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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. 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
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.
Furucnle

2. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Less than 3 stools per week
Candida albicans

3. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Colposcopy - Endocervical curettage - and directed cervical biopsy
Kids: Rotavirus Adults: Norwalk Virus
Wolff-Parkinson-White syndrome

4. What drugs do you use to treat H.pylori + PUD?
Impetigo
Rotator Cuff problem
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

5. When is a lumbar puncture contraindicated?
Slow progression of cervical cancer changes -Availability of effective early treatment
Higher filling presure - pulmonary congestion - and decreasd cardiac return
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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

6. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Warts
Supraspinatus and bicipital tendons

7. What does the classic ring worm lesion have?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
A central clear area
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
A 24hr urine protein collection and urine creatinine clearance determination

8. When does troponin rise following myocardial injury or infarction?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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

9. What is the standard tool used for diagnosis of GERD?
EGD
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Diuretics -BB -CCB -ACEi
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

10. What is the difference between a Holter monitor or an event monitor?
Associated with hypotension
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
Cellulitis
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

11. Describe the presentation of angina?
PVC or Premature atrial contraction (PAC)
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
Supraspinatus and bicipital tendons
Molluscum contagiosum- pox virus

12. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Pleurisy
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Hypertension - CAD - valvular heart disease
Streptococci

13. Pain in shoulder when throwing - swimming - or serving a tennis ball
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
S. Aureus
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Rotator cuff tendonitis

14. History for Acute bronchitis
Slow progression of cervical cancer changes -Availability of effective early treatment
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Albumin; low molecular weight proteins

15. HIgh risk pregnant patients should be evaluated for ____ and ____
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
>150mg per 24hrs
HIV and syphilis

16. What is the role of FSH in one's menstrual cycle
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
High blood pressure - focal neurologic defecit - or papilledema
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Rotator Cuff tendonitis

17. What is the role of LH in the menstrual cycle
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
A 24hr urine protein collection and urine creatinine clearance determination
LH surge triggers ovulation
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

18. Name the diagnosis: a fertilized female mite burrow through the stratum corneum to being a 30 day life cycle of egg laying and deposition of fecal matter. After the eggs have hatched - the mites can migrate to other areas such as the finger webs - wr
Kids: Rotavirus Adults: Norwalk Virus
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Excessive bleeding in amount - duration - or both at irregular intervals
Scabies

19. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Giardia
Increase; 200 g/day
Rotator cuff tendonitis
Chest pain during pneumonia or PE

20. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
100mg; means patient can be trace protein positive and not be detected
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
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

21. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Streptococci
Paroxysmal atrial fibrillation or supraventricular tachycardia
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

22. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

23. What are the most common viral causes of diarrhea in kids and adults?
Kids: Rotavirus Adults: Norwalk Virus
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.
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

24. Name the skin lesion: pustule in association with a hair follice
Chest pain during pneumonia or PE
Intermenstrual bleeding
Folliculitis
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

25. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Infectious esophagitis
S. aureus- beta hemolytic streptococcus
Less than 3 stools per week
Dehydration - anemia - cardiac causes

26. 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
Hgb - Electrolytes - and TSH
>150mg per 24hrs
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
E. Coli O157:H7

27. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
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.
Increase; 200 g/day
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

28. What are the primary glomerular diseases?
Molluscum contagiosum- pox virus
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

29. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Pain
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
ACEi - ARBS - thiazide diuretics
Cellulitis

30. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
GERD
Bence-Jones

31. Name types of laxatives
Albumin; low molecular weight proteins
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
PVC or Premature atrial contraction (PAC)
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

32. What are the signs of cerebral hemorrhage?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Acute headache - ataxia - profuse nausea - and vomiting
Increase; 200 g/day
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

33. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
MSK - pulmonary - GI - or psychological
Acute headache - ataxia - profuse nausea - and vomiting
EGD
HIV and syphilis

34. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Albumin; low molecular weight proteins
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
Fever with frontal or maxillary tenderness
Streptococci

35. Name the skin lesion: erythema - warmth - edema - pain - fever
A 24hr urine protein collection and urine creatinine clearance determination
100mg; means patient can be trace protein positive and not be detected
Cellulitis
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.

36. 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.
S. aureus- beta hemolytic streptococcus
Giardia
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Tension headache

37. How to NSAIDs contribute to gastritis and ulcer formation?
Excessive bleeding in amount - duration - or both at irregular intervals
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.
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

38. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Pain

39. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
ACEi
Albumin; low molecular weight proteins
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Wolff-Parkinson-White syndrome

40. How does CHF present on X-ray?
PE - MI - aortic dissection - pneumothorax
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Albumin; low molecular weight proteins
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

41. How do you define persistent protein uria?
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Presence of proteinuria on at least two separate ocassion
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

42. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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

43. 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
Lightheadedness - dizziness - syncope
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

44. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Rotator cuff tendonitis
Furucnle
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

45. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Cellulitis
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
Less abrupt onset and cessation of palpitations
24 hour halter

46. Lab testing for heart palpitation
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)
Hgb - Electrolytes - and TSH
Staphylococcal scalded skin syndrome

47. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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
Coronary artery disease/ angina
High blood pressure - focal neurologic defecit - or papilledema

48. What occurs after ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Pain

49. When should a patient get a stress test?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Cervical radiculopathy
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Repeat Pap after infection treated

50. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Analgesic headache
EGD
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
Tension headache