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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. Define nephrotic range proteinuria
ACEi
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
>3.5g of protein per 24hrs
Infectious esophagitis

2. Name the diagnosis of heartburn: regurgitation - dysphagia
Increase; 200 g/day
GERD
EGD
S. aureus- beta hemolytic streptococcus

3. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
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
Non-cardiac causes of palpitations
Nonulcer dyspepsia
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

4. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Bence-Jones
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
HIV and syphilis
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

5. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
High blood pressure - focal neurologic defecit - or papilledema
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

6. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
A 24hr urine protein collection and urine creatinine clearance determination
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

7. What type of imaging is need for chronic sinusitis?
HPV
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
CT

8. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Presence of proteinuria on at least two separate ocassion
Fever with frontal or maxillary tenderness
Peptic ulcer disease or gastritis
Colposcopy - Endocervical curettage - and directed cervical biopsy

9. After treatment of dysplasia - women need Pap smears every...
Giardia
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
24 hour halter
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

10. 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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Scabies
True
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

11. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HIV and syphilis
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
HPV
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

12. Tx of chronic or intermittent afibs
Repeat Pap after infection treated
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
ACEi - ARBS - thiazide diuretics
Anticoag with warfarin to prevent thromboembolism

13. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Nonulcer dyspepsia
Diuretics -BB -CCB -ACEi

14. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
>150mg per 24hrs
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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. Describe the presentation of pneumonia
Streptococci
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

16. What are the symptoms of palpitations?
GERD
Giardia
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Lightheadedness - dizziness - syncope

17. What is the Epley maneuver?
Temporal arteritis-biopsy of the temporal artery
Pts with palpitations and dizziness - near syncope - or syncope
MSK - pulmonary - GI - or psychological
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.

18. 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.
Giardia
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
Supraspinatus and bicipital tendons
Pancreatitis

19. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
Increase; 200 g/day

20. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Impetigo
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Scleroderma/polymyositis with secondary gastroesophageal reflux

21. SE Of Beta blockers?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Warts
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

22. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Hgb - Electrolytes - and TSH
CBC
Loop diuretics (Check serum K+ levels before drug admin)

23. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Adhesive capsulitis (frozen shoulder): most common in middle age women
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

24. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Other brainstem or cranial nerve findings
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
Staphylococcal scalded skin syndrome
Lightheadedness - dizziness - syncope

25. Uterine bleeding between regular cycles
Staphylococcal scalded skin syndrome
Intermenstrual bleeding
BB or CCB - catheter ablation of identified bypass tract
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

26. What are the three types of lice?
Cluster headache
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

27. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
Loop diuretics (Check serum K+ levels before drug admin)
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

28. Menometrorrhagia
Excessive bleeding in amount - duration - or both at irregular intervals
Higher filling presure - pulmonary congestion - and decreasd cardiac return
With a KOH wet mount preparation
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

29. What are the consequences of diastolic dysfunction?
HPV
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Associated with hypotension

30. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
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.
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

31. Diarrhea from custard filled pastries
Chest pain during pneumonia or PE
Nonulcer dyspepsia
S. Aureus
Polymenorrhea

32. What occurs after ovulation
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

33. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Rotator cuff tendonitis
True
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

34. 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.
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Repeat Pap after infection treated
Kids: Rotavirus Adults: Norwalk Virus

35. How do you define persistent protein uria?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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
Presence of proteinuria on at least two separate ocassion
Repeat Pap after infection treated

36. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
ACEi - ARBS - thiazide diuretics
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
Cholelithiasis
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

37. Define the patient population typically affected by orthostatic or postural proteinuria
Streptococci
Pleurisy
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
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

38. What is an acoustic neuroma?
S. Aureus
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

39. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Anticoag with warfarin to prevent thromboembolism
Infectious esophagitis
CBC

40. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
ACEi
Variability in the time for follicle development during the proliferative phase
LH surge triggers ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

41. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Chest pain during pneumonia or PE
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

42. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Albumin; low molecular weight proteins
Serotypes 16 - 18 - 31 -52 -58
Lightheadedness - dizziness - syncope

43. Discomfort with abducting the arm past 90 degress
Rotator Cuff tendonitis
CBC
Possibility of Ischemic colitis
Nonulcer dyspepsia

44. Pneumonia tx: suitable for healthy adults less than 60
EGD
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
CBC
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

45. How is constipation clinically defined?
ACEi - ARBS - thiazide diuretics
Scleroderma/polymyositis with secondary gastroesophageal reflux
Less than 3 stools per week
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

46. PE for a patient getting an abnormal vaginal bleeding work up
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

47. 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
Hgb - Electrolytes - and TSH
Coag disorders
Pain

48. What is the caUse of Meniere disease? What are the cardinal symptoms?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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
Regular bleeding at intervals of more than 35 days

49. What are the most common viral causes of diarrhea in kids and adults?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Kids: Rotavirus Adults: Norwalk Virus
Pancreatitis
Viral gastroenteritis

50. History and PE for Pneumonia
True
Adhesive capsulitis (frozen shoulder): most common in middle age women
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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