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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. Name types of laxatives
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.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

2. Uterine bleeding between regular cycles
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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Intermenstrual bleeding
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

3. Describe the presentation of angina?
Molluscum contagiosum- pox virus
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
Medication or chemical esophagitis
S. aureus- beta hemolytic streptococcus

4. What is the goal of CHF treatment? What drugs should be used?
Subarachnoid hemorrhage
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
Furucnle
35 (exception for postmenopausal women who have recently been started on HRT)

5. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Paroxysmal atrial fibrillation or supraventricular tachycardia
Folliculitis
24 hour halter

6. What are the three types of lice?
Infectious esophagitis
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Rotator Cuff tendonitis
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

7. Menometrorrhagia
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.
Anticoag with warfarin to prevent thromboembolism
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Excessive bleeding in amount - duration - or both at irregular intervals

8. What are the 2 psych disorders most commonly associated with palpitations?
Less than 80 ml of blood
Generalized Anxiety disorder and panic disorder
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Dehydration - anemia - cardiac causes

9. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Temporal arteritis-biopsy of the temporal artery
Tension headache

10. What drugs do you use to treat H.pylori + PUD?
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.
Adhesive capsulitis (frozen shoulder): most common in middle age women
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

11. What are the signs of acute sinusitis?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Fever with frontal or maxillary tenderness
Intermenstrual bleeding
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

12. What are the common causes for laryngitis?
Pleurisy
High blood pressure - focal neurologic defecit - or papilledema
Influenza - Rhinovirus - Adenovirus - Parainfluenza
ACEi

13. Name the skin lesion: erythema - warmth - edema - pain - fever
High blood pressure - focal neurologic defecit - or papilledema
Loop diuretics (Check serum K+ levels before drug admin)
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Cellulitis

14. History for Sinusitis

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15. Cycle length variabilty is primarily due to what?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
Variability in the time for follicle development during the proliferative phase
Hypertension - CAD - valvular heart disease

16. Diagnosis of HTN
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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
Less than 3 stools per week
Excessive bleeding in amount - duration - or both at irregular intervals

17. What is a markers of CNS vertigo?
Albumin; low molecular weight proteins
LH surge triggers ovulation
Other brainstem or cranial nerve findings
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

18. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
CBC
Warts
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

19. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Medication or chemical esophagitis
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
Loop diuretics (Check serum K+ levels before drug admin)

20. How can GERD (or esophageal motility disorders) lead to chest pain?
Serotypes 16 - 18 - 31 -52 -58
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
ACEi - ARBS - thiazide diuretics
Repeat Pap after infection treated

21. What are the most common viral causes of diarrhea in kids and adults?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Kids: Rotavirus Adults: Norwalk Virus
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Cellulitis

22. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Albumin; low molecular weight proteins
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

23. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Cholelithiasis
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
MSK - pulmonary - GI - or psychological

24. Carcinoma in situ is generally referred to a gynecologist and requires ______
Coronary artery disease/ angina
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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

25. What are the three major risk factors for heart failure?
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
Acute headache - ataxia - profuse nausea - and vomiting
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Hypertension - CAD - valvular heart disease

26. What test done in PE measures instability of shoulder?
Pain
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Pleurisy

27. Oligomenorrhea
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
A central clear area
Regular bleeding at intervals of more than 35 days

28. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Adhesive capsulitis (frozen shoulder): most common in middle age women
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
When the patient has symptoms in association with exercise or who describe chest pain or pressure

29. 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.
Associated with hypotension
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Tension headache

30. 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
Lightheadedness - dizziness - syncope
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

31. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
With a KOH wet mount preparation
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.
Candida albicans

32. 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
Temporal arteritis-biopsy of the temporal artery
Serotypes 16 - 18 - 31 -52 -58
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Varicella virus

33. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Giardia
CBC

34. What are the signs of cerebral hemorrhage?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Acute headache - ataxia - profuse nausea - and vomiting
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

35. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
CBC
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

36. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
S. Aureus
Candida albicans
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
Cellulitis

37. What are the secondly causes of glomerular disease?
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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
HIV and syphilis
Menorrhagia

38. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Coronary artery disease/ angina
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Chest pain during pneumonia or PE

39. 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
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Cluster headache
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

40. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Fever with frontal or maxillary tenderness
S. aureus- beta hemolytic streptococcus
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

41. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
MSK - pulmonary - GI - or psychological
Upper sternal area burning pain - associated with a productive cough
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
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. Prenatal visit schedule for low-risk pregnancies
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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
Variability in the time for follicle development during the proliferative phase

43. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
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
Hgb - Electrolytes - and TSH
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
HPV

44. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Infectious esophagitis
Echocardiogram
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Analgesic headache

45. What are the physical exam signs of CHF?
Rotator cuff tendonitis
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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
Kids: Rotavirus Adults: Norwalk Virus

46. Name the skin lesion: honey colored crusts
A 24hr urine protein collection and urine creatinine clearance determination
Impetigo
Common problem that resolves spontaneously and is most often seen in children and young adults
Cluster headache

47. What are the primary glomerular diseases?
Variability in the time for follicle development during the proliferative phase
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Influenza - Rhinovirus - Adenovirus - Parainfluenza

48. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Scleroderma/polymyositis with secondary gastroesophageal reflux
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

49. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Loop diuretics (Check serum K+ levels before drug admin)
Staphylococcal scalded skin syndrome
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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

50. Regular bleeding at intervals of less than 21 days
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
Hypertension - CAD - valvular heart disease
Polymenorrhea
Male - report irregular heartbeat Sx duration >5min - hx of heart disease