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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 of heartburn: chest pressure - nausea - diaphoresis - palpitations
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
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
Colposcopy - Endocervical curettage - and directed cervical biopsy
Coronary artery disease/ angina

2. How can GERD (or esophageal motility disorders) lead to chest pain?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
With a KOH wet mount preparation
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

3. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
ACEi
Paroxysmal atrial fibrillation or supraventricular tachycardia
Viral gastroenteritis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

4. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Pleurisy
Rotator Cuff tendonitis

5. Name the skin lesion: honey colored crusts
Diuretics -BB -CCB -ACEi
RBC casts and old to moderate HTN
Impetigo
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

6. Define nephrotic range proteinuria
>3.5g of protein per 24hrs
A central clear area
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

7. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Diuretics -BB -CCB -ACEi
Cholelithiasis
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
Furucnle

8. Uterine bleeding between regular cycles
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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
Intermenstrual bleeding

9. Pain in shoulder when throwing - swimming - or serving a tennis ball
Infectious esophagitis
Rotator cuff tendonitis
>3.5g of protein per 24hrs
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

10. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
Fever with frontal or maxillary tenderness
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

11. What should preconception counseling include?
Menorrhagia
Echocardiogram
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
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

12. What does treatment for migrans include?
Tension headache
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
Irregular bleeding between cycles
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

13. What is the mechanism of action for stimulant agents in treating constipation?
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.
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Coag disorders
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

14. Carcinoma in situ is generally referred to a gynecologist and requires ______
Impetigo
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
CBC
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

15. What test done in PE measures instability of shoulder?
Slow progression of cervical cancer changes -Availability of effective early treatment
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
These patients are associated with low renin states=less likely to respond to medication
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

16. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
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
Less than 3 stools per week
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

17. 1+ protein level on urine dipstick usually represents how much protein in the urine?
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

18. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Candida albicans
Streptococci
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
Coag disorders

19. Diagnostic Evaluation of Abnoraml vaginal bleeding
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
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

20. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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

21. Metrorrhagia
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Albumin; low molecular weight proteins
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Irregular bleeding between cycles

22. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
CBC
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

23. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Varicella virus
Cluster headache
Diuretics -BB -CCB -ACEi
PVC or Premature atrial contraction (PAC)

24. Predictors of cardiac etiology
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Repeat Pap after infection treated
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

25. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
RBC casts and old to moderate HTN
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
Hypertension - CAD - valvular heart disease

26. What are the three major risk factors for heart failure?
Supraspinatus and bicipital tendons
Hypertension - CAD - valvular heart disease
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
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

27. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
Varicella virus
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

28. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Staphylococcal scalded skin syndrome
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Medication or chemical esophagitis

29. What are the symptoms of palpitations?
Less abrupt onset and cessation of palpitations
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
Menorrhagia
Lightheadedness - dizziness - syncope

30. Describe the presentation tracheobronchitis
Less than 80 ml of blood
Paroxysmal atrial fibrillation or supraventricular tachycardia
Coronary artery disease/ angina
Upper sternal area burning pain - associated with a productive cough

31. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Colposcopy - Endocervical curettage - and directed cervical biopsy
Pleurisy
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

32. What are the most common causes for the common cold?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Viral gastroenteritis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
ACEi - ARBS - thiazide diuretics

33. Define proteinuria
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
>150mg per 24hrs
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

34. History for Acute bronchitis
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.
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
Analgesic headache
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

35. Where does the development of abnormal cervical cells begin?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Analgesic headache
Squamocolumnar junction=most common site of cervical cancer
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

36. What is a markers of CNS vertigo?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Other brainstem or cranial nerve findings
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Pancreatitis

37. Name types of laxatives
A 24hr urine protein collection and urine creatinine clearance determination
A central clear area
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Chest pain during pneumonia or PE

38. What is the caUse of benign positional vertigo?
Less than 3 stools per week
Coag disorders
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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.

39. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Pleurisy
Acute headache - ataxia - profuse nausea - and vomiting
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
Streptococci

40. What are the 2 psych disorders most commonly associated with palpitations?
Tension headache
Generalized Anxiety disorder and panic disorder
Loop diuretics (Check serum K+ levels before drug admin)
Other brainstem or cranial nerve findings

41. Prenatal visit schedule for low-risk pregnancies
Giardia
MSK - pulmonary - GI - or psychological
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

42. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
HPV
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

43. What are the secondly causes of glomerular disease?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Temporal arteritis-biopsy of the temporal artery
BB or CCB - catheter ablation of identified bypass tract
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

44. Discomfort with abducting the arm past 90 degress
Cluster headache
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Rotator Cuff tendonitis
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

45. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Possibility of Ischemic colitis
Cluster headache
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

46. Irregular cycles with excessive flow - duration - or both
Colposcopy - Endocervical curettage - and directed cervical biopsy
Menorrhagia
A 24hr urine protein collection and urine creatinine clearance determination
Rotator cuff tendonitis

47. What is afterload?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Hypertension - CAD - valvular heart disease
Streptococci

48. Shoulder pain with pain radiating to elbow
Serotypes 16 - 18 - 31 -52 -58
Cervical radiculopathy
True
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

49. When should invasive eletrophysiologic study should be considered?
Squamocolumnar junction=most common site of cervical cancer
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Possibility of Ischemic colitis

50. How does systolic vs. diastolic heart failure present on the echocardiogram?
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
>3.5g of protein per 24hrs
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid