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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. 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
With a KOH wet mount preparation
Menorrhagia
Polymenorrhea
Molluscum contagiosum- pox virus

2. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
100mg; means patient can be trace protein positive and not be detected
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Associated with hypotension

3. Describe the presentation tracheobronchitis
Irregular bleeding between cycles
Upper sternal area burning pain - associated with a productive cough
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Less than 80 ml of blood

4. What is the goal of CHF treatment? What drugs should be used?
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
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Common problem that resolves spontaneously and is most often seen in children and young adults
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

5. 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
35 (exception for postmenopausal women who have recently been started on HRT)
Pleurisy
Presence of proteinuria on at least two separate ocassion

6. What is benign transient proteinuria?
Other brainstem or cranial nerve findings
Tension headache
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Common problem that resolves spontaneously and is most often seen in children and young adults

7. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
Coronary artery disease/ angina
35 (exception for postmenopausal women who have recently been started on HRT)
Less than 3 stools per week
Albumin; low molecular weight proteins

8. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Generalized Anxiety disorder and panic disorder
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
Increase; 200 g/day

9. Initial treatment for Rhinosinusitis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Cholelithiasis

10. 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
Bence-Jones
24 hour halter
Dehydration - anemia - cardiac causes

11. Name types of laxatives
HIV and syphilis
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
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
These patients are associated with low renin states=less likely to respond to medication

12. What are the 2 psych disorders most commonly associated with palpitations?
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
Generalized Anxiety disorder and panic disorder
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

13. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Presence of proteinuria on at least two separate ocassion
Rotator Cuff problem
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Paroxysmal atrial fibrillation or supraventricular tachycardia

14. Treatment for supraventricular tachycardias
BB or CCB - catheter ablation of identified bypass tract
100mg; means patient can be trace protein positive and not be detected
Adhesive capsulitis (frozen shoulder): most common in middle age women
Generalized Anxiety disorder and panic disorder

15. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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

16. What are the three major risk factors for heart failure?
Loop diuretics (Check serum K+ levels before drug admin)
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Hypertension - CAD - valvular heart disease
Warts

17. What is the next best step if a patient has two or more positive dipstick tests?
Intermenstrual bleeding
Peptic ulcer disease or gastritis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
A 24hr urine protein collection and urine creatinine clearance determination

18. 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
Hgb - Electrolytes - and TSH
HPV
S. Aureus

19. What are the signs of acute sinusitis?
Medication or chemical esophagitis
Anticoag with warfarin to prevent thromboembolism
Fever with frontal or maxillary tenderness
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

20. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
A 24hr urine protein collection and urine creatinine clearance determination
Pancreatitis

21. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Coag disorders
Loop diuretics (Check serum K+ levels before drug admin)
Rotator Cuff tendonitis

22. Name the skin lesion: honey colored crusts
Candida albicans
Chest pain during pneumonia or PE
Impetigo
RBC casts and old to moderate HTN

23. Name the skin lesion: erythema - warmth - edema - pain - fever
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
S. Aureus
Excessive bleeding in amount - duration - or both at irregular intervals
Cellulitis

24. Describe the presentation of pneumonia
Pts with palpitations and dizziness - near syncope - or syncope
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

25. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
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
Intermenstrual bleeding
Pain
Giardia

26. When should a patient get a stress test?
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
CBC
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
When the patient has symptoms in association with exercise or who describe chest pain or pressure

27. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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
Analgesic headache
Intermenstrual bleeding

28. Chronic pain and shoulder stiffness with limited motion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Cholelithiasis

29. After treatment of dysplasia - women need Pap smears every...
Infectious esophagitis
CT
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

30. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
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
Less than 80 ml of blood
HIV and syphilis

31. Pain in shoulder when throwing - swimming - or serving a tennis ball
Rotator cuff tendonitis
Less than 80 ml of blood
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Giardia

32. 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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
GERD
E. Coli O157:H7
Cluster headache

33. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
GERD
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
Pts with palpitations and dizziness - near syncope - or syncope
Analgesic headache

34. What is an acoustic neuroma?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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.
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

35. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Furucnle
Supraspinatus and bicipital tendons
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

36. How is constipation clinically defined?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
S. Aureus
Less than 3 stools per week
Influenza - Rhinovirus - Adenovirus - Parainfluenza

37. Name some medications that can cause proteinuria
CT
Wolff-Parkinson-White syndrome
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

38. 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
Molluscum contagiosum- pox virus
ACEi - ARBS - thiazide diuretics
Scabies
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

39. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
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.
Staphylococcal scalded skin syndrome
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

40. What is the standard tool used for diagnosis of GERD?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Higher filling presure - pulmonary congestion - and decreasd cardiac return
EGD

41. SE Of Beta blockers?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Furucnle
HPV testing -Pos=colposcopy -Neg=repeat pap smear

42. Pneumonia tx: suitable for healthy adults older than 60
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
HIV and syphilis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
PE - MI - aortic dissection - pneumothorax

43. Prenatal visit schedule for low-risk pregnancies
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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 BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
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

44. What is considered normal blood loss during a menstrual cycle?
Loop diuretics (Check serum K+ levels before drug admin)
EGD
Serotypes 16 - 18 - 31 -52 -58
Less than 80 ml of blood

45. What HPV serotypes are most commonly associated with cervical cancer?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Serotypes 16 - 18 - 31 -52 -58
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Coronary artery disease/ angina

46. What are the signs of cerebral hemorrhage?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Molluscum contagiosum- pox virus
Acute headache - ataxia - profuse nausea - and vomiting
Supraspinatus and bicipital tendons

47. 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
E. Coli O157:H7
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
100mg; means patient can be trace protein positive and not be detected
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

48. History and PE for Pneumonia
Peptic ulcer disease or gastritis
Hypertension - CAD - valvular heart disease
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

49. Name the skin lesion: pustule in association with a hair follice
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Folliculitis
Tension headache
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

50. What is the difference between a Holter monitor or an event monitor?
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Diuretics -BB -CCB -ACEi