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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. What is the role of FSH in one's menstrual cycle
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

2. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Cellulitis
Medication or chemical esophagitis
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

3. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

4. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Other brainstem or cranial nerve findings
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

5. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Adhesive capsulitis (frozen shoulder): most common in middle age women
Chest pain during pneumonia or PE
HIV and syphilis
E. Coli O157:H7

6. Complete the sentence: pericarditis can cause frictional rub and......
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
Cholelithiasis
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

7. Mainstay treatment for soft tissue inflammation (Shoulder)
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Cervical radiculopathy
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Loop diuretics (Check serum K+ levels before drug admin)

8. 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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Supraspinatus and bicipital tendons

9. Name the diagnosis of heartburn: regurgitation - dysphagia
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Albumin; low molecular weight proteins
GERD
Folliculitis

10. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Acute headache - ataxia - profuse nausea - and vomiting
S. aureus- beta hemolytic streptococcus
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

11. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
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
Bulk forming: Psyllium - Methycellulose - Polycarbophil
100mg; means patient can be trace protein positive and not be detected
Viral infection of the semicircular apparatus

12. What should blood work include for suspected heart failure?
>3.5g of protein per 24hrs
Fever with frontal or maxillary tenderness
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

13. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Polymenorrhea
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium

14. What are the physical exam signs of CHF?
Rotator Cuff tendonitis
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
E. Coli O157:H7
Excessive bleeding in amount - duration - or both at irregular intervals

15. Shoulder pain with pain radiating to elbow
Cervical radiculopathy
Possibility of Ischemic colitis
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Streptococci

16. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
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

17. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Kids: Rotavirus Adults: Norwalk Virus
Candida albicans
Presence of proteinuria on at least two separate ocassion
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

18. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Slow progression of cervical cancer changes -Availability of effective early treatment
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

19. When does the American Cancer Society recommend obtaining Pap smear in low-risk 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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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
Cholelithiasis

20. What should preconception counseling include?
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
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Lightheadedness - dizziness - syncope

21. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Furucnle
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Cholelithiasis
Excessive bleeding in amount - duration - or both at irregular intervals

22. Treatment for supraventricular tachycardias
DM - HTN - DVT - seizures - depression - or anxiety
Possibility of Ischemic colitis
BB or CCB - catheter ablation of identified bypass tract
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

23. Diagnosis of HTN
Lightheadedness - dizziness - syncope
HIV and syphilis
EGD
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

24. Natural history of cervical cancer
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
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.
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Pleurisy

25. MI - pericardial tamponade - PE - GI bleed - are...
S. aureus- beta hemolytic streptococcus
Associated with hypotension
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
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

26. How does CHF present on X-ray?
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
Hgb - Electrolytes - and TSH
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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.

27. What are the signs of acute sinusitis?
Menorrhagia
Fever with frontal or maxillary tenderness
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Pts with palpitations and dizziness - near syncope - or syncope

28. What is the preload?
Molluscum contagiosum- pox virus
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

29. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
E. Coli O157:H7
Cervical radiculopathy
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

30. 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
Scabies
E. Coli O157:H7
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

31. What are the most common viral causes of diarrhea in kids and adults?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Kids: Rotavirus Adults: Norwalk Virus
Slow progression of cervical cancer changes -Availability of effective early treatment

32. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Non-cardiac causes of palpitations
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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

33. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Scleroderma/polymyositis with secondary gastroesophageal reflux
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Infectious esophagitis
Colposcopy - Endocervical curettage - and directed cervical biopsy

34. How to NSAIDs contribute to gastritis and ulcer formation?
Impetigo
Coag disorders
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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.

35. Uterine bleeding between regular cycles
Acute headache - ataxia - profuse nausea - and vomiting
Tension headache
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
Intermenstrual bleeding

36. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Temporal arteritis-biopsy of the temporal artery
Increase; 200 g/day
Regular bleeding at intervals of more than 35 days

37. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
Infectious esophagitis
MSK - pulmonary - GI - or psychological
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

38. What the consequences of decreased cardiac output?
Diuretics -BB -CCB -ACEi
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Subarachnoid hemorrhage

39. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
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
LH surge triggers ovulation
Cervical radiculopathy

40. Chronic pain and shoulder stiffness with limited motion
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
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
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Adhesive capsulitis (frozen shoulder): most common in middle age women

41. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
>3.5g of protein per 24hrs
Viral infection of the semicircular apparatus
Staphylococcal scalded skin syndrome
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

42. What lab tests are recommended for newly diagnosed hypertensive patients?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Pleurisy
>150mg per 24hrs
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

43. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Rotator Cuff tendonitis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Polymenorrhea
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

44. What are the three major risk factors for heart failure?
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
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
Hypertension - CAD - valvular heart disease
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

45. Name the diagnosis of heartburn: severe constant mid abdominal pain
Cholelithiasis
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Pancreatitis
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

46. Define proteinuria
Pleurisy
Less abrupt onset and cessation of palpitations
>150mg per 24hrs
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

47. History for Sinusitis

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48. What diagnosis does the 'worse headache of my life' suggest?
Subarachnoid hemorrhage
Medication or chemical esophagitis
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Rotator Cuff tendonitis

49. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Cellulitis
Kids: Rotavirus Adults: Norwalk Virus
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Varicella virus

50. Diagnostic Evaluation of Abnoraml vaginal bleeding
Slow progression of cervical cancer changes -Availability of effective early treatment
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation