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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. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
BB or CCB - catheter ablation of identified bypass tract
Streptococci
Increase; 200 g/day
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

2. What drugs do you use to treat H.pylori + PUD?
Presence of proteinuria on at least two separate ocassion
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

3. How are fungal infections diagnosed?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Nonulcer dyspepsia
With a KOH wet mount preparation
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

4. What is the mechanism of action for stimulant agents in treating constipation?
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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
Lightheadedness - dizziness - syncope

5. 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
Common problem that resolves spontaneously and is most often seen in children and young adults
Lightheadedness - dizziness - syncope
S. Aureus
Scabies

6. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Regular bleeding at intervals of more than 35 days

7. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
A central clear area
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

8. What are the consequences of diastolic dysfunction?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Kids: Rotavirus Adults: Norwalk Virus
Rotator cuff tendonitis
Higher filling presure - pulmonary congestion - and decreasd cardiac return

9. What are the features of glomerular nephritis
Fever with frontal or maxillary tenderness
Pleurisy
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.
RBC casts and old to moderate HTN

10. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
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
Upper sternal area burning pain - associated with a productive cough
MSK - pulmonary - GI - or psychological
Subarachnoid hemorrhage

11. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Peptic ulcer disease or gastritis
Hgb - Electrolytes - and TSH
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

12. Carcinoma in situ is generally referred to a gynecologist and requires ______
Pleurisy
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
Regular bleeding at intervals of more than 35 days
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

13. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
>150mg per 24hrs
Paroxysmal atrial fibrillation or supraventricular tachycardia
Viral infection of the semicircular apparatus
>3.5g of protein per 24hrs

14. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Molluscum contagiosum- pox virus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
These patients are associated with low renin states=less likely to respond to medication
Intermenstrual bleeding

15. HIgh risk pregnant patients should be evaluated for ____ and ____
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
HIV and syphilis
CBC
S. aureus- beta hemolytic streptococcus

16. Name the diagnosis of heartburn: regurgitation - dysphagia
>3.5g of protein per 24hrs
Slow progression of cervical cancer changes -Availability of effective early treatment
GERD
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

17. Name types of laxatives
Pancreatitis
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Lightheadedness - dizziness - syncope
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

18. Pain in shoulder when throwing - swimming - or serving a tennis ball
Streptococci
Candida albicans
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Rotator cuff tendonitis

19. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Chest pain during pneumonia or PE
Colposcopy - Endocervical curettage - and directed cervical biopsy
Furucnle
Cholelithiasis

20. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
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
CBC
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

21. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
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
Rotator cuff tendonitis
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
Staphylococcal scalded skin syndrome

22. 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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

23. Oligomenorrhea
A central clear area
Irregular bleeding between cycles
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Regular bleeding at intervals of more than 35 days

24. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Increase; 200 g/day
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

25. Uterine bleeding between regular cycles
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Intermenstrual bleeding
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

26. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
35 (exception for postmenopausal women who have recently been started on HRT)
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
CT

27. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
Cluster headache
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Nonulcer dyspepsia

28. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
CBC
PVC or Premature atrial contraction (PAC)
Subarachnoid hemorrhage

29. Complete the sentence: pericarditis can cause frictional rub and......
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

30. Regular bleeding at intervals of less than 21 days
Furucnle
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Folliculitis
Polymenorrhea

31. What lab tests are recommended for newly diagnosed hypertensive patients?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Nonulcer dyspepsia
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
S. Aureus

32. What is afterload?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Increasing fluid (8 - 8oz glasses of water/day) -fiber
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Tension headache

33. How to NSAIDs contribute to gastritis and ulcer formation?
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.
EGD
Paroxysmal atrial fibrillation or supraventricular tachycardia
Less than 3 stools per week

34. SE Of Beta blockers?
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

35. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Variability in the time for follicle development during the proliferative phase
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

36. Name the diagnosis of heartburn: severe constant mid abdominal pain
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Pancreatitis

37. What are signs of pulmonary congestion?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Cluster headache
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

38. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
PVC or Premature atrial contraction (PAC)
Excessive bleeding in amount - duration - or both at irregular intervals

39. Describes what occurs during squamous metaplasia of the cervix.
CBC
Common problem that resolves spontaneously and is most often seen in children and young adults
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

40. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Pts with palpitations and dizziness - near syncope - or syncope
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Loop diuretics (Check serum K+ levels before drug admin)
Hypertension - CAD - valvular heart disease

41. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
Giardia
Pleurisy
Variability in the time for follicle development during the proliferative phase
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

42. What is the caUse of Meniere disease? What are the cardinal symptoms?
Pts with palpitations and dizziness - near syncope - or syncope
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
HIV and syphilis
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

43. Menometrorrhagia
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
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
Excessive bleeding in amount - duration - or both at irregular intervals
Paroxysmal atrial fibrillation or supraventricular tachycardia

44. Discomfort with abducting the arm past 90 degress
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
Rotator Cuff tendonitis
Staphylococcal scalded skin syndrome
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

45. 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
Diuretics -BB -CCB -ACEi
Paroxysmal atrial fibrillation or supraventricular tachycardia
Medication or chemical esophagitis

46. Name the skin lesion: erythema - warmth - edema - pain - fever
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Cellulitis
Albumin; low molecular weight proteins
Other brainstem or cranial nerve findings

47. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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
Common problem that resolves spontaneously and is most often seen in children and young adults

48. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
A 24hr urine protein collection and urine creatinine clearance determination
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Adhesive capsulitis (frozen shoulder): most common in middle age women
Non-cardiac causes of palpitations

49. What is the role of LH in the menstrual cycle
Varicella virus
Increase; 200 g/day
LH surge triggers ovulation
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

50. Name the skin lesion: pustule in association with a hair follice
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
True
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Folliculitis