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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. What is benign transient proteinuria?
Viral infection of the semicircular apparatus
Common problem that resolves spontaneously and is most often seen in children and young adults
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Cellulitis

2. What does orthostatic positional changes that bring on dizziness suggest?
Anticoag with warfarin to prevent thromboembolism
Dehydration - anemia - cardiac causes
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Echocardiogram

3. PE for a patient getting an abnormal vaginal bleeding work up
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Cluster headache
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

4. SE Of Beta blockers?
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
Possibility of Ischemic colitis
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

5. What should preconception counseling include?
Dehydration - anemia - cardiac causes
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
Possibility of Ischemic colitis
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

6. What is the standard tool used for diagnosis of GERD?
EGD
Echocardiogram
Cellulitis
>3.5g of protein per 24hrs

7. What is the mechanism of action for stimulant agents in treating constipation?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Irregular bleeding between cycles
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
Rotator Cuff problem

8. 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.
Tension headache
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Irregular bleeding between cycles
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

9. What diagnosis does the 'worse headache of my life' suggest?
W/in 4hrs and peaks 24hrs; it is important to obtain serial markers since the first set of cardiac markers are negative in 25 - 50% of patients with an acute MI
Subarachnoid hemorrhage
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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

10. Define nephrotic range proteinuria
Scabies
Rotator Cuff problem
>3.5g of protein per 24hrs
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

11. What are the consequences of diastolic dysfunction?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
High blood pressure - focal neurologic defecit - or papilledema
EGD
Higher filling presure - pulmonary congestion - and decreasd cardiac return

12. Why is the pap smear one of the most effective cancer screening tools?
Less than 3 stools per week
Menorrhagia
Slow progression of cervical cancer changes -Availability of effective early treatment
Furucnle

13. Four muscles of rotator cuff
Scleroderma/polymyositis with secondary gastroesophageal reflux
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
E. Coli O157:H7
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

14. What the consequences of decreased cardiac output?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Temporal arteritis-biopsy of the temporal artery
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

15. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Dehydration - anemia - cardiac causes
Hypertension - CAD - valvular heart disease
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

16. What treatments are the cornerstone for treating cases of functional constipation?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Cellulitis
Kids: Rotavirus Adults: Norwalk Virus

17. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
RBC casts and old to moderate HTN
Albumin; low molecular weight proteins
MSK - pulmonary - GI - or psychological
Viral gastroenteritis

18. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Wolff-Parkinson-White syndrome
Analgesic headache
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
Hgb - Electrolytes - and TSH

19. Name the skin lesion: honey colored crusts
Impetigo
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
GERD
Loop diuretics (Check serum K+ levels before drug admin)

20. History for Acute bronchitis
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Rotator cuff tendonitis

21. Name the skin lesion: pustule in association with a hair follice
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Molluscum contagiosum- pox virus
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
Folliculitis

22. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
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
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
Viral gastroenteritis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

23. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Streptococci
Squamocolumnar junction=most common site of cervical cancer

24. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Warts
Squamocolumnar junction=most common site of cervical cancer
Paroxysmal atrial fibrillation or supraventricular tachycardia
Albumin; low molecular weight proteins

25. 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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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.
Giardia

26. What are symptoms are CHF?
Generalized Anxiety disorder and panic disorder
Peptic ulcer disease or gastritis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

27. Oligomenorrhea
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Scabies
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Regular bleeding at intervals of more than 35 days

28. What test done in PE measures instability of shoulder?
Excessive bleeding in amount - duration - or both at irregular intervals
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Menorrhagia
Adhesive capsulitis (frozen shoulder): most common in middle age women

29. Describe the history and PE of patient presenting with common cold
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
Albumin; low molecular weight proteins
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
With a KOH wet mount preparation

30. Name 4 factors that predispose an individual to develop pneumonia.
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Infectious esophagitis
PE - MI - aortic dissection - pneumothorax
Scleroderma/polymyositis with secondary gastroesophageal reflux

31. Irregular cycles with excessive flow - duration - or both
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Menorrhagia

32. What is the difference between a Holter monitor or an event monitor?
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.
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
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

33. What is the caUse of Meniere disease? What are the cardinal symptoms?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
RBC casts and old to moderate HTN
Coronary artery disease/ angina
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

34. What is the next best step if a patient has two or more positive dipstick tests?
EGD
A 24hr urine protein collection and urine creatinine clearance determination
ACEi
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

35. Pneumothorax - sudden sharp chest pain - preceded by viral illness
These patients are associated with low renin states=less likely to respond to medication
Pleurisy
Folliculitis
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

36. Discomfort with abducting the arm past 90 degress
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Albumin; low molecular weight proteins
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Rotator Cuff tendonitis

37. 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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

38. What are the three major risk factors for heart failure?
Candida albicans
100mg; means patient can be trace protein positive and not be detected
Hypertension - CAD - valvular heart disease
BB or CCB - catheter ablation of identified bypass tract

39. Isolated - extra pounding beats
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
PVC or Premature atrial contraction (PAC)
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

40. 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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Cholelithiasis
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

41. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Infectious esophagitis
Squamocolumnar junction=most common site of cervical cancer
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

42. 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.
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.
Cervical radiculopathy
Supraspinatus and bicipital tendons
Other brainstem or cranial nerve findings

43. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
ACEi - ARBS - thiazide diuretics
Furucnle
Pancreatitis

44. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Streptococci
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
Echocardiogram
MSK - pulmonary - GI - or psychological

45. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

46. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
Scabies
Bence-Jones
Coag disorders

47. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
A 24hr urine protein collection and urine creatinine clearance determination
Subarachnoid hemorrhage

48. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Warts
Medication or chemical esophagitis
High blood pressure - focal neurologic defecit - or papilledema

49. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
Cholelithiasis
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Warts

50. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
HPV
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
E. Coli O157:H7
Nonulcer dyspepsia