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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. Diarrhea from custard filled pastries
S. Aureus
Associated with hypotension
Candida albicans
Polymenorrhea

2. What are the symptoms of palpitations?
Scabies
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Lightheadedness - dizziness - syncope
Candida albicans

3. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
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.
Hgb - Electrolytes - and TSH
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Other brainstem or cranial nerve findings

4. What are the features of nephrotic syndrome?
Serotypes 16 - 18 - 31 -52 -58
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Higher filling presure - pulmonary congestion - and decreasd cardiac return

5. What the consequences of decreased cardiac output?
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
EGD

6. What treatments are the cornerstone for treating cases of functional constipation?
Medication or chemical esophagitis
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Wolff-Parkinson-White syndrome
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

7. 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
A 24hr urine protein collection and urine creatinine clearance determination
CBC
Varicella virus
Presence of proteinuria on at least two separate ocassion

8. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
35 (exception for postmenopausal women who have recently been started on HRT)
Chest pain during pneumonia or PE
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

9. What is the standard tool used for diagnosis of GERD?
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
EGD

10. When is a lumbar puncture contraindicated?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Variability in the time for follicle development during the proliferative phase
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

11. What is afterload?
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
Polymenorrhea
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

12. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
Slow progression of cervical cancer changes -Availability of effective early treatment
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
PVC or Premature atrial contraction (PAC)

13. What are symptoms are CHF?
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
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

14. Who should have Xray testing for shoulder pain?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

15. What are the most common causes for the common cold?
LH surge triggers ovulation
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Nonulcer dyspepsia

16. What is an acoustic neuroma?
E. Coli O157:H7
Warts
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Subarachnoid hemorrhage

17. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Bence-Jones
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Peptic ulcer disease or gastritis

18. Pneumonia tx: suitable for healthy adults less than 60
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Coag disorders

19. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
24 hour halter
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

20. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Varicella virus
100mg; means patient can be trace protein positive and not be detected
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)

21. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
MSK - pulmonary - GI - or psychological
Giardia
Paroxysmal atrial fibrillation or supraventricular tachycardia

22. What places women at higher risk of getting cervical cancer?
Pleurisy
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
Intermenstrual bleeding
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

23. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Other brainstem or cranial nerve findings
Associated with hypotension
Paroxysmal atrial fibrillation or supraventricular tachycardia
ACEi

24. Describe the presentation tracheobronchitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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.
Upper sternal area burning pain - associated with a productive cough
EGD

25. Menometrorrhagia
Excessive bleeding in amount - duration - or both at irregular intervals
LH surge triggers ovulation
Supraspinatus and bicipital tendons
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.

26. Diagnosis of HTN
Cervical radiculopathy
Non-cardiac causes of palpitations
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Wolff-Parkinson-White syndrome

27. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
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
Diuretics -BB -CCB -ACEi
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

28. Predictors of cardiac etiology
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Coronary artery disease/ angina
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Upper sternal area burning pain - associated with a productive cough

29. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Less abrupt onset and cessation of palpitations
Streptococci
A central clear area

30. Name some medications that can cause proteinuria
Increasing fluid (8 - 8oz glasses of water/day) -fiber
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil

31. Difference between Pneumonia and Bronchitis
Excessive bleeding in amount - duration - or both at irregular intervals
Anticoag with warfarin to prevent thromboembolism
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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

32. When should a patient get a stress test?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

33. Vaccines that should be updated before planned pregnancy
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Non-cardiac causes of palpitations
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Peptic ulcer disease or gastritis

34. What is the Epley maneuver?
Rotator cuff tendonitis
Pleurisy
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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.

35. How to NSAIDs contribute to gastritis and ulcer formation?
HPV
Serotypes 16 - 18 - 31 -52 -58
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.
Albumin; low molecular weight proteins

36. History for Acute bronchitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

37. What test done in PE measures instability of shoulder?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Irregular bleeding between cycles
Less than 3 stools per week
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

38. Describes what occurs during squamous metaplasia of the cervix.
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
>3.5g of protein per 24hrs
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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

39. What type of imaging is need for chronic sinusitis?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
CT
Medication or chemical esophagitis

40. Four muscles of rotator cuff
Viral gastroenteritis
Serotypes 16 - 18 - 31 -52 -58
Polymenorrhea
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

41. 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)
PVC or Premature atrial contraction (PAC)
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

42. What is the Barany maneuver?
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
DM - HTN - DVT - seizures - depression - or anxiety

43. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Variability in the time for follicle development during the proliferative phase
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

44. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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
Associated with hypotension
DM - HTN - DVT - seizures - depression - or anxiety

45. Why don't ACEi work well for the elderly and African Americans when treating HTN?
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Staphylococcal scalded skin syndrome
These patients are associated with low renin states=less likely to respond to medication
Supraspinatus and bicipital tendons

46. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Increase; 200 g/day
Dysfunctional Uterine bleeding: caused by hormonal imbalances from a functionally abnormal hypothalamic-pitu-ovarian axis resulting in abnormal follicle development and anovulation (metorrhagia) -Corpus luteum does not develop=progesterone-deficient
Molluscum contagiosum- pox virus

47. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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
A central clear area
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

48. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Diuretics -BB -CCB -ACEi
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Temporal arteritis-biopsy of the temporal artery
CBC

49. What are the two common clinical presentations of acute diarrhea?
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Fever with frontal or maxillary tenderness

50. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Dysfunctional Uterine bleeding: caused by hormonal imbalances from a functionally abnormal hypothalamic-pitu-ovarian axis resulting in abnormal follicle development and anovulation (metorrhagia) -Corpus luteum does not develop=progesterone-deficient
With a KOH wet mount preparation
CT
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually