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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. Uterine bleeding between regular cycles
Intermenstrual bleeding
HPV testing -Pos=colposcopy -Neg=repeat pap smear
S. Aureus
Non-cardiac causes of palpitations

2. Tx of chronic or intermittent afibs
Molluscum contagiosum- pox virus
True
Anticoag with warfarin to prevent thromboembolism
GERD

3. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
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
35 (exception for postmenopausal women who have recently been started on HRT)
These patients are associated with low renin states=less likely to respond to medication
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

4. 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
GERD
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Temporal arteritis-biopsy of the temporal artery
Varicella virus

5. Treatment for supraventricular tachycardias
Loop diuretics (Check serum K+ levels before drug admin)
Less than 3 stools per week
BB or CCB - catheter ablation of identified bypass tract
Scabies

6. Diagnostic Evaluation of Abnoraml vaginal bleeding
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

7. Menometrorrhagia
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
Excessive bleeding in amount - duration - or both at irregular intervals
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Non-cardiac causes of palpitations

8. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
24 hour halter
35 (exception for postmenopausal women who have recently been started on HRT)
Hypertension - CAD - valvular heart disease

9. 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
>150mg per 24hrs
Molluscum contagiosum- pox virus
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

10. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Pleurisy
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Generalized Anxiety disorder and panic disorder
>3.5g of protein per 24hrs

11. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Echocardiogram
Non-cardiac causes of 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
EGD

12. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
Excessive bleeding in amount - duration - or both at irregular intervals
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Hypertension - CAD - valvular heart disease

13. Name the skin lesion: pustule in association with a hair follice
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Folliculitis
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

14. What are the three major risk factors for heart failure?
A central clear area
Hypertension - CAD - valvular heart disease
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

15. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Bulk forming: Psyllium - Methycellulose - Polycarbophil
PE - MI - aortic dissection - pneumothorax
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
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

16. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
100mg; means patient can be trace protein positive and not be detected
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Loop diuretics (Check serum K+ levels before drug admin)
Less than 80 ml of blood

17. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
35 (exception for postmenopausal women who have recently been started on HRT)
CT
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
GERD

18. Mainstay treatment for soft tissue inflammation (Shoulder)
Cellulitis
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Lightheadedness - dizziness - syncope

19. What are the three types of lice?
Rotator cuff tendonitis
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.
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
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

20. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Less abrupt onset and cessation of palpitations
Scleroderma/polymyositis with secondary gastroesophageal reflux
Common problem that resolves spontaneously and is most often seen in children and young adults
Temporal arteritis-biopsy of the temporal artery

21. What are the secondly causes of glomerular disease?
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Less than 80 ml of blood
>3.5g of protein per 24hrs
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

22. Predictors of cardiac etiology
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Other brainstem or cranial nerve findings

23. What are the features of glomerular nephritis
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Viral infection of the semicircular apparatus
RBC casts and old to moderate HTN

24. How are fungal infections diagnosed?
Generalized Anxiety disorder and panic disorder
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
With a KOH wet mount preparation
Streptococci

25. Why don't ACEi work well for the elderly and African Americans when treating HTN?
These patients are associated with low renin states=less likely to respond to medication
Slow progression of cervical cancer changes -Availability of effective early treatment
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Non-cardiac causes of palpitations

26. What type of imaging is need for chronic sinusitis?
Coag disorders
CT
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Intermenstrual bleeding

27. What is the role of FSH in one's menstrual cycle
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
GERD
Regular bleeding at intervals of more than 35 days
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

28. Complete the sentence: pericarditis can cause frictional rub and......
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Medication or chemical esophagitis
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Albumin; low molecular weight proteins

29. When is a lumbar puncture contraindicated?
Folliculitis
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Slow progression of cervical cancer changes -Availability of effective early treatment

30. MI - pericardial tamponade - PE - GI bleed - are...
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Associated with hypotension
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
Supraspinatus and bicipital tendons

31. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Analgesic headache
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

32. 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
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Scabies
Diuretics -BB -CCB -ACEi
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

33. Why is the pap smear one of the most effective cancer screening tools?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Slow progression of cervical cancer changes -Availability of effective early treatment
High blood pressure - focal neurologic defecit - or papilledema

34. 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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Fever with frontal or maxillary tenderness

35. What are the most common viral causes of diarrhea in kids and adults?
Loop diuretics (Check serum K+ levels before drug admin)
Kids: Rotavirus Adults: Norwalk Virus
Cervical radiculopathy
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

36. What is a markers of CNS vertigo?
HPV
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Other brainstem or cranial nerve findings
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

37. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
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
Scleroderma/polymyositis with secondary gastroesophageal reflux
Pleurisy
Echocardiogram

38. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
With a KOH wet mount preparation
Colposcopy - Endocervical curettage - and directed cervical biopsy
Polymenorrhea
Bence-Jones

39. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Medication or chemical esophagitis
Possibility of Ischemic colitis
High blood pressure - focal neurologic defecit - or papilledema
A central clear area

40. Discomfort with abducting the arm past 90 degress
Rotator Cuff tendonitis
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Associated with hypotension
Upper sternal area burning pain - associated with a productive cough

41. Four muscles of rotator cuff
PVC or Premature atrial contraction (PAC)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Giardia

42. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
HIV and syphilis
Giardia
Irregular bleeding between cycles
100mg; means patient can be trace protein positive and not be detected

43. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Menorrhagia
CBC

44. What is the caUse of Meniere disease? What are the cardinal symptoms?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Lightheadedness - dizziness - syncope
Generalized Anxiety disorder and panic disorder

45. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Possibility of Ischemic colitis
Analgesic headache
Tension headache

46. How do you know if heart palpitations are due to stimulant or medication use?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Less abrupt onset and cessation of palpitations
Chest pain during pneumonia or PE
Medication or chemical esophagitis

47. How does systolic vs. diastolic heart failure present on the echocardiogram?
Squamocolumnar junction=most common site of cervical cancer
HPV
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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

48. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
HPV
Temporal arteritis-biopsy of the temporal artery
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Possibility of Ischemic colitis

49. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
DM - HTN - DVT - seizures - depression - or anxiety
Diuretics -BB -CCB -ACEi
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Serotypes 16 - 18 - 31 -52 -58

50. When does troponin rise following myocardial injury or infarction?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Adhesive capsulitis (frozen shoulder): most common in middle age women
Colposcopy - Endocervical curettage - and directed cervical biopsy
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct