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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. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Increase; 200 g/day
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
E. Coli O157:H7

2. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Intermenstrual bleeding
EGD
Nonulcer dyspepsia

3. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
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
Cholelithiasis
Echocardiogram

4. 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.
Repeat Pap after infection treated
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Intermenstrual bleeding
Tension headache

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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Generalized Anxiety disorder and panic disorder
Cluster headache
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

6. What are the three types of lice?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

7. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
Staphylococcal scalded skin syndrome
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

8. What is the difference between a Holter monitor or an event monitor?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Impetigo
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. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Diuretics -BB -CCB -ACEi
Candida albicans

10. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
Pancreatitis
>3.5g of protein per 24hrs
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

11. 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)
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
CT
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

12. patients with herpes zoster may experience what symptom before the rash appear?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Pain
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Impetigo

13. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
>3.5g of protein per 24hrs
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Non-cardiac causes of palpitations

14. Uterine bleeding between regular cycles
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Intermenstrual bleeding
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

15. What is the next best step if a patient has two or more positive dipstick tests?
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
A central clear area
A 24hr urine protein collection and urine creatinine clearance determination
Coronary artery disease/ angina

16. At was quantity does urine dipstick test detect elevated protein?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
100mg; means patient can be trace protein positive and not be detected
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
EGD

17. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
HPV
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. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Nonulcer dyspepsia
Rotator Cuff tendonitis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

19. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
Polymenorrhea
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Generalized Anxiety disorder and panic disorder

20. Lab testing for heart palpitation
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
Hgb - Electrolytes - and TSH
>150mg per 24hrs
Less than 80 ml of blood

21. Tx of chronic or intermittent afibs
Rotator Cuff problem
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Anticoag with warfarin to prevent thromboembolism
Subarachnoid hemorrhage

22. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Chest pain during pneumonia or PE
RBC casts and old to moderate HTN
Less than 3 stools per week

23. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Anticoag with warfarin to prevent thromboembolism
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
These patients are associated with low renin states=less likely to respond to medication
RBC casts and old to moderate HTN

24. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Paroxysmal atrial fibrillation or supraventricular tachycardia
PE - MI - aortic dissection - pneumothorax

25. Describe the history and PE of patient presenting with common cold
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
A 24hr urine protein collection and urine creatinine clearance determination
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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

26. When should a patient get a stress test?
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
Bence-Jones
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

27. Pneumonia tx: suitable for healthy adults less than 60
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
S. Aureus

28. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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

29. 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
E. Coli O157:H7
Irregular bleeding between cycles
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
24 hour halter

30. What does treatment for migrans include?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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

31. History for Acute bronchitis
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Scabies
Peptic ulcer disease or gastritis

32. Constipation: What are indications for lab testing?
Squamocolumnar junction=most common site of cervical cancer
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Warts

33. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

34. Discomfort with abducting the arm past 90 degress
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
A 24hr urine protein collection and urine creatinine clearance determination
Rotator Cuff tendonitis
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

35. What does the classic ring worm lesion have?
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.
Adhesive capsulitis (frozen shoulder): most common in middle age women
Echocardiogram
A central clear area

36. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
A 24hr urine protein collection and urine creatinine clearance determination
MSK - pulmonary - GI - or psychological

37. Metrorrhagia
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Irregular bleeding between cycles
Scleroderma/polymyositis with secondary gastroesophageal reflux
>3.5g of protein per 24hrs

38. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Pleurisy
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

39. Define proteinuria
>150mg per 24hrs
Squamocolumnar junction=most common site of cervical cancer
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Candida albicans

40. 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)
Impetigo
Adhesive capsulitis (frozen shoulder): most common in middle age women
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

41. What is benign transient proteinuria?
High blood pressure - focal neurologic defecit - or papilledema
Staphylococcal scalded skin syndrome
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Common problem that resolves spontaneously and is most often seen in children and young adults

42. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Candida albicans
Pts with palpitations and dizziness - near syncope - or syncope
Bence-Jones
35 (exception for postmenopausal women who have recently been started on HRT)

43. What should be considered in younger patients with menorrhagia
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
Coag disorders

44. Menometrorrhagia
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Rotator Cuff problem
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Excessive bleeding in amount - duration - or both at irregular intervals

45. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Paroxysmal atrial fibrillation or supraventricular tachycardia
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Non-cardiac causes of palpitations

46. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Pleurisy
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
24 hour halter
Cholelithiasis

47. How are fungal infections diagnosed?
Regular bleeding at intervals of more than 35 days
Other brainstem or cranial nerve findings
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
With a KOH wet mount preparation

48. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
>150mg per 24hrs
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Cholelithiasis
Coag disorders

49. What is the role of LH in the menstrual cycle
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Peptic ulcer disease or gastritis
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
LH surge triggers ovulation

50. Things that need to be included in history of shoulder pain
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
Adhesive capsulitis (frozen shoulder): most common in middle age women
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy