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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. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Increase; 200 g/day
Molluscum contagiosum- pox virus
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

2. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
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
Excessive bleeding in amount - duration - or both at irregular intervals
Less than 3 stools per week

3. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Non-cardiac causes of palpitations
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
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

4. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Infectious esophagitis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Less than 80 ml of blood
Echocardiogram

5. Name the skin lesion: honey colored crusts
Varicella virus
Impetigo
Other brainstem or cranial nerve findings
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

6. What type of imaging is need for chronic sinusitis?
CT
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Acute headache - ataxia - profuse nausea - and vomiting
Cholelithiasis

7. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Supraspinatus and bicipital tendons
S. Aureus
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Wolff-Parkinson-White syndrome

8. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
35 (exception for postmenopausal women who have recently been started on HRT)
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
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

9. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
EGD
Impetigo
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

10. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

11. What are the most common causes for the common cold?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
HIV and syphilis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

12. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Chest pain during pneumonia or PE
Candida albicans
Intermenstrual bleeding

13. What are the secondly causes of glomerular disease?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Associated with hypotension
CT

14. 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)
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
Other brainstem or cranial nerve findings
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

15. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Squamocolumnar junction=most common site of cervical cancer
Streptococci

16. How do you know if heart palpitations are due to stimulant or medication use?
>150mg per 24hrs
Other brainstem or cranial nerve findings
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Less abrupt onset and cessation of palpitations

17. What are the features of glomerular nephritis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
RBC casts and old to moderate HTN
Polymenorrhea
Coronary artery disease/ angina

18. What is the mechanism of action for stimulant agents in treating constipation?
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.
Other brainstem or cranial nerve findings
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

19. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
Molluscum contagiosum- pox virus
Pleurisy
100mg; means patient can be trace protein positive and not be detected

20. What the consequences of decreased cardiac output?
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
A 24hr urine protein collection and urine creatinine clearance determination
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

21. What medications can cause heart palpitations?
Generalized Anxiety disorder and panic disorder
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.
These patients are associated with low renin states=less likely to respond to medication
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

22. What is an acoustic neuroma?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Pancreatitis
DM - HTN - DVT - seizures - depression - or anxiety
Tension headache

23. Vaccines that should be updated before planned pregnancy
Menorrhagia
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Viral infection of the semicircular apparatus
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

24. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Analgesic headache
DM - HTN - DVT - seizures - depression - or anxiety
Hx: Onset of menarche and duration and frequency of the menstrual period - Bleeding pattern - hx of liver - renal - thyroid disease - Use of anticoags - oral contraception - hormone replacement - ROS: weight change - hirsutism (indicating PCOS=LH:FSH
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

25. Diarrhea from custard filled pastries
S. Aureus
Folliculitis
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

26. SE Of Beta blockers?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Analgesic headache
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

27. Discomfort with abducting the arm past 90 degress
Coag disorders
Colposcopy - Endocervical curettage - and directed cervical biopsy
Rotator Cuff tendonitis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

28. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Cervical radiculopathy
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

29. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Candida albicans
Diuretics -BB -CCB -ACEi
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Bulk forming: Psyllium - Methycellulose - Polycarbophil

30. Name the diagnosis: umbilicated skin lesion that is spread by autoinoculation - scratching - or touching a lesion. Discrete 2 to 5 mm slightly umbilicated flesh-colored - dome shaped papules occurring on the face - trunk - axillae - and extremities i
Upper sternal area burning pain - associated with a productive cough
Streptococci
Molluscum contagiosum- pox virus
High blood pressure - focal neurologic defecit - or papilledema

31. Uterine bleeding between regular cycles
Upper sternal area burning pain - associated with a productive cough
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
Cholelithiasis
Intermenstrual bleeding

32. 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
Scabies
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.
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

33. Describes what occurs during squamous metaplasia of the cervix.
PVC or Premature atrial contraction (PAC)
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Varicella virus
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

34. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Less than 3 stools per week
Variability in the time for follicle development during the proliferative phase
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

35. How does CHF present on X-ray?
Anticoag with warfarin to prevent thromboembolism
Rotator Cuff tendonitis
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

36. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Viral infection of the semicircular apparatus
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
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

37. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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
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
ACEi

38. What is benign transient proteinuria?
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
Possibility of Ischemic colitis
Common problem that resolves spontaneously and is most often seen in children and young adults

39. What is afterload?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Rotator cuff tendonitis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Giardia

40. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Colposcopy - Endocervical curettage - and directed cervical biopsy
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Excessive bleeding in amount - duration - or both at irregular intervals
HPV testing -Pos=colposcopy -Neg=repeat pap smear

41. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Polymenorrhea
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Echocardiogram
HPV testing -Pos=colposcopy -Neg=repeat pap smear

42. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Streptococci
24 hour halter
Peptic ulcer disease or gastritis

43. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Albumin; low molecular weight proteins
Rotator Cuff problem
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

44. History for Acute bronchitis
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

45. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Infectious esophagitis

46. 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
Fever with frontal or maxillary tenderness
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
E. Coli O157:H7
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

47. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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
PE - MI - aortic dissection - pneumothorax

48. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Folliculitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Presence of proteinuria on at least two separate ocassion
Coronary artery disease/ angina

49. Define proteinuria
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
These patients are associated with low renin states=less likely to respond to medication
E. Coli O157:H7
>150mg per 24hrs

50. What places women at higher risk of getting cervical cancer?
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
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
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.
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