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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 type of diuretic is the most widely used for HTN? What are some SE of this drug?
Medication or chemical esophagitis
S. aureus- beta hemolytic streptococcus
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

2. Vaccines that should be updated before planned pregnancy
Pts with palpitations and dizziness - near syncope - or syncope
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

3. What are the physical exam signs of CHF?
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
Intermenstrual bleeding
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
BB or CCB - catheter ablation of identified bypass tract

4. What diagnosis does the 'worse headache of my life' suggest?
Subarachnoid hemorrhage
Less abrupt onset and cessation of palpitations
Echocardiogram
E. Coli O157:H7

5. What does orthostatic positional changes that bring on dizziness suggest?
Dehydration - anemia - cardiac causes
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.
With a KOH wet mount preparation
Common problem that resolves spontaneously and is most often seen in children and young adults

6. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
24 hour halter
True

7. 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
EGD
Cluster headache
24 hour halter

8. Define proteinuria
A central clear area
Acute headache - ataxia - profuse nausea - and vomiting
>150mg per 24hrs
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

9. Who should have Xray testing for shoulder pain?
ACEi
PE - MI - aortic dissection - pneumothorax
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

10. What is the caUse of Meniere disease? What are the cardinal symptoms?
Irregular bleeding between cycles
Tension headache
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

11. What is the role of FSH in one's menstrual cycle
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

12. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Acute headache - ataxia - profuse nausea - and vomiting
With a KOH wet mount preparation
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

13. Name the diagnosis: umbilicated skin lesion that is spread by autoinoculation - scratching - or touching a lesion. Discrete 2 to 5 mm slightly umbilicated flesh-colored - dome shaped papules occurring on the face - trunk - axillae - and extremities i
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Increase; 200 g/day
Molluscum contagiosum- pox virus

14. What drugs do you use to treat H.pylori + PUD?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

15. 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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Cluster headache
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

16. What is a markers of CNS vertigo?
Varicella virus
Albumin; low molecular weight proteins
Other brainstem or cranial nerve findings
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

17. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Scleroderma/polymyositis with secondary gastroesophageal reflux
Paroxysmal atrial fibrillation or supraventricular tachycardia
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.

18. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
A central clear area
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Hgb - Electrolytes - and TSH

19. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Coag disorders
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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

20. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
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.
Chest pain during pneumonia or PE
Echocardiogram
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

21. Regular bleeding at intervals of less than 21 days
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Polymenorrhea
Less than 80 ml of blood

22. HIgh risk pregnant patients should be evaluated for ____ and ____
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
HIV and syphilis
>150mg per 24hrs
EGD

23. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Less abrupt onset and cessation of palpitations
E. Coli O157:H7
Streptococci
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

24. After treatment of dysplasia - women need Pap smears every...
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

25. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
High blood pressure - focal neurologic defecit - or papilledema
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Coronary artery disease/ angina
Nonulcer dyspepsia

26. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Less than 3 stools per week
ACEi
Repeat Pap after infection treated

27. What are the three types of lice?
Albumin; low molecular weight proteins
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

28. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
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
Fever with frontal or maxillary tenderness
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Rotator cuff tendonitis

29. Define nephrotic range proteinuria
>3.5g of protein per 24hrs
These patients are associated with low renin states=less likely to respond to medication
Varicella virus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

30. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

31. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
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.
Chest pain during pneumonia or PE
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

32. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Temporal arteritis-biopsy of the temporal artery
Excessive bleeding in amount - duration - or both at irregular intervals

33. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Pleurisy
Lightheadedness - dizziness - syncope
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

34. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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
Viral gastroenteritis
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

35. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Common problem that resolves spontaneously and is most often seen in children and young adults
Peptic ulcer disease or gastritis
Associated with hypotension

36. What is the mechanism of action for stimulant agents in treating constipation?
ACEi - ARBS - thiazide diuretics
Increase; 200 g/day
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

37. What does the classic ring worm lesion have?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
A central clear area
Rotator cuff tendonitis

38. patients with herpes zoster may experience what symptom before the rash appear?
Fever with frontal or maxillary tenderness
Lightheadedness - dizziness - syncope
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Pain

39. Describe the presentation tracheobronchitis
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
RBC casts and old to moderate HTN
Upper sternal area burning pain - associated with a productive cough
Increase; 200 g/day

40. 1+ protein level on urine dipstick usually represents how much protein in the urine?
Temporal arteritis-biopsy of the temporal artery
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Hypertension - CAD - valvular heart disease
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

41. How are fungal infections diagnosed?
With a KOH wet mount preparation
Temporal arteritis-biopsy of the temporal artery
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Intermenstrual bleeding

42. Describe the presentation of pneumonia
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
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
MSK - pulmonary - GI - or psychological
Intermenstrual bleeding

43. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Warts
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

44. History for Acute bronchitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

45. How is constipation clinically defined?
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Non-cardiac causes of palpitations
Less than 3 stools per week
Molluscum contagiosum- pox virus

46. What is an acoustic neuroma?
True
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
A 24hr urine protein collection and urine creatinine clearance determination
Possibility of Ischemic colitis

47. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Chest pain during pneumonia or PE
Coag disorders
Varicella virus
Analgesic headache

48. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Rotator Cuff problem
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Scleroderma/polymyositis with secondary gastroesophageal reflux

49. What are the 2 psych disorders most commonly associated with palpitations?
Generalized Anxiety disorder and panic disorder
Cervical radiculopathy
BB or CCB - catheter ablation of identified bypass tract
Regular bleeding at intervals of more than 35 days

50. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
MSK - pulmonary - GI - or psychological
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