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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. 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.
Supraspinatus and bicipital tendons
Viral infection of the semicircular apparatus
Higher filling presure - pulmonary congestion - and decreasd cardiac return
35 (exception for postmenopausal women who have recently been started on HRT)

2. Describes what occurs during squamous metaplasia of the cervix.
Variability in the time for follicle development during the proliferative phase
Infectious esophagitis
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

3. Define the patient population typically affected by orthostatic or postural proteinuria
Generalized Anxiety disorder and panic disorder
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
Infectious esophagitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

4. Treatment for supraventricular tachycardias
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
BB or CCB - catheter ablation of identified bypass tract
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

5. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Upper sternal area burning pain - associated with a productive cough
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
Adhesive capsulitis (frozen shoulder): most common in middle age women
Peptic ulcer disease or gastritis

6. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
CBC

7. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Scleroderma/polymyositis with secondary gastroesophageal reflux
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
Upper sternal area burning pain - associated with a productive cough

8. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Paroxysmal atrial fibrillation or supraventricular tachycardia
Cervical radiculopathy
Scleroderma/polymyositis with secondary gastroesophageal reflux
Irregular bleeding between cycles

9. Initial treatment for Rhinosinusitis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
100mg; means patient can be trace protein positive and not be detected
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

10. In regards to a Pap smear - What should be done if a patient has cervical inflammation from infections such as Chlamydia or yeast that may cause cells to appear abnormal.
CT
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Medication or chemical esophagitis
Repeat Pap after infection treated

11. What are the 2 psych disorders most commonly associated with palpitations?
Generalized Anxiety disorder and panic disorder
100mg; means patient can be trace protein positive and not be detected
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Viral infection of the semicircular apparatus

12. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Impetigo
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Warts

13. Tx of chronic or intermittent afibs
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
DM - HTN - DVT - seizures - depression - or anxiety
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
Anticoag with warfarin to prevent thromboembolism

14. What are the indiciations for neuroimaging?
Menorrhagia
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

15. HIgh risk pregnant patients should be evaluated for ____ and ____
CBC
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Possibility of Ischemic colitis
HIV and syphilis

16. What is the standard tool used for diagnosis of GERD?
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Polymenorrhea
EGD

17. Prenatal visit schedule for low-risk pregnancies
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

18. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Colposcopy - Endocervical curettage - and directed cervical biopsy
Giardia
Furucnle
Subarachnoid hemorrhage

19. After treatment of dysplasia - women need Pap smears every...
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

20. At was quantity does urine dipstick test detect elevated protein?
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
100mg; means patient can be trace protein positive and not be detected
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
PE - MI - aortic dissection - pneumothorax

21. What are symptoms are CHF?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Anticoag with warfarin to prevent thromboembolism
BB or CCB - catheter ablation of identified bypass tract
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

22. Define nephrotic range proteinuria
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
>3.5g of protein per 24hrs
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

23. What treatments are the cornerstone for treating cases of functional constipation?
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Less abrupt onset and cessation of palpitations

24. Name the skin lesion: honey colored crusts
Anticoag with warfarin to prevent thromboembolism
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Subarachnoid hemorrhage
Impetigo

25. What occurs after ovulation
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Albumin; low molecular weight proteins
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

26. What are the features of nephrotic syndrome?
Non-cardiac causes of palpitations
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Infectious esophagitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

27. What type of imaging is need for chronic sinusitis?
Irregular bleeding between cycles
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
CT

28. Why is the pap smear one of the most effective cancer screening tools?
Variability in the time for follicle development during the proliferative phase
BB or CCB - catheter ablation of identified bypass tract
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Slow progression of cervical cancer changes -Availability of effective early treatment

29. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
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
Coronary artery disease/ angina
DM - HTN - DVT - seizures - depression - or anxiety

30. What is the caUse of benign positional vertigo?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Chest pain during pneumonia or PE
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.
Less than 3 stools per week

31. What the consequences of decreased cardiac output?
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Molluscum contagiosum- pox virus

32. What are the three types of lice?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Hypertension - CAD - valvular heart disease
Coag disorders

33. 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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
100mg; means patient can be trace protein positive and not be detected
Colposcopy - Endocervical curettage - and directed cervical biopsy

34. Define proteinuria
>150mg per 24hrs
GERD
Rotator Cuff problem
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

35. Chronic pain and shoulder stiffness with limited motion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Intermenstrual bleeding
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

36. Describe the presentation of angina?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Squamocolumnar junction=most common site of cervical cancer
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

37. What are the signs of acute sinusitis?
Fever with frontal or maxillary tenderness
E. Coli O157:H7
Irregular bleeding between cycles
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

38. Name the skin lesion: erythema - warmth - edema - pain - fever
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Cellulitis
Excessive bleeding in amount - duration - or both at irregular intervals
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

39. Regular bleeding at intervals of less than 21 days
Polymenorrhea
True
Temporal arteritis-biopsy of the temporal artery
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

40. How does systolic vs. diastolic heart failure present on the echocardiogram?
PE - MI - aortic dissection - pneumothorax
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

41. What are the primary glomerular diseases?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Albumin; low molecular weight proteins
Nonulcer dyspepsia
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

42. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Other brainstem or cranial nerve findings
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Supraspinatus and bicipital tendons

43. 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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Scabies
Viral gastroenteritis

44. What is the role of FSH in one's menstrual cycle
Medication or chemical esophagitis
Regular bleeding at intervals of more than 35 days
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Viral infection of the semicircular apparatus

45. 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
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Pain
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

46. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
PE - MI - aortic dissection - pneumothorax
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Echocardiogram

47. Describe the presentation tracheobronchitis
>150mg per 24hrs
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
Upper sternal area burning pain - associated with a productive cough
Increase; 200 g/day

48. What are the features of glomerular nephritis
Pancreatitis
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
RBC casts and old to moderate HTN

49. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
BB or CCB - catheter ablation of identified bypass tract
S. aureus- beta hemolytic streptococcus
Adhesive capsulitis (frozen shoulder): most common in middle age women
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

50. What medications can cause heart palpitations?
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
Warts
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Giardia