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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.
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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 benign transient proteinuria?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Common problem that resolves spontaneously and is most often seen in children and young adults

2. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Cervical radiculopathy
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
Nonulcer dyspepsia
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

3. What is the preload?
Molluscum contagiosum- pox virus
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Rotator cuff tendonitis
Bence-Jones

4. After treatment of dysplasia - women need Pap smears every...
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
HPV
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Squamocolumnar junction=most common site of cervical cancer

5. 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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Coag disorders
Cluster headache
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

6. Pneumonia tx: suitable for healthy adults less than 60
A central clear area
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Menorrhagia
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

7. What are the three types of lice?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

8. Pneumonia tx: suitable for healthy adults older than 60
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
24 hour halter

9. What are the signs of malignant hypertension?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
High blood pressure - focal neurologic defecit - or papilledema
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

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

11. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Kids: Rotavirus Adults: Norwalk Virus
Streptococci
Viral gastroenteritis

12. What medications can cause heart palpitations?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Associated with hypotension

13. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
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
Scleroderma/polymyositis with secondary gastroesophageal reflux
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

14. How do you define persistent protein uria?
Staphylococcal scalded skin syndrome
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Presence of proteinuria on at least two separate ocassion
Squamocolumnar junction=most common site of cervical cancer

15. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
>3.5g of protein per 24hrs
Cervical radiculopathy
Loop diuretics (Check serum K+ levels before drug admin)

16. Constipation: What are indications for lab testing?
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
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
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

17. History for Acute bronchitis
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Warts
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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

18. Describe the presentation tracheobronchitis
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.
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Upper sternal area burning pain - associated with a productive cough
CBC

19. Four muscles of rotator cuff
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

20. At was quantity does urine dipstick test detect elevated protein?
Presence of proteinuria on at least two separate ocassion
Irregular bleeding between cycles
100mg; means patient can be trace protein positive and not be detected
Excessive bleeding in amount - duration - or both at irregular intervals

21. Complete the sentence: pericarditis can cause frictional rub and......
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Tension headache
Medication or chemical esophagitis

22. What does treatment for migrans include?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Less abrupt onset and cessation of palpitations
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
Polymenorrhea

23. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Pts with palpitations and dizziness - near syncope - or syncope
DM - HTN - DVT - seizures - depression - or anxiety
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

24. MI - pericardial tamponade - PE - GI bleed - are...
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Scleroderma/polymyositis with secondary gastroesophageal reflux
Associated with hypotension
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

25. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Loop diuretics (Check serum K+ levels before drug admin)
CT
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Furucnle

26. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Pleurisy
Bence-Jones
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

27. What places women at higher risk of getting cervical cancer?
Cellulitis
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
Associated with hypotension
Cholelithiasis

28. Name 4 factors that predispose an individual to develop pneumonia.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

29. What test done in PE measures instability of shoulder?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
GERD
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
True

30. What are the indiciations for neuroimaging?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
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
Upper sternal area burning pain - associated with a productive cough

31. What type of imaging is need for chronic sinusitis?
DM - HTN - DVT - seizures - depression - or anxiety
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
CT

32. Shoulder pain with pain radiating to elbow
Associated with hypotension
Cervical radiculopathy
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
Peptic ulcer disease or gastritis

33. When does troponin rise following myocardial injury or infarction?
Regular bleeding at intervals of more than 35 days
Streptococci
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

34. name the 4 emergent causes of chest pain
Chest pain during pneumonia or PE
PE - MI - aortic dissection - pneumothorax
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
Wolff-Parkinson-White syndrome

35. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Analgesic headache
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Albumin; low molecular weight proteins
Anticoag with warfarin to prevent thromboembolism

36. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Paroxysmal atrial fibrillation or supraventricular tachycardia
Possibility of Ischemic colitis
Diuretics -BB -CCB -ACEi
100mg; means patient can be trace protein positive and not be detected

37. 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
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
Acute headache - ataxia - profuse nausea - and vomiting
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

38. What is the caUse of benign positional vertigo?
Dehydration - anemia - cardiac causes
Folliculitis
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.
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

39. What is the Epley maneuver?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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.
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
CBC

40. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Lightheadedness - dizziness - syncope
Candida albicans
Loop diuretics (Check serum K+ levels before drug admin)

41. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Warts
Non-cardiac causes of palpitations
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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.

42. Describe the history and PE of patient presenting with common cold
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
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Streptococci
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

43. Isolated - extra pounding beats
Viral gastroenteritis
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
PVC or Premature atrial contraction (PAC)
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

44. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Rotator cuff tendonitis
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
Menorrhagia
Viral infection of the semicircular apparatus

45. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
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.
Viral infection of the semicircular apparatus
Giardia
ACEi

46. What the consequences of decreased cardiac output?
A 24hr urine protein collection and urine creatinine clearance determination
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

47. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Hgb - Electrolytes - and TSH
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

48. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

49. What is the goal of CHF treatment? What drugs should be used?
EGD
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

50. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Infectious esophagitis
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
ACEi - ARBS - thiazide diuretics