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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. Cycle length variabilty is primarily due to what?
Variability in the time for follicle development during the proliferative phase
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Hgb - Electrolytes - and TSH

2. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Presence of proteinuria on at least two separate ocassion

3. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Subarachnoid hemorrhage
Rotator Cuff problem
A central clear area
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

4. 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)
Cervical radiculopathy
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
Nonulcer dyspepsia

5. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Peptic ulcer disease or gastritis
Impetigo
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
Temporal arteritis-biopsy of the temporal artery

6. SE Of Beta blockers?
Rotator cuff tendonitis
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
Pancreatitis
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

7. How does systolic vs. diastolic heart failure present on the echocardiogram?
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
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)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

8. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Menorrhagia
Infectious esophagitis
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

9. Isolated - extra pounding beats
Coronary artery disease/ angina
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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.
PVC or Premature atrial contraction (PAC)

10. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

11. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

12. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
High blood pressure - focal neurologic defecit - or papilledema
Pain
CBC
Furucnle

13. Constipation: What are indications for lab testing?
Variability in the time for follicle development during the proliferative phase
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.
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in 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

14. Name the diagnosis of heartburn: regurgitation - dysphagia
Supraspinatus and bicipital tendons
Bulk forming: Psyllium - Methycellulose - Polycarbophil
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
GERD

15. Describe the presentation of myocardial pain?
A 24hr urine protein collection and urine creatinine clearance determination
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Rotator Cuff tendonitis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

16. Diagnosis of HTN
Possibility of Ischemic colitis
Intermenstrual bleeding
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

17. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Colposcopy - Endocervical curettage - and directed cervical biopsy
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

18. What drugs do you use to treat H.pylori + PUD?
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
True
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

19. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
35 (exception for postmenopausal women who have recently been started on HRT)
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Chest pain during pneumonia or PE

20. Carcinoma in situ is generally referred to a gynecologist and requires ______
Scabies
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

21. What is the standard tool used for diagnosis of GERD?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
EGD

22. What are the physical exam signs of CHF?
Molluscum contagiosum- pox virus
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
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

23. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Rotator Cuff problem
Infectious esophagitis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

24. MI - pericardial tamponade - PE - GI bleed - are...
Viral gastroenteritis
Other brainstem or cranial nerve findings
Associated with hypotension
Polymenorrhea

25. What is the caUse of Meniere disease? What are the cardinal symptoms?
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
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

26. What is the Barany maneuver?
CT
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
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
Regular bleeding at intervals of more than 35 days

27. Describe the presentation tracheobronchitis
Viral gastroenteritis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Upper sternal area burning pain - associated with a productive cough
Colposcopy - Endocervical curettage - and directed cervical biopsy

28. What is the role of FSH in one's menstrual cycle
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
E. Coli O157:H7
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

29. Metrorrhagia
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Irregular bleeding between cycles
Rotator cuff tendonitis
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.

30. What is the preload?
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
Other brainstem or cranial nerve findings
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

31. After treatment of dysplasia - women need Pap smears every...
CT
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
High blood pressure - focal neurologic defecit - or papilledema
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

32. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Folliculitis
Candida albicans

33. History for Sinusitis

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34. What diagnosis does the 'worse headache of my life' suggest?
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
HIV and syphilis
Subarachnoid hemorrhage
Furucnle

35. Name the skin lesion: honey colored crusts
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Rotator Cuff tendonitis
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Impetigo

36. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
LH surge triggers ovulation
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Warts

37. Pain in shoulder when throwing - swimming - or serving a tennis ball
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
Rotator cuff tendonitis
24 hour halter
Adhesive capsulitis (frozen shoulder): most common in middle age women

38. HIgh risk pregnant patients should be evaluated for ____ and ____
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Tension headache
HIV and syphilis

39. Name 4 factors that predispose an individual to develop pneumonia.
Streptococci
A central clear area
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
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

40. Mainstay treatment for soft tissue inflammation (Shoulder)
GERD
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
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. Who should have Xray testing for shoulder pain?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
LH surge triggers ovulation
Lightheadedness - dizziness - syncope
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

42. Regular bleeding at intervals of less than 21 days
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Polymenorrhea
True
Increase; 200 g/day

43. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
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
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.

44. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Pts with palpitations and dizziness - near syncope - or syncope
Presence of proteinuria on at least two separate ocassion
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Upper sternal area burning pain - associated with a productive cough

45. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
LH surge triggers ovulation
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

46. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
Cluster headache
Fever with frontal or maxillary tenderness
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

47. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
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.
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Cluster headache
Echocardiogram

48. Uterine bleeding between regular cycles
Intermenstrual bleeding
Pleurisy
Chest pain during pneumonia or PE
Less than 80 ml of blood

49. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
Generalized Anxiety disorder and panic disorder
Subarachnoid hemorrhage

50. What are the signs of acute sinusitis?
A 24hr urine protein collection and urine creatinine clearance determination
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Anticoag with warfarin to prevent thromboembolism
Fever with frontal or maxillary tenderness