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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 is the role of LH in the menstrual cycle
High blood pressure - focal neurologic defecit - or papilledema
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
Irregular bleeding between cycles
LH surge triggers ovulation

2. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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
Pts with palpitations and dizziness - near syncope - or syncope

3. How are fungal infections diagnosed?
Squamocolumnar junction=most common site of cervical cancer
With a KOH wet mount preparation
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

4. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
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
Intermenstrual bleeding
Bulk forming: Psyllium - Methycellulose - Polycarbophil

5. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Increase; 200 g/day

6. Why is the pap smear one of the most effective cancer screening tools?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Nonulcer dyspepsia
Slow progression of cervical cancer changes -Availability of effective early treatment

7. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Increasing fluid (8 - 8oz glasses of water/day) -fiber
100mg; means patient can be trace protein positive and not be detected
Regular bleeding at intervals of more than 35 days
Pleurisy

8. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
Peptic ulcer disease or gastritis
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
Less abrupt onset and cessation of palpitations

9. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
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
CBC
Colposcopy - Endocervical curettage - and directed cervical biopsy
Possibility of Ischemic colitis

10. Name some medications that can cause proteinuria
HPV testing -Pos=colposcopy -Neg=repeat pap smear
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Upper sternal area burning pain - associated with a productive cough
Non-cardiac causes of palpitations

11. What are the symptoms of palpitations?
Giardia
Lightheadedness - dizziness - syncope
Adhesive capsulitis (frozen shoulder): most common in middle age women
Regular bleeding at intervals of more than 35 days

12. Define nephrotic range proteinuria
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
BB or CCB - catheter ablation of identified bypass tract
24 hour halter
>3.5g of protein per 24hrs

13. SE Of Beta blockers?
E. Coli O157:H7
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
HPV
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

14. Describe the presentation of angina?
Giardia
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
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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

15. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
>150mg per 24hrs
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Increase; 200 g/day

16. At was quantity does urine dipstick test detect elevated protein?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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.
100mg; means patient can be trace protein positive and not be detected
HIV and syphilis

17. Name the diagnosis of heartburn: regurgitation - dysphagia
GERD
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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
Cervical radiculopathy

18. What is an acoustic neuroma?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Candida albicans

19. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
Viral gastroenteritis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Other brainstem or cranial nerve findings

20. What does orthostatic positional changes that bring on dizziness suggest?
Possibility of Ischemic colitis
Lightheadedness - dizziness - syncope
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Dehydration - anemia - cardiac causes

21. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Kids: Rotavirus Adults: Norwalk Virus
Pts with palpitations and dizziness - near syncope - or syncope

22. How to NSAIDs contribute to gastritis and ulcer formation?
>150mg per 24hrs
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.
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

23. Describe the history and PE of patient presenting with common cold
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.
Less than 80 ml of blood
CBC
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

24. Vaccines that should be updated before planned pregnancy
E. Coli O157:H7
GERD
Common problem that resolves spontaneously and is most often seen in children and young adults
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

25. What occurs after ovulation
Acute headache - ataxia - profuse nausea - and vomiting
PE - MI - aortic dissection - pneumothorax
Bulk forming: Psyllium - Methycellulose - Polycarbophil
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

26. 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
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
True
Viral infection of the semicircular apparatus

27. What type of imaging is need for chronic sinusitis?
Kids: Rotavirus Adults: Norwalk Virus
CT
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
Albumin; low molecular weight proteins

28. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Loop diuretics (Check serum K+ levels before drug admin)

29. Describe the presentation of myocardial pain?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Varicella virus
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
S. aureus- beta hemolytic streptococcus

30. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Chest pain during pneumonia or PE
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

31. What places women at higher risk of getting cervical cancer?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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
CBC
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

32. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Streptococci
Variability in the time for follicle development during the proliferative phase
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Cluster headache

33. Describes what occurs during squamous metaplasia of the cervix.
Cervical radiculopathy
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Echocardiogram
Coag disorders

34. What is the peripheral caUse of vertigo?
ACEi - ARBS - thiazide diuretics
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

35. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Folliculitis
MSK - pulmonary - GI - or psychological
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Pleurisy

36. What are the primary glomerular diseases?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Excessive bleeding in amount - duration - or both at irregular intervals

37. What is benign transient proteinuria?
Medication or chemical esophagitis
Candida albicans
Common problem that resolves spontaneously and is most often seen in children and young adults
Influenza - Rhinovirus - Adenovirus - Parainfluenza

38. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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
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
Furucnle

39. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
ACEi - ARBS - thiazide diuretics
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Colposcopy - Endocervical curettage - and directed cervical biopsy

40. What drugs do you use to treat H.pylori + PUD?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Cervical radiculopathy
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
Generalized Anxiety disorder and panic disorder

41. How does systolic vs. diastolic heart failure present on the echocardiogram?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
CBC
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

42. 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.
Excessive bleeding in amount - duration - or both at irregular intervals
Supraspinatus and bicipital tendons
HIV and syphilis
Impetigo

43. When is a lumbar puncture contraindicated?
Dehydration - anemia - cardiac causes
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

44. name the 4 emergent causes of chest pain
ACEi
GERD
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
PE - MI - aortic dissection - pneumothorax

45. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
Rotator Cuff tendonitis
Possibility of Ischemic colitis
Variability in the time for follicle development during the proliferative phase

46. What should be considered in younger patients with menorrhagia
Less abrupt onset and cessation of palpitations
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Coag disorders

47. Uterine bleeding between regular cycles
Intermenstrual bleeding
S. Aureus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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

48. Shoulder pain with pain radiating to elbow
Cervical radiculopathy
High blood pressure - focal neurologic defecit - or papilledema
Anticoag with warfarin to prevent thromboembolism
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

49. Tx of chronic or intermittent afibs
35 (exception for postmenopausal women who have recently been started on HRT)
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
Anticoag with warfarin to prevent thromboembolism
Fever with frontal or maxillary tenderness

50. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Viral gastroenteritis
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Acute headache - ataxia - profuse nausea - and vomiting
Non-cardiac causes of palpitations