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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 diagnosis: a fertilized female mite burrow through the stratum corneum to being a 30 day life cycle of egg laying and deposition of fecal matter. After the eggs have hatched - the mites can migrate to other areas such as the finger webs - wr
Cluster headache
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Scabies
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

2. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Subarachnoid hemorrhage

3. When does troponin rise following myocardial injury or infarction?
PE - MI - aortic dissection - pneumothorax
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

4. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
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.
Subarachnoid hemorrhage
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
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.

5. At was quantity does urine dipstick test detect elevated protein?
100mg; means patient can be trace protein positive and not be detected
Streptococci
Rotator cuff tendonitis
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

6. Uterine bleeding between regular cycles
Intermenstrual bleeding
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
Temporal arteritis-biopsy of the temporal artery
A 24hr urine protein collection and urine creatinine clearance determination

7. What type of imaging is need for chronic sinusitis?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
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
CT
Rotator Cuff tendonitis

8. What is the caUse of benign positional vertigo?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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
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.
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

9. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Irregular bleeding between cycles
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
Excessive bleeding in amount - duration - or both at irregular intervals
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.

10. 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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
True
Warts
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

11. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Acute headache - ataxia - profuse nausea - and vomiting
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Analgesic headache
Less than 3 stools per week

12. Name the skin lesion: honey colored crusts
24 hour halter
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Impetigo
Candida albicans

13. Diagnostic Evaluation of Abnoraml vaginal bleeding
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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

14. What is the standard tool used for diagnosis of GERD?
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
EGD
Slow progression of cervical cancer changes -Availability of effective early treatment

15. What is considered normal blood loss during a menstrual cycle?
Less than 80 ml of blood
Hgb - Electrolytes - and TSH
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

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

17. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Pancreatitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Acute headache - ataxia - profuse nausea - and vomiting
Paroxysmal atrial fibrillation or supraventricular tachycardia

18. What is afterload?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
E. Coli O157:H7
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
Medication or chemical esophagitis

19. Difference between Pneumonia and Bronchitis
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
Increase; 200 g/day
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Loop diuretics (Check serum K+ levels before drug admin)

20. Why is the pap smear one of the most effective cancer screening tools?
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
Slow progression of cervical cancer changes -Availability of effective early treatment
ACEi - ARBS - thiazide diuretics
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

21. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
GERD
Varicella virus

22. Describes what occurs during squamous metaplasia of the cervix.
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

23. What is the caUse of Meniere disease? What are the cardinal symptoms?
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
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

24. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
35 (exception for postmenopausal women who have recently been started on HRT)
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

25. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
Folliculitis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Kids: Rotavirus Adults: Norwalk Virus

26. Predictors of cardiac etiology
High blood pressure - focal neurologic defecit - or papilledema
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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
Molluscum contagiosum- pox virus

27. Pneumonia tx: suitable for healthy adults older than 60
Infectious esophagitis
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
CBC

28. What are the features of glomerular nephritis
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
PVC or Premature atrial contraction (PAC)
A central clear area
RBC casts and old to moderate HTN

29. What does orthostatic positional changes that bring on dizziness suggest?
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
Dehydration - anemia - cardiac causes
EGD
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

30. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Temporal arteritis-biopsy of the temporal artery
Peptic ulcer disease or gastritis
Variability in the time for follicle development during the proliferative phase

31. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Bence-Jones
Increase; 200 g/day
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

32. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Slow progression of cervical cancer changes -Availability of effective early treatment
LH surge triggers ovulation
BB or CCB - catheter ablation of identified bypass tract

33. What are signs of pulmonary congestion?
Chest pain during pneumonia or PE
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

34. Menometrorrhagia
Diuretics -BB -CCB -ACEi
Excessive bleeding in amount - duration - or both at irregular intervals
Increase; 200 g/day
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

35. Mainstay treatment for soft tissue inflammation (Shoulder)
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Diuretics -BB -CCB -ACEi
Echocardiogram
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

36. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Wolff-Parkinson-White syndrome
S. aureus- beta hemolytic streptococcus
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Diuretics -BB -CCB -ACEi

37. HIgh risk pregnant patients should be evaluated for ____ and ____
HIV and syphilis
Fever with frontal or maxillary tenderness
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Rotator Cuff tendonitis

38. What is the Barany maneuver?
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
Peptic ulcer disease or gastritis
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
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

39. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Generalized Anxiety disorder and panic disorder
GERD
Furucnle
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

40. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Hypertension - CAD - valvular heart disease
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

41. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Viral gastroenteritis
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
Increase; 200 g/day
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

42. 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
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
ACEi
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

43. What is an acoustic neuroma?
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Regular bleeding at intervals of more than 35 days
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

44. Define nephrotic range proteinuria
LH surge triggers ovulation
>3.5g of protein per 24hrs
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

45. MI - pericardial tamponade - PE - GI bleed - are...
Associated with hypotension
Giardia
E. Coli O157:H7
Less abrupt onset and cessation of palpitations

46. Clinical Manifestations of HTN
Warts
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

47. What are the symptoms of palpitations?
RBC casts and old to moderate HTN
CBC
Lightheadedness - dizziness - syncope
Rotator Cuff problem

48. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
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
Less abrupt onset and cessation of palpitations

49. What occurs after ovulation
Infectious esophagitis
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
A central clear area
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

50. Describe the presentation of pericardial pain
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Coronary artery disease/ angina
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing