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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
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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. Things that need to be included in history of shoulder pain
Dehydration - anemia - cardiac causes
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Bence-Jones
With a KOH wet mount preparation

2. Tx of chronic or intermittent afibs
Cellulitis
Anticoag with warfarin to prevent thromboembolism
Increase; 200 g/day
Upper sternal area burning pain - associated with a productive cough

3. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Increase; 200 g/day
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

4. What is the Epley maneuver?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Regular bleeding at intervals of more than 35 days
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.

5. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Pleurisy
Candida albicans
Rotator Cuff problem
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

6. How does systolic vs. diastolic heart failure present on the echocardiogram?
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Hgb - Electrolytes - and TSH
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

7. What are the three types of lice?
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.
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Candida albicans
HPV

8. Diarrhea from custard filled pastries
BB or CCB - catheter ablation of identified bypass tract
S. Aureus
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
PVC or Premature atrial contraction (PAC)

9. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
True
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
Varicella virus
Cellulitis

10. Natural history of cervical cancer
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Dehydration - anemia - cardiac causes

11. HIgh risk pregnant patients should be evaluated for ____ and ____
Irregular bleeding between cycles
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
HIV and syphilis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

12. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Slow progression of cervical cancer changes -Availability of effective early treatment
Infectious esophagitis
Rotator cuff tendonitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

13. Treatment for supraventricular tachycardias
Bulk forming: Psyllium - Methycellulose - Polycarbophil
BB or CCB - catheter ablation of identified bypass tract
Medication or chemical esophagitis
Coag disorders

14. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

15. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Pain
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
CT
Furucnle

16. 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
MSK - pulmonary - GI - or psychological
Giardia
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

17. Describe the presentation of myocardial pain?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Common problem that resolves spontaneously and is most often seen in children and young adults
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

18. When is a lumbar puncture contraindicated?
DM - HTN - DVT - seizures - depression - or anxiety
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Pancreatitis
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

19. What are the features of nephrotic syndrome?
Tension headache
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Varicella virus
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

20. History for Sinusitis

21. What places women at higher risk of getting cervical cancer?
Tension headache
True
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

22. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Molluscum contagiosum- pox virus
Chest pain during pneumonia or PE
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

23. Describes what occurs during squamous metaplasia of the cervix.
Associated with hypotension
LH surge triggers ovulation
Furucnle
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

24. Name types of laxatives
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
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
Irregular bleeding between cycles

25. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Analgesic headache
CBC
GERD

26. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
HIV and syphilis
Generalized Anxiety disorder and panic disorder
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
Viral gastroenteritis

27. Initial treatment for Rhinosinusitis
Regular bleeding at intervals of more than 35 days
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
HPV

28. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Candida albicans
Increasing fluid (8 - 8oz glasses of water/day) -fiber

29. What are the consequences of diastolic dysfunction?
Upper sternal area burning pain - associated with a productive cough
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

30. 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.
Tension headache
Fever with frontal or maxillary tenderness
ACEi
Adhesive capsulitis (frozen shoulder): most common in middle age women

31. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Albumin; low molecular weight proteins
Diuretics -BB -CCB -ACEi
BB or CCB - catheter ablation of identified bypass tract
Non-cardiac causes of palpitations

32. 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.
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Variability in the time for follicle development during the proliferative phase
Supraspinatus and bicipital tendons
Non-cardiac causes of palpitations

33. Oligomenorrhea
Associated with hypotension
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Medication or chemical esophagitis
Regular bleeding at intervals of more than 35 days

34. What the consequences of decreased cardiac output?
Lightheadedness - dizziness - syncope
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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
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

35. Pain in shoulder when throwing - swimming - or serving a tennis ball
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Rotator cuff tendonitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

36. In regards to a Pap smear - What should be done if a patient has cervical inflammation from infections such as Chlamydia or yeast that may cause cells to appear abnormal.
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Repeat Pap after infection treated
Supraspinatus and bicipital tendons
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

37. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Possibility of Ischemic colitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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

38. Name 4 factors that predispose an individual to develop pneumonia.
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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Furucnle
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

39. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Warts
Viral infection of the semicircular apparatus
Adhesive capsulitis (frozen shoulder): most common in middle age women

40. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Candida albicans
BB or CCB - catheter ablation of identified bypass tract
Possibility of Ischemic colitis
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

41. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Non-cardiac causes of palpitations
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
Cholelithiasis
ACEi

42. History and PE for Pneumonia
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
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.
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
HPV

43. Clinical Manifestations of HTN
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
S. aureus- beta hemolytic streptococcus
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

44. SE Of Beta blockers?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

45. What is the caUse of benign positional vertigo?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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 infection of the semicircular apparatus

46. What are signs of pulmonary congestion?
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

47. Uterine bleeding between regular cycles
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
24 hour halter
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Intermenstrual bleeding

48. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Cholelithiasis
Acute headache - ataxia - profuse nausea - and vomiting
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
Rotator Cuff tendonitis

49. What are symptoms are CHF?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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

50. Shoulder pain with pain radiating to elbow
Intermenstrual bleeding
Cervical radiculopathy
Increase; 200 g/day
Peptic ulcer disease or gastritis