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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 peripheral caUse of vertigo?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Nonulcer dyspepsia
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

2. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Scabies
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

3. Pneumonia tx: suitable for healthy adults older than 60
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Diuretics -BB -CCB -ACEi
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

4. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Viral infection of the semicircular apparatus
True
Candida albicans

5. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Furucnle
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

6. Diagnosis of HTN
LH surge triggers ovulation
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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
A 24hr urine protein collection and urine creatinine clearance determination

7. What are the secondly causes of glomerular disease?
These patients are associated with low renin states=less likely to respond to medication
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
PE - MI - aortic dissection - pneumothorax
Polymenorrhea

8. What are the primary glomerular diseases?
Anticoag with warfarin to prevent thromboembolism
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

9. What are the symptoms of palpitations?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Scabies
Lightheadedness - dizziness - syncope
Viral infection of the semicircular apparatus

10. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Kids: Rotavirus Adults: Norwalk Virus
Giardia
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

11. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
These patients are associated with low renin states=less likely to respond to medication
Acute headache - ataxia - profuse nausea - and vomiting
Staphylococcal scalded skin syndrome

12. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Giardia
Albumin; low molecular weight proteins
Furucnle
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.

13. What should preconception counseling include?
Subarachnoid hemorrhage
Intermenstrual bleeding
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
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

14. Initial treatment for Rhinosinusitis
HPV
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Peptic ulcer disease or gastritis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

15. Name the diagnosis of heartburn: severe constant mid abdominal pain
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Pancreatitis
Coronary artery disease/ angina
Polymenorrhea

16. After treatment of dysplasia - women need Pap smears every...
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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

17. When is a lumbar puncture contraindicated?
A 24hr urine protein collection and urine creatinine clearance determination
Staphylococcal scalded skin syndrome
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

18. What are the three types of lice?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Common problem that resolves spontaneously and is most often seen in children and young adults
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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

19. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
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
HPV
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
35 (exception for postmenopausal women who have recently been started on HRT)

20. When should invasive eletrophysiologic study should be considered?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
True
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

21. What are the indiciations for neuroimaging?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
E. Coli O157:H7
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
Excessive bleeding in amount - duration - or both at irregular intervals

22. What are signs of pulmonary congestion?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Rotator Cuff problem
Streptococci

23. Describe the presentation of pericardial pain
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Menorrhagia
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

24. Difference between Pneumonia and Bronchitis
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Wolff-Parkinson-White syndrome
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

25. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
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.
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Variability in the time for follicle development during the proliferative phase
Temporal arteritis-biopsy of the temporal artery

26. 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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Varicella virus

27. Name some medications that can cause proteinuria
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Possibility of Ischemic colitis

28. What are the 2 psych disorders most commonly associated with palpitations?
Generalized Anxiety disorder and panic disorder
Non-cardiac causes of palpitations
Furucnle
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

29. What places women at higher risk of getting cervical cancer?
Fever with frontal or maxillary tenderness
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
PVC or Premature atrial contraction (PAC)

30. Diagnostic Evaluation of Abnoraml vaginal bleeding
Cholelithiasis
PVC or Premature atrial contraction (PAC)
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
Other brainstem or cranial nerve findings

31. What is benign transient proteinuria?
Common problem that resolves spontaneously and is most often seen in children and young adults
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Molluscum contagiosum- pox virus

32. What is the standard tool used for diagnosis of GERD?
EGD
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
Menorrhagia
Bence-Jones

33. Chronic pain and shoulder stiffness with limited motion
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
Menorrhagia
Adhesive capsulitis (frozen shoulder): most common in middle age women
100mg; means patient can be trace protein positive and not be detected

34. Menometrorrhagia
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Albumin; low molecular weight proteins
Excessive bleeding in amount - duration - or both at irregular intervals
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

35. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Albumin; low molecular weight proteins
Cervical radiculopathy
Lightheadedness - dizziness - syncope

36. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Pts with palpitations and dizziness - near syncope - or syncope
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
CBC

37. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Wolff-Parkinson-White syndrome
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Less than 80 ml of blood

38. What drugs do you use to treat H.pylori + PUD?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
>150mg per 24hrs

39. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Lightheadedness - dizziness - syncope
Staphylococcal scalded skin syndrome
Cellulitis
Scleroderma/polymyositis with secondary gastroesophageal reflux

40. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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
Lightheadedness - dizziness - syncope
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

41. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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
Impetigo
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

42. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Subarachnoid hemorrhage
S. aureus- beta hemolytic streptococcus
Common problem that resolves spontaneously and is most often seen in children and young adults
Warts

43. Irregular cycles with excessive flow - duration - or both
Menorrhagia
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Dehydration - anemia - cardiac causes
Non-cardiac causes of palpitations

44. What are the signs of acute sinusitis?
Molluscum contagiosum- pox virus
ACEi - ARBS - thiazide diuretics
Scleroderma/polymyositis with secondary gastroesophageal reflux
Fever with frontal or maxillary tenderness

45. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
100mg; means patient can be trace protein positive and not be detected
LH surge triggers ovulation
Possibility of Ischemic colitis

46. Diarrhea from custard filled pastries
Colposcopy - Endocervical curettage - and directed cervical biopsy
S. Aureus
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
Rotator Cuff problem

47. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Rotator cuff tendonitis
ACEi - ARBS - thiazide diuretics
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Streptococci

48. What diagnosis does the 'worse headache of my life' suggest?
Candida albicans
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Subarachnoid hemorrhage
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

49. Isolated - extra pounding beats
True
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
PVC or Premature atrial contraction (PAC)
Scleroderma/polymyositis with secondary gastroesophageal reflux

50. What are the physical exam signs of CHF?
Less abrupt onset and cessation of palpitations
Cluster headache
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
Upper sternal area burning pain - associated with a productive cough