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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. Menometrorrhagia
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
Variability in the time for follicle development during the proliferative phase
BB or CCB - catheter ablation of identified bypass tract
Excessive bleeding in amount - duration - or both at irregular intervals

2. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Echocardiogram
HPV
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

3. Diarrhea is defined as an ____ in stool weight to more than ____g per day
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Regular bleeding at intervals of more than 35 days

4. What are the signs of malignant hypertension?
Albumin; low molecular weight proteins
Molluscum contagiosum- pox virus
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.
High blood pressure - focal neurologic defecit - or papilledema

5. Uterine bleeding between regular cycles
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Repeat Pap after infection treated
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Intermenstrual bleeding

6. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Serotypes 16 - 18 - 31 -52 -58
Polymenorrhea
Cellulitis
Cholelithiasis

7. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Irregular bleeding between cycles
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Albumin; low molecular weight proteins

8. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
Cervical radiculopathy
Lightheadedness - dizziness - syncope
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

9. What is an acoustic neuroma?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
ACEi - ARBS - thiazide diuretics

10. Prenatal visit schedule for low-risk pregnancies
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
Possibility of Ischemic colitis
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Chest pain during pneumonia or PE

11. What is the Epley maneuver?
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.
Slow progression of cervical cancer changes -Availability of effective early treatment
A central clear area
Acute headache - ataxia - profuse nausea - and vomiting

12. What are the features of glomerular nephritis
RBC casts and old to moderate HTN
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
High blood pressure - focal neurologic defecit - or papilledema
Irregular bleeding between cycles

13. What HPV serotypes are most commonly associated with cervical cancer?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Serotypes 16 - 18 - 31 -52 -58
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

14. Constipation: What are indications for lab testing?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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

15. What is the peripheral caUse of vertigo?
Generalized Anxiety disorder and panic disorder
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

16. History and PE for Pneumonia
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

17. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Fever with frontal or maxillary tenderness
RBC casts and old to moderate HTN
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Non-cardiac causes of palpitations

18. What are the primary glomerular diseases?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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

19. What are the symptoms of palpitations?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Lightheadedness - dizziness - syncope

20. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
Warts
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
A 24hr urine protein collection and urine creatinine clearance determination
Albumin; low molecular weight proteins

21. What places women at higher risk of getting cervical cancer?
PE - MI - aortic dissection - pneumothorax
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
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
>3.5g of protein per 24hrs

22. Why is the pap smear one of the most effective cancer screening tools?
Pleurisy
Cellulitis
Slow progression of cervical cancer changes -Availability of effective early treatment
Streptococci

23. What are the most common causes for the 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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Fever with frontal or maxillary tenderness

24. Pneumonia tx: suitable for healthy adults older than 60
Rotator Cuff tendonitis
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

25. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
DM - HTN - DVT - seizures - depression - or anxiety
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Rotator Cuff problem

26. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
LH surge triggers ovulation
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Intermenstrual bleeding
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

27. What are the two common clinical presentations of acute diarrhea?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

28. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Pancreatitis
Giardia
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

29. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
E. Coli O157:H7
Colposcopy - Endocervical curettage - and directed cervical biopsy
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

30. What is the role of LH in the menstrual cycle
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
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.
LH surge triggers ovulation

31. What are the three major risk factors for heart failure?
Kids: Rotavirus Adults: Norwalk Virus
Hypertension - CAD - valvular heart disease
E. Coli O157:H7
Giardia

32. Name the diagnosis of heartburn: regurgitation - dysphagia
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Loop diuretics (Check serum K+ levels before drug admin)
GERD
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

33. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Chest pain during pneumonia or PE
Cervical radiculopathy
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

34. 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.
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
Tension headache
Albumin; low molecular weight proteins
Echocardiogram

35. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Paroxysmal atrial fibrillation or supraventricular tachycardia
ACEi - ARBS - thiazide diuretics
Pain
Excessive bleeding in amount - duration - or both at irregular intervals

36. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Giardia
Upper sternal area burning pain - associated with a productive cough
PE - MI - aortic dissection - pneumothorax

37. name the 4 emergent causes of chest pain
Cellulitis
PE - MI - aortic dissection - pneumothorax
Staphylococcal scalded skin syndrome
True

38. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
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
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
HPV
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

39. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
E. Coli O157:H7
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
CBC

40. What should preconception counseling include?
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
With a KOH wet mount preparation
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Common problem that resolves spontaneously and is most often seen in children and young adults

41. What is the Barany maneuver?
Anticoag with warfarin to prevent thromboembolism
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
Streptococci
Folliculitis

42. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Coag disorders
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
HPV testing -Pos=colposcopy -Neg=repeat pap smear

43. What is the difference between a Holter monitor or an event monitor?
Pain
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
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
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

44. 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
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.
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
>3.5g of protein per 24hrs

45. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
PE - MI - aortic dissection - pneumothorax
Subarachnoid hemorrhage
Peptic ulcer disease or gastritis
Pancreatitis

46. What is the role of FSH in one's menstrual cycle
CBC
Scleroderma/polymyositis with secondary gastroesophageal reflux
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Scabies

47. Diarrhea from custard filled pastries
Subarachnoid hemorrhage
>150mg per 24hrs
S. Aureus
Presence of proteinuria on at least two separate ocassion

48. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Scabies
Cluster headache

49. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Serotypes 16 - 18 - 31 -52 -58
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Rotator Cuff problem
DM - HTN - DVT - seizures - depression - or anxiety

50. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
BB or CCB - catheter ablation of identified bypass tract
When the patient has symptoms in association with exercise or who describe chest pain or pressure
24 hour halter
Streptococci