Test your basic knowledge |

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. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Kids: Rotavirus Adults: Norwalk Virus
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

2. Diagnostic Evaluation of Abnoraml vaginal bleeding
S. Aureus
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
CBC

3. How to NSAIDs contribute to gastritis and ulcer formation?
Temporal arteritis-biopsy of the temporal artery
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.
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Higher filling presure - pulmonary congestion - and decreasd cardiac return

4. How is constipation clinically defined?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Less than 3 stools per week
Peptic ulcer disease or gastritis
Increase; 200 g/day

5. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
DM - HTN - DVT - seizures - depression - or anxiety
Associated with hypotension

6. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
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
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
Bence-Jones
Paroxysmal atrial fibrillation or supraventricular tachycardia

7. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Colposcopy - Endocervical curettage - and directed cervical biopsy
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
LH surge triggers ovulation
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.

8. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Serotypes 16 - 18 - 31 -52 -58
Medication or chemical esophagitis
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
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

9. What are the 2 psych disorders most commonly associated with palpitations?
CT
Generalized Anxiety disorder and panic disorder
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Other brainstem or cranial nerve findings

10. What are symptoms are CHF?
Furucnle
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Anticoag with warfarin to prevent thromboembolism
Less abrupt onset and cessation of palpitations

11. 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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Warts
Variability in the time for follicle development during the proliferative phase

12. How are fungal infections diagnosed?
Hypertension - CAD - valvular heart disease
With a KOH wet mount preparation
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
RBC casts and old to moderate HTN

13. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Cholelithiasis
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
When the patient has symptoms in association with exercise or who describe chest pain or pressure

14. Metrorrhagia
Irregular bleeding between cycles
S. Aureus
PVC or Premature atrial contraction (PAC)
E. Coli O157:H7

15. Tx of chronic or intermittent afibs
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Anticoag with warfarin to prevent thromboembolism
Adhesive capsulitis (frozen shoulder): most common in middle age women
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

16. What test done in PE measures instability of shoulder?
Albumin; low molecular weight proteins
Variability in the time for follicle development during the proliferative phase
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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

17. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
CBC
DM - HTN - DVT - seizures - depression - or anxiety
35 (exception for postmenopausal women who have recently been started on HRT)
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

18. Describe the presentation tracheobronchitis
Regular bleeding at intervals of more than 35 days
Upper sternal area burning pain - associated with a productive cough
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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

19. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Rotator Cuff problem
When the patient has symptoms in association with exercise or who describe chest pain or pressure
ACEi - ARBS - thiazide diuretics
Adhesive capsulitis (frozen shoulder): most common in middle age women

20. Vaccines that should be updated before planned pregnancy
Temporal arteritis-biopsy of the temporal artery
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Cholelithiasis
Pts with palpitations and dizziness - near syncope - or syncope

21. At was quantity does urine dipstick test detect elevated protein?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
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
100mg; means patient can be trace protein positive and not be detected

22. Describe the presentation of myocardial pain?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Cholelithiasis

23. Constipation: What are indications for lab testing?
Fever with frontal or maxillary tenderness
Chest pain during pneumonia or PE
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
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

24. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Tension headache
Temporal arteritis-biopsy of the temporal artery
>150mg per 24hrs
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

25. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Hgb - Electrolytes - and TSH
Chest pain during pneumonia or PE
Peptic ulcer disease or gastritis
Rotator Cuff problem

26. Treatment for supraventricular tachycardias
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Less abrupt onset and cessation of palpitations
BB or CCB - catheter ablation of identified bypass tract
DM - HTN - DVT - seizures - depression - or anxiety

27. Isolated - extra pounding beats
Pain
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
PVC or Premature atrial contraction (PAC)
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

28. Diarrhea from custard filled pastries
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
S. Aureus
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

29. Name the diagnosis of heartburn: upper abdominal/ epigastric pain - bloating - belching - flatulence - nausea
Generalized Anxiety disorder and panic disorder
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Nonulcer dyspepsia
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

30. Initial treatment for Rhinosinusitis
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
When the patient has symptoms in association with exercise or who describe chest pain or pressure

31. What is an acoustic neuroma?
Adhesive capsulitis (frozen shoulder): most common in middle age women
Menorrhagia
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
HIV and syphilis

32. After treatment of dysplasia - women need Pap smears every...
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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
Temporal arteritis-biopsy of the temporal artery
Less than 80 ml of blood

33. What is the difference between a Holter monitor or an event monitor?
Bence-Jones
Slow progression of cervical cancer changes -Availability of effective early treatment
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
>150mg per 24hrs

34. 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.
Polymenorrhea
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Repeat Pap after infection treated
Variability in the time for follicle development during the proliferative phase

35. Pneumonia tx: suitable for healthy adults less than 60
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Variability in the time for follicle development during the proliferative phase
>150mg per 24hrs

36. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Bulk forming: Psyllium - Methycellulose - Polycarbophil
HIV and syphilis
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

37. Where does the development of abnormal cervical cells begin?
Squamocolumnar junction=most common site of cervical cancer
Fever with frontal or maxillary tenderness
24 hour halter
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

38. Name the skin lesion: erythema - warmth - edema - pain - fever
Streptococci
Cellulitis
Increasing fluid (8 - 8oz glasses of water/day) -fiber
E. Coli O157:H7

39. What are the physical exam signs of CHF?
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
Pancreatitis
Diuretics -BB -CCB -ACEi
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

40. Complete the sentence: pericarditis can cause frictional rub and......
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Lightheadedness - dizziness - syncope
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

41. What is the Epley maneuver?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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.
Paroxysmal atrial fibrillation or supraventricular tachycardia
When the patient has symptoms in association with exercise or who describe chest pain or pressure

42. Regular bleeding at intervals of less than 21 days
HIV and syphilis
Anticoag with warfarin to prevent thromboembolism
Polymenorrhea
Upper sternal area burning pain - associated with a productive cough

43. Name the skin lesion: pustule in association with a hair follice
Scabies
Coronary artery disease/ angina
Folliculitis
S. aureus- beta hemolytic streptococcus

44. 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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Molluscum contagiosum- pox virus
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

45. What should be considered in younger patients with menorrhagia
24 hour halter
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Coag disorders
Staphylococcal scalded skin syndrome

46. When does the American Cancer Society recommend obtaining Pap smear in low-risk women
Pancreatitis
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis

47. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
Less abrupt onset and cessation of palpitations
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
Bence-Jones
Non-cardiac causes of palpitations

48. True or false: Migraine headaches require two of these four headache characteristics for diagnosis: unilateral location - pulsatile quality - moderate to severe intensity - or aggravation by movement. They must also be associated with one of the foll
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
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.
True
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

49. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Varicella virus
Less than 80 ml of blood
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

50. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
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
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Associated with hypotension
Pts with palpitations and dizziness - near syncope - or syncope