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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 are the signs of malignant hypertension?
100mg; means patient can be trace protein positive and not be detected
Slow progression of cervical cancer changes -Availability of effective early treatment
Molluscum contagiosum- pox virus
High blood pressure - focal neurologic defecit - or papilledema

2. When should a patient get a stress test?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Rotator Cuff problem
Generalized Anxiety disorder and panic disorder

3. Carcinoma in situ is generally referred to a gynecologist and requires ______
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Coag disorders

4. Four muscles of rotator cuff
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Warts
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

5. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
High blood pressure - focal neurologic defecit - or papilledema
Rotator Cuff problem
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.
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

6. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
MSK - pulmonary - GI - or psychological
Nonulcer dyspepsia
Less than 3 stools per week
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

7. What is the Barany maneuver?
Rotator cuff tendonitis
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

8. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Medication or chemical esophagitis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Less than 80 ml of blood
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

9. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
Common problem that resolves spontaneously and is most often seen in children and young adults
Coag disorders

10. What occurs after ovulation
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
CT
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
MSK - pulmonary - GI - or psychological

11. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Medication or chemical esophagitis
Furucnle
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

12. What test done in PE measures instability of shoulder?
Streptococci
Tension headache
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.
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

13. What are the features of glomerular nephritis
Scleroderma/polymyositis with secondary gastroesophageal reflux
RBC casts and old to moderate HTN
ACEi - ARBS - thiazide diuretics
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

14. What is afterload?
Paroxysmal atrial fibrillation or supraventricular tachycardia
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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

15. Irregular cycles with excessive flow - duration - or both
Menorrhagia
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Cervical radiculopathy
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

16. In regards to a Pap smear - What should be done if a patient has cervical inflammation from infections such as Chlamydia or yeast that may cause cells to appear abnormal.
Repeat Pap after infection treated
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Coronary artery disease/ angina

17. What are the symptoms of palpitations?
>3.5g of protein per 24hrs
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
ACEi - ARBS - thiazide diuretics
Lightheadedness - dizziness - syncope

18. How does CHF present on X-ray?
Presence of proteinuria on at least two separate ocassion
Paroxysmal atrial fibrillation or supraventricular tachycardia
Upper sternal area burning pain - associated with a productive cough
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

19. When should invasive eletrophysiologic study should be considered?
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Viral gastroenteritis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

20. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Echocardiogram
Scleroderma/polymyositis with secondary gastroesophageal reflux
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
24 hour halter

21. Difference between Pneumonia and Bronchitis
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
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

22. What type of imaging is need for chronic sinusitis?
CT
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

23. Describe the presentation of pericardial pain
Anticoag with warfarin to prevent thromboembolism
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Lightheadedness - dizziness - syncope
Bulk forming: Psyllium - Methycellulose - Polycarbophil

24. What are the three major risk factors for heart failure?
Peptic ulcer disease or gastritis
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
Hypertension - CAD - valvular heart disease
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

25. 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
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.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

26. What should be considered in younger patients with menorrhagia
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Coag disorders
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

27. Complete the sentence: pericarditis can cause frictional rub and......
Presence of proteinuria on at least two separate ocassion
True
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
RBC casts and old to moderate HTN

28. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
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
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
MSK - pulmonary - GI - or psychological
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

29. What is the standard tool used for diagnosis of GERD?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
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
EGD

30. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
RBC casts and old to moderate HTN
Adhesive capsulitis (frozen shoulder): most common in middle age women
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

31. What are the physical exam signs of CHF?
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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
Other brainstem or cranial nerve findings

32. Describe the presentation of myocardial pain?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Cluster headache
Anticoag with warfarin to prevent thromboembolism
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

33. Describe the history and PE of patient presenting with common cold
Albumin; low molecular weight proteins
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
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
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.

34. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Squamocolumnar junction=most common site of cervical cancer
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
Nonulcer dyspepsia
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

35. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

36. What is the caUse of Meniere disease? What are the cardinal symptoms?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Non-cardiac causes of palpitations
MSK - pulmonary - GI - or psychological

37. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Chest pain during pneumonia or PE
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

38. Name the diagnosis: live in the mouth - vaginal tract - and gut; produce budding spores - pseudohypahe (elongated cells) - or true hypae
Candida albicans
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Squamocolumnar junction=most common site of cervical cancer
Excessive bleeding in amount - duration - or both at irregular intervals

39. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
CT
Peptic ulcer disease or gastritis
PVC or Premature atrial contraction (PAC)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

40. What places women at higher risk of getting cervical cancer?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Viral infection of the semicircular apparatus
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
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

41. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
True
Bence-Jones
Kids: Rotavirus Adults: Norwalk Virus

42. What diagnosis does the 'worse headache of my life' suggest?
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
Coronary artery disease/ angina
Loop diuretics (Check serum K+ levels before drug admin)
Subarachnoid hemorrhage

43. What are symptoms are CHF?
Regular bleeding at intervals of more than 35 days
Varicella virus
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Possibility of Ischemic colitis

44. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Non-cardiac causes of palpitations
Wolff-Parkinson-White syndrome
Excessive bleeding in amount - duration - or both at irregular intervals
Tension headache

45. Name the skin lesion: small tumors of the skin that obscure normal skin lines - have a mosaic surface pattern - and may have thrombosed vessels appeairng as black dots on the surface
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Warts
A 24hr urine protein collection and urine creatinine clearance determination

46. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
HPV
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

47. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Pleurisy
Increase; 200 g/day

48. HIgh risk pregnant patients should be evaluated for ____ and ____
Pleurisy
HIV and syphilis
Increase; 200 g/day
Analgesic headache

49. What are the secondly causes of glomerular disease?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Infectious esophagitis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Impetigo

50. Clinical Manifestations of HTN
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Presence of proteinuria on at least two separate ocassion
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema