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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. Difference between Pneumonia and Bronchitis
BB or CCB - catheter ablation of identified bypass tract
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
Acute headache - ataxia - profuse nausea - and vomiting
Higher filling presure - pulmonary congestion - and decreasd cardiac return

2. What are the consequences of diastolic dysfunction?
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
Candida albicans
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Anticoag with warfarin to prevent thromboembolism

3. History and PE for Pneumonia
Cluster headache
True
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
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

4. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Less than 80 ml of blood
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
ACEi - ARBS - thiazide diuretics

5. Shoulder pain with pain radiating to elbow
LH surge triggers ovulation
Lightheadedness - dizziness - syncope
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Cervical radiculopathy

6. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
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
High blood pressure - focal neurologic defecit - or papilledema
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.

7. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
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
S. aureus- beta hemolytic streptococcus
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Pain

8. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
24 hour halter
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

9. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Colposcopy - Endocervical curettage - and directed cervical biopsy
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Lightheadedness - dizziness - syncope
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

10. 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
E. Coli O157:H7
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
Slow progression of cervical cancer changes -Availability of effective early treatment
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

11. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
PVC or Premature atrial contraction (PAC)
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Warts

12. What is the difference between a Holter monitor or an event monitor?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
Upper sternal area burning pain - associated with a productive cough
S. Aureus

13. Treatment for supraventricular tachycardias
Staphylococcal scalded skin syndrome
Less than 80 ml of blood
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
BB or CCB - catheter ablation of identified bypass tract

14. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Polymenorrhea
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

15. What places women at higher risk of getting cervical cancer?
Rotator Cuff tendonitis
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.
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
Rotator Cuff problem

16. Define proteinuria
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
>150mg per 24hrs
Tension headache
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

17. What are the signs of cerebral hemorrhage?
True
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Acute headache - ataxia - profuse nausea - and vomiting
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

18. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Giardia
Polymenorrhea
PVC or Premature atrial contraction (PAC)
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

19. After treatment of dysplasia - women need Pap smears every...
Rotator Cuff problem
True
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

20. Diarrhea is defined as an ____ in stool weight to more than ____g per day
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
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
Increase; 200 g/day
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

21. 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
Common problem that resolves spontaneously and is most often seen in children and young adults
Molluscum contagiosum- pox virus
Excessive bleeding in amount - duration - or both at irregular intervals
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

22. 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
Pts with palpitations and dizziness - near syncope - or syncope
CT
Repeat Pap after infection treated
Cluster headache

23. 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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Adhesive capsulitis (frozen shoulder): most common in middle age women

24. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Fever with frontal or maxillary tenderness
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Medication or chemical esophagitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

25. What is the peripheral caUse of vertigo?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Coronary artery disease/ angina
>150mg per 24hrs
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

26. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
Repeat Pap after infection treated
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

27. What is the mechanism of action for stimulant agents in treating constipation?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
100mg; means patient can be trace protein positive and not be detected
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
Less abrupt onset and cessation of palpitations

28. What are the three types of lice?
Bence-Jones
Coronary artery disease/ angina
Impetigo
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

29. What drugs do you use to treat H.pylori + PUD?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
24 hour halter

30. Describe the presentation of myocardial pain?
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Loop diuretics (Check serum K+ levels before drug admin)
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

31. Regular bleeding at intervals of less than 21 days
HPV
Polymenorrhea
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
Furucnle

32. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Candida albicans
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

33. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Less abrupt onset and cessation of palpitations
Temporal arteritis-biopsy of the temporal artery
Other brainstem or cranial nerve findings

34. What are the common causes for laryngitis?
Candida albicans
Streptococci
Influenza - Rhinovirus - Adenovirus - Parainfluenza
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

35. Metrorrhagia
RBC casts and old to moderate HTN
Irregular bleeding between cycles
High blood pressure - focal neurologic defecit - or papilledema
True

36. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
PE - MI - aortic dissection - pneumothorax
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
Possibility of Ischemic colitis
Peptic ulcer disease or gastritis

37. Predictors of cardiac etiology
S. aureus- beta hemolytic streptococcus
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
Anticoag with warfarin to prevent thromboembolism
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

38. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Cellulitis
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Hgb - Electrolytes - and TSH

39. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
Hgb - Electrolytes - and TSH
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Dehydration - anemia - cardiac causes

40. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
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
Impetigo
Pts with palpitations and dizziness - near syncope - or syncope
Paroxysmal atrial fibrillation or supraventricular tachycardia

41. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Serotypes 16 - 18 - 31 -52 -58
HPV testing -Pos=colposcopy -Neg=repeat pap smear
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

42. How do you know if heart palpitations are due to stimulant or medication use?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
HPV
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Less abrupt onset and cessation of palpitations

43. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Bence-Jones
Staphylococcal scalded skin syndrome
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
HPV

44. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
High blood pressure - focal neurologic defecit - or papilledema
Dehydration - anemia - cardiac causes
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
DM - HTN - DVT - seizures - depression - or anxiety

45. Clinical Manifestations of HTN
Variability in the time for follicle development during the proliferative phase
Cervical radiculopathy
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

46. What are the three major risk factors for heart failure?
Kids: Rotavirus Adults: Norwalk Virus
Polymenorrhea
Hypertension - CAD - valvular heart disease
Adhesive capsulitis (frozen shoulder): most common in middle age women

47. Oligomenorrhea
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Pancreatitis
Regular bleeding at intervals of more than 35 days

48. What are the signs of malignant hypertension?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
High blood pressure - focal neurologic defecit - or papilledema

49. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Viral infection of the semicircular apparatus
Menorrhagia
Bence-Jones

50. What the consequences of decreased cardiac output?
Supraspinatus and bicipital tendons
Less than 3 stools per week
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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