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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 are the most common causes for the common cold?
Lightheadedness - dizziness - syncope
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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

2. What is the difference between a Holter monitor or an event monitor?
S. Aureus
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
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
Paroxysmal atrial fibrillation or supraventricular tachycardia

3. What drugs do you use to treat H.pylori + PUD?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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

4. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Temporal arteritis-biopsy of the temporal artery
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

5. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Less than 80 ml of blood
Warts
Hypertension - CAD - valvular heart disease

6. What are signs of pulmonary congestion?
Less abrupt onset and cessation of palpitations
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
RBC casts and old to moderate HTN
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

7. What is the peripheral caUse of vertigo?
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
HPV
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

8. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Supraspinatus and bicipital tendons
High blood pressure - focal neurologic defecit - or papilledema
Echocardiogram
Less abrupt onset and cessation of palpitations

9. How do you define persistent protein uria?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Supraspinatus and bicipital tendons
Presence of proteinuria on at least two separate ocassion

10. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Viral infection of the semicircular apparatus

11. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Associated with hypotension
Staphylococcal scalded skin syndrome
Generalized Anxiety disorder and panic disorder

12. How are fungal infections diagnosed?
Peptic ulcer disease or gastritis
Increase; 200 g/day
Intermenstrual bleeding
With a KOH wet mount preparation

13. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
PVC or Premature atrial contraction (PAC)
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
Increase; 200 g/day
Coag disorders

14. Describe the history and PE of patient presenting with common cold
CBC
E. Coli O157:H7
A 24hr urine protein collection and urine creatinine clearance determination
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

15. Carcinoma in situ is generally referred to a gynecologist and requires ______
Temporal arteritis-biopsy of the temporal artery
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

16. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
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
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Chest pain during pneumonia or PE

17. What is the role of FSH in one's menstrual cycle
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Serotypes 16 - 18 - 31 -52 -58
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Echocardiogram

18. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
PE - MI - aortic dissection - pneumothorax
RBC casts and old to moderate HTN
ACEi
These patients are associated with low renin states=less likely to respond to medication

19. SE Of Beta blockers?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Coronary artery disease/ angina
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

20. When does troponin rise following myocardial injury or infarction?
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
Increase; 200 g/day
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

21. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
24 hour halter
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

22. Difference between Pneumonia and Bronchitis
These patients are associated with low renin states=less likely to respond to medication
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
EGD
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

23. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
LH surge triggers ovulation
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Paroxysmal atrial fibrillation or supraventricular tachycardia

24. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Less abrupt onset and cessation of palpitations
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Dehydration - anemia - cardiac causes

25. Shoulder pain with pain radiating to elbow
Varicella virus
Cervical radiculopathy
Less abrupt onset and cessation of palpitations
Cluster headache

26. Name the skin lesion: pustule in association with a hair follice
Folliculitis
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Pleurisy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

27. What does the classic ring worm lesion have?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
A central clear area
Peptic ulcer disease or gastritis

28. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
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
Anticoag with warfarin to prevent thromboembolism
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear

29. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
LH surge triggers ovulation
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Streptococci
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

30. What the consequences of decreased cardiac output?
Intermenstrual bleeding
Infectious esophagitis
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

31. What is the standard tool used for diagnosis of GERD?
A 24hr urine protein collection and urine creatinine clearance determination
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
EGD

32. When should a patient get a stress test?
Presence of proteinuria on at least two separate ocassion
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Subarachnoid hemorrhage
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

33. Name 4 factors that predispose an individual to develop pneumonia.
Anticoag with warfarin to prevent thromboembolism
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
35 (exception for postmenopausal women who have recently been started on HRT)
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

34. When is a lumbar puncture contraindicated?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
ACEi
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
High blood pressure - focal neurologic defecit - or papilledema

35. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Repeat Pap after infection treated
Rotator Cuff problem
EGD
Streptococci

36. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Less than 3 stools per week
DM - HTN - DVT - seizures - depression - or anxiety
Supraspinatus and bicipital tendons
Tension headache

37. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Bence-Jones
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

38. Diagnosis of HTN
Non-cardiac causes of palpitations
With a KOH wet mount preparation
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
>3.5g of protein per 24hrs

39. 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
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Varicella virus
S. aureus- beta hemolytic streptococcus
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

40. 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.
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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.
Supraspinatus and bicipital tendons

41. Why don't ACEi work well for the elderly and African Americans when treating HTN?
These patients are associated with low renin states=less likely to respond to medication
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
E. Coli O157:H7
Streptococci

42. What occurs after ovulation
These patients are associated with low renin states=less likely to respond to medication
Less than 80 ml of blood
Streptococci
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

43. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Less than 3 stools per week

44. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

45. 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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
LH surge triggers ovulation
Warts
Colposcopy - Endocervical curettage - and directed cervical biopsy

46. Who should have Xray testing for shoulder pain?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Pts with palpitations and dizziness - near syncope - or syncope
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

47. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
PE - MI - aortic dissection - pneumothorax
DM - HTN - DVT - seizures - depression - or anxiety
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

48. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
Subarachnoid hemorrhage
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

49. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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.
Non-cardiac causes of palpitations

50. What is considered normal blood loss during a menstrual cycle?
Pleurisy
Less than 80 ml of blood
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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