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Family Medicine Shelf

Subjects : health-sciences, family-medicine

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
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 caUse of Meniere disease? What are the cardinal symptoms?
Non-cardiac causes of palpitations
With a KOH wet mount preparation
S. Aureus
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

2. What HPV serotypes are most commonly associated with cervical cancer?
Menorrhagia
PE - MI - aortic dissection - pneumothorax
Serotypes 16 - 18 - 31 -52 -58
35 (exception for postmenopausal women who have recently been started on HRT)

3. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
24 hour halter
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Diuretics -BB -CCB -ACEi
Increase; 200 g/day

4. How does CHF present on X-ray?
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Cholelithiasis

5. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
Supraspinatus and bicipital tendons
A central clear area
Impetigo

6. Name 4 factors that predispose an individual to develop pneumonia.
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

7. Clinical Manifestations of HTN
Streptococci
GERD
Furucnle
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

8. Pneumonia tx: suitable for healthy adults older than 60
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Lightheadedness - dizziness - syncope
LH surge triggers ovulation

9. Pneumonia tx: suitable for healthy adults less than 60
Analgesic headache
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

10. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Infectious esophagitis
Coag disorders
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

11. 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
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.
ACEi
Colposcopy - Endocervical curettage - and directed cervical biopsy
E. Coli O157:H7

12. What is the Barany maneuver?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
>150mg per 24hrs
The patient is seated with the head turned to the right and is quickly lowered to the supine position with the head over the edge of the examination table 30 degrees below horizontal. The test is then repeated with the head turned to the left. The te

13. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

14. How do you define persistent protein uria?
Streptococci
Presence of proteinuria on at least two separate ocassion
Furucnle
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

15. Treatment for supraventricular tachycardias
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
BB or CCB - catheter ablation of identified bypass tract
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Infectious esophagitis

16. 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
Cluster headache
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
GERD

17. What are signs of pulmonary congestion?
Dehydration - anemia - cardiac causes
Varicella virus
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

18. What are the three major risk factors for heart failure?
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
Hypertension - CAD - valvular heart disease
LH surge triggers ovulation
Cellulitis

19. Isolated - extra pounding beats
Less abrupt onset and cessation of palpitations
PVC or Premature atrial contraction (PAC)
Rotator Cuff tendonitis
Supraspinatus and bicipital tendons

20. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Wolff-Parkinson-White syndrome
Cluster headache

21. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Upper sternal area burning pain - associated with a productive cough
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

22. PE for a patient getting an abnormal vaginal bleeding work up
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Common problem that resolves spontaneously and is most often seen in children and young adults
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.

23. Initial treatment for Rhinosinusitis
Pleurisy
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

24. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Analgesic headache
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
S. aureus- beta hemolytic streptococcus

25. Diarrhea from custard filled pastries
Adhesive capsulitis (frozen shoulder): most common in middle age women
S. aureus- beta hemolytic streptococcus
S. Aureus
Diuretics -BB -CCB -ACEi

26. What is the role of LH in the menstrual cycle
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
LH surge triggers ovulation
Generalized Anxiety disorder and panic disorder
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

27. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Kids: Rotavirus Adults: Norwalk Virus
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Non-cardiac causes of palpitations

28. 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.
HPV testing -Pos=colposcopy -Neg=repeat pap smear
S. Aureus
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Tension headache

29. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
24 hour halter
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

30. What occurs after ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Staphylococcal scalded skin syndrome
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
Scabies
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Pain

32. When should invasive eletrophysiologic study should be considered?
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
ACEi - ARBS - thiazide diuretics
Pts with palpitations and dizziness - near syncope - or syncope

33. What are the two common clinical presentations of acute diarrhea?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Less abrupt onset and cessation of palpitations
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

34. What are the features of nephrotic syndrome?
Coronary artery disease/ angina
Less than 3 stools per week
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Pleurisy

35. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Albumin; low molecular weight proteins
Pain

36. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Warts
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

37. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Intermenstrual bleeding
Paroxysmal atrial fibrillation or supraventricular tachycardia

38. Metrorrhagia
Lightheadedness - dizziness - syncope
Tension headache
Irregular bleeding between cycles
Scleroderma/polymyositis with secondary gastroesophageal reflux

39. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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

40. What is the Epley maneuver?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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.
HPV
Candida albicans

41. Describes what occurs during squamous metaplasia of the cervix.
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
PVC or Premature atrial contraction (PAC)
Coag disorders

42. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Non-cardiac causes of palpitations
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

43. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
ACEi
Chest pain during pneumonia or PE
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Coag disorders

44. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Echocardiogram
Pleurisy
Medication or chemical esophagitis

45. Define proteinuria
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
>150mg per 24hrs

46. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bence-Jones
Peptic ulcer disease or gastritis
CBC
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

47. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
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
Supraspinatus and bicipital tendons
Furucnle
HPV

48. Discomfort with abducting the arm past 90 degress
Rotator Cuff tendonitis
BB or CCB - catheter ablation of identified bypass tract
Folliculitis
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

49. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Acute headache - ataxia - profuse nausea - and vomiting
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Viral infection of the semicircular apparatus
Intermenstrual bleeding

50. What is benign transient proteinuria?
Rotator Cuff problem
Variability in the time for follicle development during the proliferative phase
Peptic ulcer disease or gastritis
Common problem that resolves spontaneously and is most often seen in children and young adults