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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. What are the secondly causes of glomerular disease?
Colposcopy - Endocervical curettage - and directed cervical biopsy
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

2. What are signs of pulmonary congestion?
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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

3. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Excessive bleeding in amount - duration - or both at irregular intervals
True

4. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Colposcopy - Endocervical curettage - and directed cervical biopsy
Pts with palpitations and dizziness - near syncope - or syncope
Supraspinatus and bicipital tendons

5. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

6. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Analgesic headache
Colposcopy - Endocervical curettage - and directed cervical biopsy
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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

7. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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

8. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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

9. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Upper sternal area burning pain - associated with a productive cough
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

10. What are the common causes for laryngitis?
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
Nonulcer dyspepsia
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

11. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
ACEi - ARBS - thiazide diuretics
DM - HTN - DVT - seizures - depression - or anxiety
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Temporal arteritis-biopsy of the temporal artery

12. Natural history of cervical cancer
>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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

13. Define the patient population typically affected by orthostatic or postural proteinuria
LH surge triggers ovulation
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

14. 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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Cluster headache
With a KOH wet mount preparation
Temporal arteritis-biopsy of the temporal artery

15. 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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Regular bleeding at intervals of more than 35 days
Serotypes 16 - 18 - 31 -52 -58

16. What the consequences of decreased cardiac output?
Rotator Cuff tendonitis
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
RBC casts and old to moderate HTN
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

17. What are the three types of lice?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Variability in the time for follicle development during the proliferative phase
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.

18. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Infectious esophagitis
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

19. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Colposcopy - Endocervical curettage - and directed cervical biopsy
Cholelithiasis
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
CBC

20. What are the signs of cerebral hemorrhage?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Increase; 200 g/day
Acute headache - ataxia - profuse nausea - and vomiting

21. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Slow progression of cervical cancer changes -Availability of effective early treatment
Medication or chemical esophagitis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

22. What test done in PE measures instability of shoulder?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

23. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Colposcopy - Endocervical curettage - and directed cervical biopsy

24. Lab testing for heart palpitation
Less than 3 stools per week
Hgb - Electrolytes - and TSH
Analgesic headache
Dehydration - anemia - cardiac causes

25. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Furucnle
S. aureus- beta hemolytic streptococcus
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

26. What are the symptoms of palpitations?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Lightheadedness - dizziness - syncope
Rotator Cuff problem

27. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Echocardiogram
Impetigo

28. What are the signs of acute sinusitis?
Fever with frontal or maxillary tenderness
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
>3.5g of protein per 24hrs

29. What does the classic ring worm lesion have?
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
A central clear area
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

30. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Viral gastroenteritis
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.
Streptococci
Scleroderma/polymyositis with secondary gastroesophageal reflux

31. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
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
Variability in the time for follicle development during the proliferative phase
Medication or chemical esophagitis

32. 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
Nonulcer dyspepsia
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
True
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

33. When does troponin rise following myocardial injury or infarction?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Pts with palpitations and dizziness - near syncope - or syncope
S. Aureus

34. Difference between Pneumonia and Bronchitis
High blood pressure - focal neurologic defecit - or papilledema
BB or CCB - catheter ablation of identified bypass tract
Infectious esophagitis
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

35. Complete the sentence: pericarditis can cause frictional rub and......
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

36. Name the diagnosis of heartburn: regurgitation - dysphagia
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Lightheadedness - dizziness - syncope
Diuretics -BB -CCB -ACEi
GERD

37. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
Less than 3 stools per week

38. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
35 (exception for postmenopausal women who have recently been started on HRT)
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
HIV and syphilis
Cellulitis

39. Tx of chronic or intermittent afibs
Hgb - Electrolytes - and TSH
Viral infection of the semicircular apparatus
Anticoag with warfarin to prevent thromboembolism
Increasing fluid (8 - 8oz glasses of water/day) -fiber

40. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Nonulcer dyspepsia

41. How are fungal infections diagnosed?
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Warts
With a KOH wet mount preparation

42. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Rotator Cuff problem
With a KOH wet mount preparation
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

43. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
CT
PE - MI - aortic dissection - pneumothorax
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
DM - HTN - DVT - seizures - depression - or anxiety

44. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
CBC
Diuretics -BB -CCB -ACEi
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
Subarachnoid hemorrhage

45. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
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.
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
ACEi
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

46. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

47. Vaccines that should be updated before planned pregnancy
HPV
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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

48. MI - pericardial tamponade - PE - GI bleed - are...
ACEi
Rotator cuff tendonitis
CBC
Associated with hypotension

49. Describe the presentation of pneumonia
Lightheadedness - dizziness - syncope
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
100mg; means patient can be trace protein positive and not be detected
Scleroderma/polymyositis with secondary gastroesophageal reflux

50. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
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
S. Aureus
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Acute headache - ataxia - profuse nausea - and vomiting