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. What are the primary glomerular diseases?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Hypertension - CAD - valvular heart disease
LH surge triggers ovulation

2. 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
Chest pain during pneumonia or PE
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Cluster headache
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

3. How can GERD (or esophageal motility disorders) lead to chest pain?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
Pain

4. Cycle length variabilty is primarily due to what?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Hgb - Electrolytes - and TSH
Variability in the time for follicle development during the proliferative phase

5. What are the signs of cerebral hemorrhage?
Impetigo
Acute headache - ataxia - profuse nausea - and vomiting
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Generalized Anxiety disorder and panic disorder

6. Where does the development of abnormal cervical cells begin?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Squamocolumnar junction=most common site of cervical cancer
Wolff-Parkinson-White syndrome
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

7. What is the peripheral caUse of vertigo?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Staphylococcal scalded skin syndrome
Generalized Anxiety disorder and panic disorder

8. What is the preload?
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
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

9. 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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
True

10. What is the caUse of benign positional vertigo?
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.
Hypertension - CAD - valvular heart disease
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
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

11. What is the next best step if a patient has two or more positive dipstick tests?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
A 24hr urine protein collection and urine creatinine clearance determination
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

12. Pt has Atypical squamous cells of undetermined significance (ASCUS): When to do repeat pap?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

13. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Bence-Jones
PVC or Premature atrial contraction (PAC)

14. What does the classic ring worm lesion have?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Nonulcer dyspepsia
Variability in the time for follicle development during the proliferative phase
A central clear area

15. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
A central clear area
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

16. Constipation: What are indications for lab testing?
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
MSK - pulmonary - GI - or psychological

17. Pneumothorax - sudden sharp chest pain - preceded by viral illness
Dehydration - anemia - cardiac causes
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Pleurisy
Other brainstem or cranial nerve findings

18. Name the skin lesion: honey colored crusts
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Scleroderma/polymyositis with secondary gastroesophageal reflux
Cellulitis
Impetigo

19. What are the most common viral causes of diarrhea in kids and adults?
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.
Kids: Rotavirus Adults: Norwalk Virus
CT
Slow progression of cervical cancer changes -Availability of effective early treatment

20. 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
HIV and syphilis
With a KOH wet mount preparation
Molluscum contagiosum- pox virus
Lightheadedness - dizziness - syncope

21. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
DM - HTN - DVT - seizures - depression - or anxiety
CT
Candida albicans
Streptococci

22. Treatment of Rhinosinusitis for symptoms persisting longer than 7-10 days
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
A central clear area
100mg; means patient can be trace protein positive and not be detected
Increasing fluid (8 - 8oz glasses of water/day) -fiber

23. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Pleurisy
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
S. Aureus
Viral infection of the semicircular apparatus

24. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Rotator Cuff problem
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Scleroderma/polymyositis with secondary gastroesophageal reflux

25. 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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
E. Coli O157:H7
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

26. 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
Wolff-Parkinson-White syndrome
Varicella virus
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
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

27. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
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
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
ACEi
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria

28. After treatment of dysplasia - women need Pap smears every...
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Bence-Jones
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
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

29. How does CHF present on X-ray?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Kids: Rotavirus Adults: Norwalk Virus
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

30. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Variability in the time for follicle development during the proliferative phase
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
CBC
Menorrhagia

31. What are the most common causes for the common cold?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
MSK - pulmonary - GI - or psychological
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

32. What are the secondly causes of glomerular disease?
Temporal arteritis-biopsy of the temporal artery
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Anticoag with warfarin to prevent thromboembolism
Variability in the time for follicle development during the proliferative phase

33. 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.
Scabies
Coag disorders
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Repeat Pap after infection treated

34. When should invasive eletrophysiologic study should be considered?
Scleroderma/polymyositis with secondary gastroesophageal reflux
Bence-Jones
Regular bleeding at intervals of more than 35 days
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

35. 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
Scabies
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
Fever with frontal or maxillary tenderness
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

36. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Loop diuretics (Check serum K+ levels before drug admin)
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
High blood pressure - focal neurologic defecit - or papilledema

37. What is an acoustic neuroma?
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.
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
Fever with frontal or maxillary tenderness

38. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
Cluster headache
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
Less abrupt onset and cessation of palpitations
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

39. What are signs of pulmonary congestion?
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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Hypertension - CAD - valvular heart disease
Medication or chemical esophagitis

40. HIgh risk pregnant patients should be evaluated for ____ and ____
Other brainstem or cranial nerve findings
HIV and syphilis
Medication or chemical esophagitis
Staphylococcal scalded skin syndrome

41. Initial treatment for Rhinosinusitis
24 hour halter
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
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

42. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Hypertension - CAD - valvular 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.
BB or CCB - catheter ablation of identified bypass tract
Scleroderma/polymyositis with secondary gastroesophageal reflux

43. What are the common causes for laryngitis?
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Loop diuretics (Check serum K+ levels before drug admin)
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
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

44. What is the 1st step in treatment for patients with normal renal function and nondiabetic patients with preHTN?
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Squamocolumnar junction=most common site of cervical cancer
Associated with hypotension
Streptococci

45. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
High blood pressure - focal neurologic defecit - or papilledema
Slow progression of cervical cancer changes -Availability of effective early treatment
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

46. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
When the patient has symptoms in association with exercise or who describe chest pain or pressure
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

47. 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
Nonulcer dyspepsia
24 hour halter
Warts
Subarachnoid hemorrhage

48. What is considered normal blood loss during a menstrual cycle?
Less than 80 ml of blood
Serotypes 16 - 18 - 31 -52 -58
Pain
Furucnle

49. What should blood work include for suspected heart failure?
Variability in the time for follicle development during the proliferative phase
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
BB or CCB - catheter ablation of identified bypass tract
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

50. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
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
ACEi
GERD
Non-cardiac causes of palpitations