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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.
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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 considered normal blood loss during a menstrual cycle?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Less than 80 ml of blood
Cellulitis
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

2. 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
Analgesic headache
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Medication or chemical esophagitis

3. HIgh risk pregnant patients should be evaluated for ____ and ____
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
24 hour halter
HIV and syphilis
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

4. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Candida albicans
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

5. What are the physical exam signs of CHF?
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Less abrupt onset and cessation of palpitations

6. 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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
These patients are associated with low renin states=less likely to respond to medication
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Cluster headache

7. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
100mg; means patient can be trace protein positive and not be detected
Chest pain during pneumonia or PE
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre

8. Difference between Pneumonia and Bronchitis
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
>150mg per 24hrs
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

9. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
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
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

10. Why don't ACEi work well for the elderly and African Americans when treating HTN?
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
These patients are associated with low renin states=less likely to respond to medication

11. 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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Squamocolumnar junction=most common site of cervical cancer

12. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
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
>3.5g of protein per 24hrs
Possibility of Ischemic colitis
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.

13. Irregular cycles with excessive flow - duration - or both
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
Wolff-Parkinson-White syndrome
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Menorrhagia

14. Diarrhea from custard filled pastries
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
S. Aureus
Warts

15. 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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

16. What are the secondly causes of glomerular disease?
>3.5g of protein per 24hrs
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

17. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
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
Viral infection of the semicircular apparatus

18. Name 4 factors that predispose an individual to develop pneumonia.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

19. What are the most common viral causes of diarrhea in kids and adults?
BB or CCB - catheter ablation of identified bypass tract
Kids: Rotavirus Adults: Norwalk Virus
Bence-Jones
Colposcopy - Endocervical curettage - and directed cervical biopsy

20. Initial treatment for Rhinosinusitis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

21. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Warts
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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.

22. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
With a KOH wet mount preparation
Pleurisy

23. 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.
MSK - pulmonary - GI - or psychological
Supraspinatus and bicipital tendons
Varicella virus
Analgesic headache

24. What does the classic ring worm lesion have?
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
HPV
Serotypes 16 - 18 - 31 -52 -58
A central clear area

25. Four muscles of rotator cuff
A central clear area
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
Candida albicans

26. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Medication or chemical esophagitis
Hypertension - CAD - valvular heart disease

27. What are symptoms are CHF?
Upper sternal area burning pain - associated with a productive cough
Colposcopy - Endocervical curettage - and directed cervical biopsy
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
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

28. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
PVC or Premature atrial contraction (PAC)
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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
Bence-Jones

29. What is the next best step if a patient has two or more positive dipstick tests?
Serotypes 16 - 18 - 31 -52 -58
High blood pressure - focal neurologic defecit - or papilledema
A 24hr urine protein collection and urine creatinine clearance determination
Slow progression of cervical cancer changes -Availability of effective early treatment

30. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

31. Describe the history and PE of patient presenting with common cold
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.
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

32. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Generalized Anxiety disorder and panic disorder

33. What is benign transient proteinuria?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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.
Common problem that resolves spontaneously and is most often seen in children and young adults
Upper sternal area burning pain - associated with a productive cough

34. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Cholelithiasis
S. aureus- beta hemolytic streptococcus
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
Streptococci

35. What are the signs of malignant hypertension?
Cholelithiasis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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
High blood pressure - focal neurologic defecit - or papilledema

36. Pneumonia tx: suitable for healthy adults older than 60
Headache of recent onset (<6 months) -headache beginning after 50 years of age -worsening headaches -headache that does not fit primary headache pattern -associated seizure -focal neurologic signs or symptoms -personality change-severe headaches unre
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

37. What are the signs of acute sinusitis?
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
Viral infection of the semicircular apparatus
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Fever with frontal or maxillary tenderness

38. 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.
Supraspinatus and bicipital tendons
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

39. What HPV serotypes are most commonly associated with cervical cancer?
Echocardiogram
Generalized Anxiety disorder and panic disorder
Serotypes 16 - 18 - 31 -52 -58
Tension headache

40. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Polymenorrhea
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.
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

41. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Fever with frontal or maxillary tenderness
Serotypes 16 - 18 - 31 -52 -58
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Nonulcer dyspepsia

42. What are the features of glomerular nephritis
RBC casts and old to moderate HTN
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

43. What are the two common clinical presentations of acute diarrhea?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
24 hour halter
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

44. When should a patient get a stress test?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
When the patient has symptoms in association with exercise or who describe chest pain or pressure
24 hour halter
BB or CCB - catheter ablation of identified bypass tract

45. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
Viral gastroenteritis
Chest pain during pneumonia or PE
Squamocolumnar junction=most common site of cervical cancer

46. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
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
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

47. Prenatal visit schedule for low-risk pregnancies
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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.

48. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
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
Peptic ulcer disease or gastritis
With a KOH wet mount preparation
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

49. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Candida albicans
True
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
Wolff-Parkinson-White syndrome

50. What type of imaging is need for chronic sinusitis?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Influenza - Rhinovirus - Adenovirus - Parainfluenza
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
CT