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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. History for Acute bronchitis
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
E. Coli O157:H7
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Bence-Jones

2. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Peptic ulcer disease or gastritis
Rotator Cuff problem

3. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Fever with frontal or maxillary tenderness

4. What occurs after ovulation
Paroxysmal atrial fibrillation or supraventricular tachycardia
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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
Bence-Jones

5. 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
EGD
Temporal arteritis-biopsy of the temporal artery
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Varicella virus

6. What are the three major risk factors for heart failure?
Analgesic headache
Pts with palpitations and dizziness - near syncope - or syncope
Hypertension - CAD - valvular heart disease
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

7. Describe the presentation of myocardial pain?
ACEi
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Presence of proteinuria on at least two separate ocassion
HIV and syphilis

8. Constipation: What are indications for lab testing?
Viral gastroenteritis
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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

9. What does the classic ring worm lesion have?
Slow progression of cervical cancer changes -Availability of effective early treatment
A central clear area
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

10. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
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
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
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
Temporal arteritis-biopsy of the temporal artery

11. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Cellulitis

12. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Influenza - Rhinovirus - Adenovirus - Parainfluenza
RBC casts and old to moderate HTN

13. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Cervical radiculopathy
Excessive bleeding in amount - duration - or both at irregular intervals
Pts with palpitations and dizziness - near syncope - or syncope
LH surge triggers ovulation

14. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Fever with frontal or maxillary tenderness
Wolff-Parkinson-White syndrome
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

15. What is the standard tool used for diagnosis of GERD?
Increase; 200 g/day
RBC casts and old to moderate HTN
EGD
S. Aureus

16. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
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
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

17. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
PE - MI - aortic dissection - pneumothorax
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Viral infection of the semicircular apparatus

18. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Echocardiogram
Irregular bleeding between cycles

19. What are the most common viral causes of diarrhea in kids and adults?
Folliculitis
E. Coli O157:H7
Kids: Rotavirus Adults: Norwalk Virus
Variability in the time for follicle development during the proliferative phase

20. What is the caUse of benign positional vertigo?
MSK - pulmonary - GI - or psychological
Possibility of Ischemic colitis
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
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.

21. Natural history of cervical cancer
Echocardiogram
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

22. Describe the presentation tracheobronchitis
Upper sternal area burning pain - associated with a productive cough
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
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Supraspinatus and bicipital tendons

23. Regular bleeding at intervals of less than 21 days
Polymenorrhea
Repeat Pap after infection treated
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Viral gastroenteritis

24. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
EGD
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Analgesic headache

25. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Higher filling presure - pulmonary congestion - and decreasd cardiac return
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Paroxysmal atrial fibrillation or supraventricular tachycardia
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

26. What lab tests are recommended for newly diagnosed hypertensive patients?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
CBC

27. Metrorrhagia
Supraspinatus and bicipital tendons
Irregular bleeding between cycles
HIV and syphilis
Intermenstrual bleeding

28. Prenatal visit schedule for low-risk pregnancies
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
Increase; 200 g/day
S. aureus- beta hemolytic streptococcus
CBC

29. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
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.
Non-cardiac causes of palpitations
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

30. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
A 24hr urine protein collection and urine creatinine clearance determination
Fever with frontal or maxillary tenderness
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.
Streptococci

31. Lab testing for heart palpitation
Pain
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Hgb - Electrolytes - and TSH
Chest pain during pneumonia or PE

32. When should invasive eletrophysiologic study should be considered?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Lightheadedness - dizziness - syncope
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

33. What are the consequences of diastolic dysfunction?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
CBC

34. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
HPV
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

35. Describes what occurs during squamous metaplasia of the cervix.
ACEi
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
Increase; 200 g/day
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

36. What is the role of LH in the menstrual cycle
LH surge triggers ovulation
With a KOH wet mount preparation
CT
Pancreatitis

37. Name the skin lesion: erythema - warmth - edema - pain - fever
Pain
Cellulitis
Less abrupt onset and cessation of palpitations
HIV and syphilis

38. Shoulder pain with pain radiating to elbow
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Subarachnoid hemorrhage
Echocardiogram
Cervical radiculopathy

39. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
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
Scabies
MSK - pulmonary - GI - or psychological

40. What are the symptoms of palpitations?
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Lightheadedness - dizziness - syncope

41. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Temporal arteritis-biopsy of the temporal artery
Fever with frontal or maxillary tenderness
Cervical radiculopathy

42. How to NSAIDs contribute to gastritis and ulcer formation?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
CT
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
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.

43. Pneumonia tx: suitable for healthy adults older than 60
Polymenorrhea
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
RBC casts and old to moderate HTN
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

44. name the 4 emergent causes of chest pain
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
PE - MI - aortic dissection - pneumothorax
A central clear area
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

45. What is the difference between a Holter monitor or an event monitor?
Candida albicans
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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

46. 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
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
35 (exception for postmenopausal women who have recently been started on HRT)

47. What are the features of nephrotic syndrome?
Repeat Pap after infection treated
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
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

48. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
E. Coli O157:H7
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Increasing fluid (8 - 8oz glasses of water/day) -fiber

49. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
>150mg per 24hrs
Intermenstrual bleeding
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

50. What is the Epley maneuver?
Pancreatitis
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.
>3.5g of protein per 24hrs
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse