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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. 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.
>3.5g of protein per 24hrs
Jugular venous distension: elevated venous pressures -PMI is displaced laterally and downward: cardiomegaly -bibasilar rales -third and fourth heart sounds: fluid overloaded - stiff ventricles -murmurs: valvular pathology -hepatomegaly: right sided
ACEi
Tension headache

2. What are the signs of cerebral hemorrhage?
>3.5g of protein per 24hrs
Acute headache - ataxia - profuse nausea - and vomiting
LH surge triggers ovulation
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

3. What is the mechanism of action for stimulant agents in treating constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Dehydration - anemia - cardiac causes
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

4. What is the peripheral caUse of vertigo?
Slow progression of cervical cancer changes -Availability of effective early treatment
DM - HTN - DVT - seizures - depression - or anxiety
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

5. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Variability in the time for follicle development during the proliferative phase
Wolff-Parkinson-White syndrome
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Pleurisy

6. Carcinoma in situ is generally referred to a gynecologist and requires ______
CBC
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

7. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Peptic ulcer disease or gastritis
HPV
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

8. Why don't ACEi work well for the elderly and African Americans when treating HTN?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Rotator Cuff problem
These patients are associated with low renin states=less likely to respond to medication
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

9. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
True
Dehydration - anemia - cardiac causes
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

10. What does orthostatic positional changes that bring on dizziness suggest?
Dehydration - anemia - cardiac causes
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
Wolff-Parkinson-White syndrome
S. aureus- beta hemolytic streptococcus

11. Name 4 factors that predispose an individual to develop pneumonia.
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Coronary artery disease/ angina

12. What medications can cause heart palpitations?
LH surge triggers ovulation
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
When the patient has symptoms in association with exercise or who describe chest pain or pressure

13. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
24 hour halter
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
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.

14. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Supraspinatus and bicipital tendons
Coag disorders
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

15. What are the primary glomerular diseases?
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
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

16. What drugs do you use to treat H.pylori + PUD?
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
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
Loop diuretics (Check serum K+ levels before drug admin)
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

17. What is the preload?
Variability in the time for follicle development during the proliferative phase
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Less than 80 ml of blood

18. What are the consequences of diastolic dysfunction?
MSK - pulmonary - GI - or psychological
Excessive bleeding in amount - duration - or both at irregular intervals
Higher filling presure - pulmonary congestion - and decreasd cardiac return
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

19. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
ACEi
Cellulitis
Pleurisy
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

20. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Rotator Cuff tendonitis
Supraspinatus and bicipital tendons
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Diuretics -BB -CCB -ACEi

21. HIgh risk pregnant patients should be evaluated for ____ and ____
HIV and syphilis
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Cholelithiasis
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

22. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Bence-Jones
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
PE - MI - aortic dissection - pneumothorax
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

23. What are the signs of acute sinusitis?
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
S. aureus- beta hemolytic streptococcus
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Fever with frontal or maxillary tenderness

24. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Dehydration - anemia - cardiac causes
35 (exception for postmenopausal women who have recently been started on HRT)
Candida albicans

25. What are the physical exam signs of CHF?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Jugular venous distension: elevated venous pressures -PMI is displaced laterally and downward: cardiomegaly -bibasilar rales -third and fourth heart sounds: fluid overloaded - stiff ventricles -murmurs: valvular pathology -hepatomegaly: right sided
PE - MI - aortic dissection - pneumothorax

26. Pain in shoulder when throwing - swimming - or serving a tennis ball
Rotator cuff tendonitis
CT
Repeat Pap after infection treated
Chest pain during pneumonia or PE

27. What test done in PE measures instability of shoulder?
Viral infection of the semicircular apparatus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Hypertension - CAD - valvular heart disease
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

28. How do you know if heart palpitations are due to stimulant or medication use?
Non-cardiac causes of palpitations
Less abrupt onset and cessation of palpitations
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

29. What are the features of glomerular nephritis
Diuretics -BB -CCB -ACEi
RBC casts and old to moderate HTN
Colposcopy - Endocervical curettage - and directed cervical biopsy
Giardia

30. Oligomenorrhea
Chest pain during pneumonia or PE
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
Regular bleeding at intervals of more than 35 days
Rotator Cuff tendonitis

31. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
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
Cellulitis
Candida albicans
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

32. When should a patient get a stress test?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Slow progression of cervical cancer changes -Availability of effective early treatment
LH surge triggers ovulation

33. Name the diagnosis of heartburn: regurgitation - dysphagia
GERD
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Viral gastroenteritis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

34. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Diuretics -BB -CCB -ACEi

35. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
True
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

36. Complete the sentence: pericarditis can cause frictional rub and......
Loop diuretics (Check serum K+ levels before drug admin)
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

37. What are the most common causes for the common cold?
Slow progression of cervical cancer changes -Availability of effective early treatment
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
>150mg per 24hrs
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

38. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
MSK - pulmonary - GI - or psychological
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Pleurisy
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

39. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Furucnle
Kids: Rotavirus Adults: Norwalk Virus
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

40. What is a markers of CNS vertigo?
Other brainstem or cranial nerve findings
Molluscum contagiosum- pox virus
Serotypes 16 - 18 - 31 -52 -58
Warts

41. What are the 2 psych disorders most commonly associated with palpitations?
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
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
Less than 3 stools per week

42. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
Regular bleeding at intervals of more than 35 days
Kids: Rotavirus Adults: Norwalk Virus
Rotator Cuff problem

43. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
Less abrupt onset and cessation of palpitations
Upper sternal area burning pain - associated with a productive cough
Candida albicans

44. Pneumonia tx: suitable for healthy adults less than 60
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

45. What is benign transient proteinuria?
With a KOH wet mount preparation
Diuretics -BB -CCB -ACEi
Common problem that resolves spontaneously and is most often seen in children and young adults
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

46. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
RBC casts and old to moderate HTN
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Bence-Jones

47. What should be considered in younger patients with menorrhagia
S. Aureus
Coag disorders
Common problem that resolves spontaneously and is most often seen in children and young adults
HIV and syphilis

48. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
CBC
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Temporal arteritis-biopsy of the temporal artery
>150mg per 24hrs

49. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Upper sternal area burning pain - associated with a productive cough
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Staphylococcal scalded skin syndrome
GERD

50. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
GERD
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Supraspinatus and bicipital tendons