pneumonia.
ACEi
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

6. Oligomenorrhea
PVC or Premature atrial contraction (PAC)
Regular bleeding at intervals of more than 35 days
Rotator cuff tendonitis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

7. Metrorrhagia
Infectious esophagitis
Irregular bleeding between cycles
PVC or Premature atrial contraction (PAC)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

8. At was quantity does urine dipstick test detect elevated protein?
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.
Supraspinatus and bicipital tendons
100mg; means patient can be trace protein positive and not be detected
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

9. What are the most common viral causes of diarrhea in kids and adults?
Cluster headache
S. aureus- beta hemolytic streptococcus
Kids: Rotavirus Adults: Norwalk Virus
True

10. Pain in shoulder when throwing - swimming - or serving a tennis ball
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Rotator cuff tendonitis
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

11. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Medication or chemical esophagitis
Pancreatitis
Rotator Cuff problem
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

12. 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.
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Tension headache
DM - HTN - DVT - seizures - depression - or anxiety
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

13. Describe the presentation of angina?
Coronary artery disease/ angina
Generalized Anxiety disorder and panic disorder
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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

14. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
GERD
Giardia
RBC casts and old to moderate HTN

15. After treatment of dysplasia - women need Pap smears every...
Temporal arteritis-biopsy of the temporal artery
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
GERD

16. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Upper sternal area burning pain - associated with a productive cough
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. When does troponin rise following myocardial injury or infarction?
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
Menorrhagia
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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

18. What is benign transient proteinuria?
Impetigo
E. Coli O157:H7
Common problem that resolves spontaneously and is most often seen in children and young adults
HPV testing -Pos=colposcopy -Neg=repeat pap smear

19. Name some medications that can cause proteinuria
Increase; 200 g/day
Cluster headache
E. Coli O157:H7
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

20. What is the goal of CHF treatment? What drugs should be used?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Analgesic headache
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

21. Name types of laxatives
Increase; 200 g/day
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Less than 80 ml of blood
Pancreatitis

22. What are signs of pulmonary congestion?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
S. Aureus
Tension headache

23. What microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
MSK - pulmonary - GI - or psychological
Dehydration - anemia - cardiac causes
Echocardiogram
E. Coli O157:H7

24. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
With a KOH wet mount preparation
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
Fever with frontal or maxillary tenderness

25. What test done in PE measures instability of shoulder?
Scabies
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
A 24hr urine protein collection and urine creatinine clearance determination
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

26. What does treatment for migrans include?
A 24hr urine protein collection and urine creatinine clearance determination
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
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.
Warts

27. What diagnosis does the 'worse headache of my life' suggest?
Cellulitis
Supraspinatus and bicipital tendons
Folliculitis
Subarachnoid hemorrhage

28. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
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.
Repeat Pap after infection treated
CT
Furucnle

29. Name the skin lesion: honey colored crusts
100mg; means patient can be trace protein positive and not be detected
Intermenstrual bleeding
Impetigo
Viral infection of the semicircular apparatus

30. Where does the development of abnormal cervical cells begin?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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
Squamocolumnar junction=most common site of cervical cancer
When the patient has symptoms in association with exercise or who describe chest pain or pressure

31. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
CBC
Chest pain during pneumonia or PE
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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

32. How to NSAIDs contribute to gastritis and ulcer formation?
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.
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Pancreatitis
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

33. How is constipation clinically defined?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Analgesic headache
Less than 3 stools per week
LH surge triggers ovulation

34. 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
Varicella virus
Increasing fluid (8 - 8oz glasses of water/day) -fiber

35. What are symptoms are CHF?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
24 hour halter
Supraspinatus and bicipital tendons
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

36. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Generalized Anxiety disorder and panic disorder
ACEi - ARBS - thiazide diuretics
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

37. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
MSK - pulmonary - GI - or psychological
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

38. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
Giardia
Cholelithiasis
CT

39. 1+ protein level on urine dipstick usually represents how much protein in the urine?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
LH surge triggers ovulation
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Polymenorrhea

40. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Viral infection of the semicircular apparatus
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Scleroderma/polymyositis with secondary gastroesophageal reflux

41. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Molluscum contagiosum- pox virus
Pts with palpitations and dizziness - near syncope - or syncope
Less than 80 ml of blood
Scleroderma/polymyositis with secondary gastroesophageal reflux

42. How do you define persistent protein uria?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Acute headache - ataxia - profuse nausea - and vomiting
Presence of proteinuria on at least two separate ocassion
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

43. What are the signs of malignant hypertension?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
High blood pressure - focal neurologic defecit - or papilledema
Giardia
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

44. Describe the history and PE of patient presenting with common cold
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
With a KOH wet mount preparation
Staphylococcal scalded skin syndrome
Infectious esophagitis

45. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
Streptococci
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

46. Menometrorrhagia
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
Excessive bleeding in amount - duration - or both at irregular intervals
LH surge triggers ovulation
When the patient has symptoms in association with exercise or who describe chest pain or pressure

47. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
Pain
Echocardiogram

48. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Temporal arteritis-biopsy of the temporal artery
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

49. When should invasive eletrophysiologic study should be considered?
A 24hr urine protein collection and urine creatinine clearance determination
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

50. name the 4 emergent causes of chest pain
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
PE - MI - aortic dissection - pneumothorax
Infectious esophagitis
Pain