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Family Medicine Shelf
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Subjects
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health-sciences
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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 two common clinical presentations of acute diarrhea?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Cervical radiculopathy
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
2. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
Furucnle
100mg; means patient can be trace protein positive and not be detected
HPV
Infectious esophagitis
3. How to NSAIDs contribute to gastritis and ulcer formation?
Pain
Pleurisy
Adhesive capsulitis (frozen shoulder): most common in middle age women
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. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Pleurisy
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
RBC casts and old to moderate HTN
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
5. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Chest pain during pneumonia or PE
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
6. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Temporal arteritis-biopsy of the temporal artery
Fever with frontal or maxillary tenderness
7. Describe the history and PE of patient presenting with common cold
Variability in the time for follicle development during the proliferative phase
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Scabies
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
8. What lab tests are recommended for newly diagnosed hypertensive patients?
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
100mg; means patient can be trace protein positive and not be detected
9. How does systolic vs. diastolic heart failure present on the echocardiogram?
Hypertension - CAD - valvular heart disease
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
10. patients with herpes zoster may experience what symptom before the rash appear?
>150mg per 24hrs
Pain
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
11. What are the features of nephrotic syndrome?
Lightheadedness - dizziness - syncope
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Cholelithiasis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
12. History for Sinusitis
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13. Four muscles of rotator cuff
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
14. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Viral infection of the semicircular apparatus
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
S. aureus- beta hemolytic streptococcus
Cluster headache
15. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Viral gastroenteritis
Staphylococcal scalded skin syndrome
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
16. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
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
HIV and syphilis
PVC or Premature atrial contraction (PAC)
A central clear area
17. What is an acoustic neuroma?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Increase; 200 g/day
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
True
18. What are the primary glomerular diseases?
Dehydration - anemia - cardiac causes
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Subarachnoid hemorrhage
19. What should blood work include for suspected heart failure?
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
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
20. What is afterload?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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
Less than 80 ml of blood
21. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
CT
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
22. name the 4 emergent causes of chest pain
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
PE - MI - aortic dissection - pneumothorax
Bence-Jones
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
23. What are the features of glomerular nephritis
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
RBC casts and old to moderate HTN
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Rotator cuff tendonitis
24. Pneumonia tx: suitable for healthy adults older than 60
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
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
When the patient has symptoms in association with exercise or who describe chest pain or pressure
25. Cycle length variabilty is primarily due to what?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Cellulitis
Variability in the time for follicle development during the proliferative phase
Albumin; low molecular weight proteins
26. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
S. Aureus
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Varicella virus
27. Menometrorrhagia
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Kids: Rotavirus Adults: Norwalk Virus
Excessive bleeding in amount - duration - or both at irregular intervals
Echocardiogram
28. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
29. History for Acute bronchitis
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Squamocolumnar junction=most common site of cervical cancer
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Anticoag with warfarin to prevent thromboembolism
30. What is the peripheral caUse of vertigo?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
31. 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
Regular bleeding at intervals of more than 35 days
Staphylococcal scalded skin syndrome
Presence of proteinuria on at least two separate ocassion
32. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
35 (exception for postmenopausal women who have recently been started on HRT)
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Medication or chemical esophagitis
33. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Scleroderma/polymyositis with secondary gastroesophageal reflux
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
34. Describe the presentation of pericardial pain
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
E. Coli O157:H7
Warts
35. What are the physical exam signs of CHF?
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
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
Generalized Anxiety disorder and panic disorder
Varicella virus
36. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
37. Discomfort with abducting the arm past 90 degress
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
Rotator Cuff tendonitis
Common problem that resolves spontaneously and is most often seen in children and young adults
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
38. Predictors of cardiac etiology
Adhesive capsulitis (frozen shoulder): most common in middle age women
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Staphylococcal scalded skin syndrome
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.
39. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - 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
Albumin; low molecular weight proteins
Coronary artery disease/ angina
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
40. Define proteinuria
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
>150mg per 24hrs
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
41. What occurs after ovulation
Coag disorders
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
CBC
42. What are the three major risk factors for heart failure?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
>3.5g of protein per 24hrs
Hypertension - CAD - valvular heart disease
43. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
Diuretics -BB -CCB -ACEi
RBC casts and old to moderate HTN
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
44. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
Nonulcer dyspepsia
Folliculitis
Peptic ulcer disease or gastritis
45. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
EGD
Temporal arteritis-biopsy of the temporal artery
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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
46. What are signs of pulmonary congestion?
Menorrhagia
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
47. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
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
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
BB or CCB - catheter ablation of identified bypass tract
Viral infection of the semicircular apparatus
48. What type of imaging is need for chronic sinusitis?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
E. Coli O157:H7
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
CT
49. Things that need to be included in history of shoulder pain
Irregular bleeding between cycles
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Varicella virus
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
50. Name the diagnosis: a fertilized female mite burrow through the stratum corneum to being a 30 day life cycle of egg laying and deposition of fecal matter. After the eggs have hatched - the mites can migrate to other areas such as the finger webs - wr
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
Loop diuretics (Check serum K+ levels before drug admin)
Scabies
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