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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 type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Analgesic headache
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

2. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Pleurisy
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

3. Name some medications that can cause proteinuria
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
Rotator Cuff tendonitis
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

4. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Hypertension - CAD - valvular heart disease
Regular bleeding at intervals of more than 35 days
Nonulcer dyspepsia
Repeat Pap after infection treated

5. Complete the sentence: pericarditis can cause frictional rub and......
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
High blood pressure - focal neurologic defecit - or papilledema
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

6. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Coag disorders
Wolff-Parkinson-White syndrome
Candida albicans
Intermenstrual bleeding

7. Cycle length variabilty is primarily due to what?
Folliculitis
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Variability in the time for follicle development during the proliferative phase
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

8. 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.
S. aureus- beta hemolytic streptococcus
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Repeat Pap after infection treated
Serotypes 16 - 18 - 31 -52 -58

9. What are the features of nephrotic syndrome?
Cluster headache
Serotypes 16 - 18 - 31 -52 -58
Peptic ulcer disease or gastritis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

10. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
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
Peptic ulcer disease or gastritis
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Loop diuretics (Check serum K+ levels before drug admin)

11. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Candida albicans
Common problem that resolves spontaneously and is most often seen in children and young adults
True

12. Chronic pain and shoulder stiffness with limited motion
Infectious esophagitis
Adhesive capsulitis (frozen shoulder): most common in middle age women
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

13. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Coronary artery disease/ angina
24 hour halter
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Repeat Pap after infection treated

14. What are the signs of cerebral hemorrhage?
Medication or chemical esophagitis
Pts with palpitations and dizziness - near syncope - or syncope
PE - MI - aortic dissection - pneumothorax
Acute headache - ataxia - profuse nausea - and vomiting

15. Describe the presentation of angina?
RBC casts and old to moderate HTN
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
Furucnle
PVC or Premature atrial contraction (PAC)

16. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Rotator Cuff tendonitis
Cholelithiasis
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

17. Regular bleeding at intervals of less than 21 days
Polymenorrhea
Excessive bleeding in amount - duration - or both at irregular intervals
Generalized Anxiety disorder and panic disorder
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

18. What does treatment for migrans include?
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
Slow progression of cervical cancer changes -Availability of effective early treatment
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
>150mg per 24hrs

19. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Rotator Cuff tendonitis

20. What are the primary glomerular diseases?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

21. After treatment of dysplasia - women need Pap smears every...
Chest pain during pneumonia or PE
Generalized Anxiety disorder and panic disorder
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

22. Name the diagnosis of heartburn: severe constant mid abdominal pain
Furucnle
Pancreatitis
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Other brainstem or cranial nerve findings

23. Pneumothorax - sudden sharp chest pain - preceded by viral illness
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.
Pleurisy
Supraspinatus and bicipital tendons
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

24. What does orthostatic positional changes that bring on dizziness suggest?
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
Common problem that resolves spontaneously and is most often seen in children and young adults
PE - MI - aortic dissection - pneumothorax
Dehydration - anemia - cardiac causes

25. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
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
CT
ACEi - ARBS - thiazide diuretics
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

26. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Streptococci
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

27. How do you define persistent protein uria?
PVC or Premature atrial contraction (PAC)
Colposcopy - Endocervical curettage - and directed cervical biopsy
Presence of proteinuria on at least two separate ocassion
Cholelithiasis

28. PE for a patient getting an abnormal vaginal bleeding work up
Scabies
Possibility of Ischemic colitis
Analgesic headache
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

29. What treatments are the cornerstone for treating cases of functional constipation?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Upper sternal area burning pain - associated with a productive cough
Increasing fluid (8 - 8oz glasses of water/day) -fiber
These patients are associated with low renin states=less likely to respond to medication

30. Difference between Pneumonia and Bronchitis
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Peptic ulcer disease or gastritis
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
HIV and syphilis

31. 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)
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.
Hgb - Electrolytes - and TSH
Non-cardiac causes of palpitations

32. History and PE for Pneumonia
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
Pts with palpitations and dizziness - near syncope - or syncope
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
E. Coli O157:H7

33. Mainstay treatment for soft tissue inflammation (Shoulder)
Pleurisy
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Tension headache
High blood pressure - focal neurologic defecit - or papilledema

34. Treatment for supraventricular tachycardias
Subarachnoid hemorrhage
Anticoag with warfarin to prevent thromboembolism
>150mg per 24hrs
BB or CCB - catheter ablation of identified bypass tract

35. Name the diagnosis of heartburn: regurgitation - dysphagia
Lightheadedness - dizziness - syncope
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
GERD
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

36. How does systolic vs. diastolic heart failure present on the echocardiogram?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
Hgb - Electrolytes - and TSH
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

37. When is a lumbar puncture contraindicated?
Excessive bleeding in amount - duration - or both at irregular intervals
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
Upper sternal area burning pain - associated with a productive cough
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

38. Lab testing for heart palpitation
Temporal arteritis-biopsy of the temporal artery
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Hgb - Electrolytes - and TSH

39. What is the peripheral caUse of vertigo?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Supraspinatus and bicipital tendons
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

40. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
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
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

41. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Upper sternal area burning pain - associated with a productive cough
Intermenstrual bleeding
DM - HTN - DVT - seizures - depression - or anxiety
Bulk forming: Psyllium - Methycellulose - Polycarbophil

42. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Common problem that resolves spontaneously and is most often seen in children and young adults
Scleroderma/polymyositis with secondary gastroesophageal reflux
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

43. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Slow progression of cervical cancer changes -Availability of effective early treatment
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Cholelithiasis

44. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Pts with palpitations and dizziness - near syncope - or syncope
Infectious esophagitis
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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. Define the patient population typically affected by orthostatic or postural proteinuria
Common problem that resolves spontaneously and is most often seen in children and young adults
Pleurisy
Rotator Cuff tendonitis
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

46. What diagnosis does the 'worse headache of my life' suggest?
Cholelithiasis
Less than 80 ml of blood
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Subarachnoid hemorrhage

47. name the 4 emergent causes of chest pain
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
CBC
PE - MI - aortic dissection - pneumothorax
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

48. 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
Scabies
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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

49. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Analgesic headache
Hypertension - CAD - valvular heart disease
Viral infection of the semicircular apparatus

50. What type of imaging is need for chronic sinusitis?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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
Cholelithiasis
CT