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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. Name the skin lesion: honey colored crusts
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Impetigo
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

2. What is the caUse of Meniere disease? What are the cardinal symptoms?
Irregular bleeding between cycles
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

3. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Infectious esophagitis
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

4. What places women at higher risk of getting cervical cancer?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Echocardiogram
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

5. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

6. PE for a patient getting an abnormal vaginal bleeding work up
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

7. How are fungal infections diagnosed?
HPV
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
With a KOH wet mount preparation
DM - HTN - DVT - seizures - depression - or anxiety

8. Name the diagnosis of heartburn: regurgitation - dysphagia
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
GERD
Folliculitis

9. What is the preload?
Rotator Cuff problem
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Loop diuretics (Check serum K+ levels before drug admin)
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

10. What drugs do you use to treat H.pylori + PUD?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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
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.

11. Where does the development of abnormal cervical cells begin?
Possibility of Ischemic colitis
A 24hr urine protein collection and urine creatinine clearance determination
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Squamocolumnar junction=most common site of cervical cancer

12. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
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

13. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
GERD
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

14. Regular bleeding at intervals of less than 21 days
S. aureus- beta hemolytic streptococcus
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Wolff-Parkinson-White syndrome
Polymenorrhea

15. Name 4 factors that predispose an individual to develop pneumonia.
Cervical radiculopathy
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

16. 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
Other brainstem or cranial nerve findings
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
Streptococci

17. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Bence-Jones
Generalized Anxiety disorder and panic disorder
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

18. What are the common causes for laryngitis?
Warts
Presence of proteinuria on at least two separate ocassion
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Peptic ulcer disease or gastritis

19. What are the physical exam signs of CHF?
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
Temporal arteritis-biopsy of the temporal artery
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
Hgb - Electrolytes - and TSH

20. Predictors of cardiac etiology
Chest pain during pneumonia or PE
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
35 (exception for postmenopausal women who have recently been started on HRT)

21. 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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Warts
Viral gastroenteritis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

22. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Candida albicans
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
Analgesic headache
HPV

23. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
HPV testing -Pos=colposcopy -Neg=repeat pap smear
EGD
DM - HTN - DVT - seizures - depression - or anxiety

24. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Menorrhagia
Coronary artery disease/ angina
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

25. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Other brainstem or cranial nerve findings
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
Viral infection of the semicircular apparatus
Paroxysmal atrial fibrillation or supraventricular tachycardia

26. What test done in PE measures instability of shoulder?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
A 24hr urine protein collection and urine creatinine clearance determination
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

27. Vaccines that should be updated before planned pregnancy
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.
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Acute headache - ataxia - profuse nausea - and vomiting
Candida albicans

28. Describe the presentation tracheobronchitis
Upper sternal area burning pain - associated with a productive cough
Peptic ulcer disease or gastritis
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
Pleurisy

29. Describe the history and PE of patient presenting with common cold
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
Wolff-Parkinson-White syndrome
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
Medication or chemical esophagitis

30. Describe the presentation of pericardial pain
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Less abrupt onset and cessation of palpitations
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

31. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Rotator Cuff problem
ACEi

32. What are the primary glomerular diseases?
>3.5g of protein per 24hrs
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
GERD

33. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Cervical radiculopathy
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
Possibility of Ischemic colitis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

34. What are the three major risk factors for heart failure?
Presence of proteinuria on at least two separate ocassion
Hypertension - CAD - valvular heart disease
Excessive bleeding in amount - duration - or both at irregular intervals
Common problem that resolves spontaneously and is most often seen in children and young adults

35. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
ACEi
Giardia
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

36. What diagnosis does the 'worse headache of my life' suggest?
Less than 80 ml of blood
PE - MI - aortic dissection - pneumothorax
Upper sternal area burning pain - associated with a productive cough
Subarachnoid hemorrhage

37. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

38. Describe the presentation of pneumonia
HIV and syphilis
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
When the patient has symptoms in association with exercise or who describe chest pain or pressure
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

39. Clinical Manifestations of HTN
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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
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
Lightheadedness - dizziness - syncope

40. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
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
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Influenza - Rhinovirus - Adenovirus - Parainfluenza

41. What is the next best step if a patient has two or more positive dipstick tests?
A 24hr urine protein collection and urine creatinine clearance determination
Bence-Jones
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
A central clear area

42. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Menorrhagia
35 (exception for postmenopausal women who have recently been started on HRT)
Intermenstrual bleeding

43. Treatment for supraventricular tachycardias
Slow progression of cervical cancer changes -Availability of effective early treatment
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
BB or CCB - catheter ablation of identified bypass tract
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

44. What is the goal of CHF treatment? What drugs should be used?
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
Temporal arteritis-biopsy of the temporal artery
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Adhesive capsulitis (frozen shoulder): most common in middle age women

45. Mainstay treatment for soft tissue inflammation (Shoulder)
Viral infection of the semicircular apparatus
Streptococci
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Slow progression of cervical cancer changes -Availability of effective early treatment

46. What is the role of LH in the menstrual cycle
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
LH surge triggers ovulation
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Infectious esophagitis

47. Constipation: What are indications for lab testing?
Viral infection of the semicircular apparatus
Colposcopy - Endocervical curettage - and directed cervical biopsy
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

48. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Cellulitis
High blood pressure - focal neurologic defecit - or papilledema

49. What are the consequences of diastolic dysfunction?
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Viral gastroenteritis
Influenza - Rhinovirus - Adenovirus - Parainfluenza

50. Shoulder pain with pain radiating to elbow
Cervical radiculopathy
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF