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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.
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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 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
BB or CCB - catheter ablation of identified bypass tract
Common problem that resolves spontaneously and is most often seen in children and young adults
Coronary artery disease/ angina
Scabies

2. Who should have Xray testing for shoulder pain?
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
DM - HTN - DVT - seizures - depression - or anxiety
Anticoag with warfarin to prevent thromboembolism

3. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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

4. What are the secondly causes of glomerular disease?
Diuretics -BB -CCB -ACEi
A 24hr urine protein collection and urine creatinine clearance determination
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

5. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Nonulcer dyspepsia
Infectious esophagitis
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

6. What is the role of LH in the menstrual cycle
100mg; means patient can be trace protein positive and not be detected
Streptococci
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
LH surge triggers ovulation

7. What diagnosis does the 'worse headache of my life' suggest?
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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
Subarachnoid hemorrhage
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

8. What are the most common viral causes of diarrhea in kids and adults?
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Kids: Rotavirus Adults: Norwalk Virus
Higher filling presure - pulmonary congestion - and decreasd cardiac return

9. What is the role of FSH in one's menstrual cycle
When the patient has symptoms in association with exercise or who describe chest pain or pressure
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

10. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
CT
True
Pleurisy

11. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

12. What are the two common clinical presentations of acute diarrhea?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Rotator Cuff problem
Presence of proteinuria on at least two separate ocassion
Scleroderma/polymyositis with secondary gastroesophageal reflux

13. What does orthostatic positional changes that bring on dizziness suggest?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Dehydration - anemia - cardiac causes
Excessive bleeding in amount - duration - or both at irregular intervals
Associated with hypotension

14. Mainstay treatment for soft tissue inflammation (Shoulder)
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
GERD
HPV testing -Pos=colposcopy -Neg=repeat pap smear
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

15. When does troponin rise following myocardial injury or infarction?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Presence of proteinuria on at least two separate ocassion
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

16. What are the three types of lice?
Chest pain during pneumonia or PE
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
>150mg per 24hrs

17. Describe the history and PE of patient presenting with common cold
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Higher filling presure - pulmonary congestion - and decreasd cardiac return

18. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
A central clear area
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
Coronary artery disease/ angina

19. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Infectious esophagitis
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Acute headache - ataxia - profuse nausea - and vomiting

20. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
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
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Intermenstrual bleeding
Viral infection of the semicircular apparatus

21. What test done in PE measures instability of shoulder?
Viral infection of the semicircular apparatus
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Cholelithiasis
DM - HTN - DVT - seizures - depression - or anxiety

22. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Streptococci
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

23. History for Sinusitis

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24. 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
Echocardiogram
Fever with frontal or maxillary tenderness
Varicella virus
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

25. Shoulder pain with pain radiating to elbow
S. Aureus
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Cervical radiculopathy
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

26. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Furucnle
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

27. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Variability in the time for follicle development during the proliferative phase

28. What are the indiciations for neuroimaging?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
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
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

29. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Staphylococcal scalded skin syndrome
CT
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Bulk forming: Psyllium - Methycellulose - Polycarbophil

30. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Analgesic headache
Colposcopy - Endocervical curettage - and directed cervical biopsy
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue

31. What does the classic ring worm lesion have?
Peptic ulcer disease or gastritis
A central clear area
S. Aureus
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

32. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
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.
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Acute headache - ataxia - profuse nausea - and vomiting

33. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Pleurisy
Intermenstrual bleeding
Temporal arteritis-biopsy of the temporal artery
Generalized Anxiety disorder and panic disorder

34. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Possibility of Ischemic colitis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Generalized Anxiety disorder and panic disorder

35. What is an acoustic neuroma?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Other brainstem or cranial nerve findings
Rotator cuff tendonitis
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

36. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
S. aureus- beta hemolytic streptococcus
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
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

37. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Echocardiogram
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Viral infection of the semicircular apparatus
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

38. Describe the presentation tracheobronchitis
Upper sternal area burning pain - associated with a productive cough
>150mg per 24hrs
Dehydration - anemia - cardiac causes
ACEi

39. 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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
>150mg per 24hrs
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

40. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Wolff-Parkinson-White syndrome
Serotypes 16 - 18 - 31 -52 -58
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

41. 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
Bence-Jones
Repeat Pap after infection treated
Pts with palpitations and dizziness - near syncope - or syncope

42. Define nephrotic range proteinuria
>3.5g of protein per 24hrs
Anticoag with warfarin to prevent thromboembolism
Warts
S. Aureus

43. Carcinoma in situ is generally referred to a gynecologist and requires ______
Pain
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
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Other brainstem or cranial nerve findings

44. Name some medications that can cause proteinuria
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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.
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Presence of proteinuria on at least two separate ocassion

45. Four muscles of rotator cuff
Impetigo
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Rotator cuff tendonitis
Colposcopy - Endocervical curettage - and directed cervical biopsy

46. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Colposcopy - Endocervical curettage - and directed cervical biopsy
DM - HTN - DVT - seizures - depression - or anxiety
Less than 80 ml of blood
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

47. Treatment for supraventricular tachycardias
Tension headache
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Presence of proteinuria on at least two separate ocassion
BB or CCB - catheter ablation of identified bypass tract

48. What are the features of nephrotic syndrome?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Nonulcer dyspepsia

49. What microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
GERD
E. Coli O157:H7
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

50. What is the mechanism of action for stimulant agents in treating constipation?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Diuretics -BB -CCB -ACEi
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually