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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. Describe the presentation of myocardial pain?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Kids: Rotavirus Adults: Norwalk Virus
Supraspinatus and bicipital tendons

2. 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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Molluscum contagiosum- pox virus

3. Define proteinuria
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Viral gastroenteritis
>150mg per 24hrs
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

4. SE Of Beta blockers?
ACEi - ARBS - thiazide diuretics
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Molluscum contagiosum- pox virus

5. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Possibility of Ischemic colitis
RBC casts and old to moderate HTN

6. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
A central clear area
Bence-Jones
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
Furucnle

7. patients with herpes zoster may experience what symptom before the rash appear?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Regular bleeding at intervals of more than 35 days
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Pain

8. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Colposcopy - Endocervical curettage - and directed cervical biopsy
Loop diuretics (Check serum K+ levels before drug admin)
Nonulcer dyspepsia

9. Name some medications that can cause proteinuria
Menorrhagia
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.
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

10. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Hypertension - CAD - valvular heart disease
Folliculitis
Subarachnoid hemorrhage
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

11. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Acute headache - ataxia - profuse nausea - and vomiting
Adhesive capsulitis (frozen shoulder): most common in middle age women
Cellulitis
Nonulcer dyspepsia

12. Diarrhea from custard filled pastries
Presence of proteinuria on at least two separate ocassion
S. Aureus
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Cluster headache

13. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Pancreatitis
Generalized Anxiety disorder and panic disorder
Loop diuretics (Check serum K+ levels before drug admin)
Rotator Cuff problem

14. What medications can cause heart palpitations?
Pancreatitis
Repeat Pap after infection treated
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
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

15. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
S. aureus- beta hemolytic streptococcus
Albumin; low molecular weight proteins
Echocardiogram

16. What are the consequences of diastolic dysfunction?
Non-cardiac causes of palpitations
GERD
Hgb - Electrolytes - and TSH
Higher filling presure - pulmonary congestion - and decreasd cardiac return

17. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Variability in the time for follicle development during the proliferative phase
Pleurisy
Associated with hypotension
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

18. What treatments are the cornerstone for treating cases of functional constipation?
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
ACEi - ARBS - thiazide diuretics
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Increase; 200 g/day

19. When should invasive eletrophysiologic study should be considered?
Hypertension - CAD - valvular heart disease
Viral infection of the semicircular apparatus
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

20. How are fungal infections diagnosed?
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
With a KOH wet mount preparation
Impetigo

21. 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
MSK - pulmonary - GI - or psychological
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

22. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
These patients are associated with low renin states=less likely to respond to medication
CT
ACEi
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

23. 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
RBC casts and old to moderate HTN
Warts
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.
Loop diuretics (Check serum K+ levels before drug admin)

24. History for Acute bronchitis
Acute headache - ataxia - profuse nausea - and vomiting
Candida albicans
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

25. What is considered normal blood loss during a menstrual cycle?
Less than 80 ml of blood
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
PVC or Premature atrial contraction (PAC)
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

26. Name types of laxatives
Hgb - Electrolytes - and TSH
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Presence of proteinuria on at least two separate ocassion

27. MI - pericardial tamponade - PE - GI bleed - are...
GERD
Varicella virus
Associated with hypotension
Scabies

28. What test done in PE measures instability of shoulder?
Molluscum contagiosum- pox virus
ACEi
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

29. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Loop diuretics (Check serum K+ levels before drug admin)
35 (exception for postmenopausal women who have recently been started on HRT)
Repeat Pap after infection treated
Infectious esophagitis

30. What are the physical exam signs of CHF?
Chest pain during pneumonia or PE
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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

31. 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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Less than 3 stools per week
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

32. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Nonulcer dyspepsia
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Bulk forming: Psyllium - Methycellulose - Polycarbophil
LH surge triggers ovulation

33. 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
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Paroxysmal atrial fibrillation or supraventricular tachycardia
Warts

34. Name the skin lesion: erythema - warmth - edema - pain - fever
Associated with hypotension
Cellulitis
LH surge triggers ovulation
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

35. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Squamocolumnar junction=most common site of cervical cancer
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

36. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
High blood pressure - focal neurologic defecit - or papilledema
Bence-Jones

37. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
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.
Other brainstem or cranial nerve findings
LH surge triggers ovulation

38. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Presence of proteinuria on at least two separate ocassion
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Warts

39. Regular bleeding at intervals of less than 21 days
Infectious esophagitis
Increase; 200 g/day
Polymenorrhea
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

40. Where does the development of abnormal cervical cells begin?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Squamocolumnar junction=most common site of cervical cancer
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.

41. Name the diagnosis: transmitted by airborne droplets or vesicular fluid; patients are contagious from 2 days before onset of the rash until all lesions have crusted. The rash has a centripetal distribution - starting at the trunk and spreading to the
Varicella virus
ACEi
Associated with hypotension
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

42. Describe the history and PE of patient presenting with common cold
Colposcopy - Endocervical curettage - and directed cervical biopsy
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
Wolff-Parkinson-White syndrome
Regular bleeding at intervals of more than 35 days

43. PE for a patient getting an abnormal vaginal bleeding work up
A 24hr urine protein collection and urine creatinine clearance determination
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Infectious esophagitis
CBC

44. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
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
24 hour halter
Streptococci
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

45. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Wolff-Parkinson-White syndrome
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

46. What are the two common clinical presentations of acute diarrhea?
Albumin; low molecular weight proteins
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Cervical radiculopathy
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

47. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
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
Viral gastroenteritis
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
Echocardiogram

48. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
ACEi - ARBS - thiazide diuretics
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
>150mg per 24hrs

49. What does the classic ring worm lesion have?
Folliculitis
A central clear area
Anticoag with warfarin to prevent thromboembolism
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

50. What are the signs of cerebral hemorrhage?
Acute headache - ataxia - profuse nausea - and vomiting
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation