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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 is the Epley maneuver?
BB or CCB - catheter ablation of identified bypass tract
Cholelithiasis
Coronary artery disease/ angina
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.

2. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
Less than 3 stools per week
S. aureus- beta hemolytic streptococcus
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

3. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
A 24hr urine protein collection and urine creatinine clearance determination
Repeat Pap after infection treated
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

4. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Polymenorrhea
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Adhesive capsulitis (frozen shoulder): most common in middle age women
Albumin; low molecular weight proteins

5. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Tension headache
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

6. Who should have Xray testing for shoulder pain?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Chest pain during pneumonia or PE
Dehydration - anemia - cardiac causes
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

7. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
A 24hr urine protein collection and urine creatinine clearance determination
Echocardiogram
Cluster headache
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

8. What are the three major risk factors for heart failure?
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.
Tension headache
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Hypertension - CAD - valvular heart disease

9. Regular bleeding at intervals of less than 21 days
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Polymenorrhea
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.

10. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Intermenstrual bleeding
Less than 3 stools per week
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

11. 1+ protein level on urine dipstick usually represents how much protein in the urine?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Peptic ulcer disease or gastritis
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
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

12. What is an acoustic neuroma?
Temporal arteritis-biopsy of the temporal artery
Adhesive capsulitis (frozen shoulder): most common in middle age women
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
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. What diagnosis does the 'worse headache of my life' suggest?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Subarachnoid hemorrhage
Cluster headache

14. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Acute headache - ataxia - profuse nausea - and vomiting
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
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

15. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
RBC casts and old to moderate HTN
LH surge triggers ovulation
Nonulcer dyspepsia
Coronary artery disease/ angina

16. What are the most common viral causes of diarrhea in kids and adults?
Squamocolumnar junction=most common site of cervical cancer
100mg; means patient can be trace protein positive and not be detected
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Kids: Rotavirus Adults: Norwalk Virus

17. Tx of chronic or intermittent afibs
Supraspinatus and bicipital tendons
Cluster headache
Anticoag with warfarin to prevent thromboembolism
Presence of proteinuria on at least two separate ocassion

18. Name the skin lesion: honey colored crusts
Impetigo
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

19. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
24 hour halter
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Varicella virus
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

20. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Chest pain during pneumonia or PE

21. What type of imaging is need for chronic sinusitis?
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
CT
Infectious esophagitis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

22. How to NSAIDs contribute to gastritis and ulcer formation?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Anticoag with warfarin to prevent thromboembolism
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.
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

23. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
These patients are associated with low renin states=less likely to respond to medication

24. Treatment for supraventricular tachycardias
CBC
Paroxysmal atrial fibrillation or supraventricular tachycardia
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
BB or CCB - catheter ablation of identified bypass tract

25. What medications can cause heart palpitations?
High blood pressure - focal neurologic defecit - or papilledema
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

26. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
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
Kids: Rotavirus Adults: Norwalk Virus
Regular bleeding at intervals of more than 35 days
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

27. Metrorrhagia
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
Irregular bleeding between cycles
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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

28. What is the preload?
Slow progression of cervical cancer changes -Availability of effective early treatment
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
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

29. What is the peripheral caUse of vertigo?
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Medication or chemical esophagitis
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

30. MI - pericardial tamponade - PE - GI bleed - are...
24 hour halter
Cholelithiasis
Associated with hypotension
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

31. Define the patient population typically affected by orthostatic or postural proteinuria
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
True
Echocardiogram

32. Describe the presentation of pneumonia
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
Lightheadedness - dizziness - syncope
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Varicella virus

33. Complete the sentence: pericarditis can cause frictional rub and......
Kids: Rotavirus Adults: Norwalk Virus
Generalized Anxiety disorder and panic disorder
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
S. aureus- beta hemolytic streptococcus

34. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Impetigo
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
RBC casts and old to moderate HTN

35. Name types of laxatives
Pts with palpitations and dizziness - near syncope - or syncope
Upper sternal area burning pain - associated with a productive cough
A central clear area
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

36. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
LH surge triggers ovulation
Intermenstrual bleeding
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

37. What are the physical exam signs of CHF?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
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
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
EGD

38. What is benign transient proteinuria?
Candida albicans
These patients are associated with low renin states=less likely to respond to medication
Common problem that resolves spontaneously and is most often seen in children and young adults
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

39. What the consequences of decreased cardiac output?
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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
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
Tension headache

40. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
ACEi - ARBS - thiazide diuretics
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

41. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
High blood pressure - focal neurologic defecit - or papilledema
Increasing fluid (8 - 8oz glasses of water/day) -fiber
ACEi

42. What are the indiciations for neuroimaging?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
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

43. 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
Furucnle
ACEi
E. Coli O157:H7
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.

44. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Subarachnoid hemorrhage
Variability in the time for follicle development during the proliferative phase

45. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
>150mg per 24hrs
Furucnle
Wolff-Parkinson-White syndrome
Temporal arteritis-biopsy of the temporal artery

46. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Temporal arteritis-biopsy of the temporal artery
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
35 (exception for postmenopausal women who have recently been started on HRT)
HIV and syphilis

47. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Nonulcer dyspepsia
Kids: Rotavirus Adults: Norwalk Virus
Generalized Anxiety disorder and panic disorder

48. Diarrhea from custard filled pastries
S. Aureus
Loop diuretics (Check serum K+ levels before drug admin)
S. aureus- beta hemolytic streptococcus
Slow progression of cervical cancer changes -Availability of effective early treatment

49. 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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Scabies
Nonulcer dyspepsia
Possibility of Ischemic colitis

50. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Chest pain during pneumonia or PE
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid