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 medications can cause heart palpitations?
Excessive bleeding in amount - duration - or both at irregular intervals
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

2. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Colposcopy - Endocervical curettage - and directed cervical biopsy
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
S. Aureus

3. Four muscles of rotator cuff
Pts with palpitations and dizziness - near syncope - or syncope
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Paroxysmal atrial fibrillation or supraventricular tachycardia

4. Pneumonia tx: suitable for healthy adults older than 60
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

5. When is a lumbar puncture contraindicated?
Subarachnoid hemorrhage
>3.5g of protein per 24hrs
RBC casts and old to moderate HTN
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

6. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
Rotator Cuff problem
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
LH surge triggers ovulation

7. How do you know if heart palpitations are due to stimulant or medication use?
MSK - pulmonary - GI - or psychological
Excessive bleeding in amount - duration - or both at irregular intervals
Less abrupt onset and cessation of palpitations
CBC

8. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Candida albicans
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
35 (exception for postmenopausal women who have recently been started on HRT)
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

9. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Less than 80 ml of blood
35 (exception for postmenopausal women who have recently been started on HRT)
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

10. 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
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Repeat Pap after infection treated
Cluster headache

11. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
>3.5g of protein per 24hrs
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
Dehydration - anemia - cardiac causes
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

12. What does orthostatic positional changes that bring on dizziness suggest?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Dehydration - anemia - cardiac causes
Candida albicans
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

13. Isolated - extra pounding beats
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
PVC or Premature atrial contraction (PAC)
Folliculitis
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

14. Chronic pain and shoulder stiffness with limited motion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
>150mg per 24hrs

15. Describe the presentation tracheobronchitis
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Irregular bleeding between cycles
Upper sternal area burning pain - associated with a productive cough

16. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Rotator cuff tendonitis
LH surge triggers ovulation
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Bence-Jones

17. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Coag disorders
Diuretics -BB -CCB -ACEi
Nonulcer dyspepsia
Triptans - ergotamine - DHE (emergency); prophylaxis- beta blockeres - tricyclic antidepressants - CCBs - anticonvulsants - serotonin antagonists - MAOIs; avoidance of stress - alcohol - caffeine - tyramine (red wine and cheese) - nitrates (cured mea

18. What are symptoms are CHF?
Slow progression of cervical cancer changes -Availability of effective early treatment
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Medication or chemical esophagitis
Cholelithiasis

19. How do you define persistent protein uria?
Presence of proteinuria on at least two separate ocassion
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Varicella virus
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

20. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Irregular bleeding between cycles
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
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
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

21. What HPV serotypes are most commonly associated with cervical cancer?
Serotypes 16 - 18 - 31 -52 -58
True
Analgesic headache
S. aureus- beta hemolytic streptococcus

22. Tx of chronic or intermittent afibs
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Anticoag with warfarin to prevent thromboembolism

23. What are the signs of acute sinusitis?
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
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Fever with frontal or maxillary tenderness
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

24. Who should have Xray testing for shoulder pain?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Cervical radiculopathy
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

25. Diagnostic Evaluation of Abnoraml vaginal bleeding
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Rotator cuff tendonitis

26. What drugs do you use to treat H.pylori + PUD?
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
High blood pressure - focal neurologic defecit - or papilledema
HPV

27. Name the diagnosis of heartburn: regurgitation - dysphagia
Generalized Anxiety disorder and panic disorder
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
GERD
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

28. What are the 2 psych disorders most commonly associated with palpitations?
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
Generalized Anxiety disorder and panic disorder
Temporal arteritis-biopsy of the temporal artery
Pleurisy

29. MI - pericardial tamponade - PE - GI bleed - are...
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Associated with hypotension
BB or CCB - catheter ablation of identified bypass tract
ACEi

30. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
LH surge triggers ovulation
Hgb - Electrolytes - and TSH
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

31. 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
Molluscum contagiosum- pox virus
DM - HTN - DVT - seizures - depression - or anxiety
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.
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

32. Describe the history and PE of patient presenting with common cold
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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
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
DM - HTN - DVT - seizures - depression - or anxiety

33. Constipation: What are indications for lab testing?
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
Other brainstem or cranial nerve findings
Increase; 200 g/day
Echocardiogram

34. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
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
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Viral gastroenteritis
Hgb - Electrolytes - and TSH

35. How can GERD (or esophageal motility disorders) lead to chest pain?
Adhesive capsulitis (frozen shoulder): most common in middle age women
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

36. What is the difference between a Holter monitor or an event monitor?
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Lightheadedness - dizziness - syncope
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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

37. What are the three major risk factors for heart failure?
Hypertension - CAD - valvular heart disease
Paroxysmal atrial fibrillation or supraventricular tachycardia
Intermenstrual bleeding
Diuretics -BB -CCB -ACEi

38. 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
BB or CCB - catheter ablation of identified bypass tract
True
ACEi - ARBS - thiazide diuretics
S. Aureus

39. Describes what occurs during squamous metaplasia of the cervix.
Folliculitis
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Triptans - ergotamine - DHE (emergency); prophylaxis- beta blockeres - tricyclic antidepressants - CCBs - anticonvulsants - serotonin antagonists - MAOIs; avoidance of stress - alcohol - caffeine - tyramine (red wine and cheese) - nitrates (cured mea
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

40. What are the most common causes for the common cold?
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Albumin; low molecular weight proteins
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

41. What are the secondly causes of glomerular disease?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Peptic ulcer disease or gastritis
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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

42. What is the mechanism of action for stimulant agents in treating constipation?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
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
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
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

43. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Staphylococcal scalded skin syndrome
Viral infection of the semicircular apparatus
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

44. What lab test is recommended as baseline for future evaluation of HTN in the event of medication induced neutropenia or agranulocytosis?
Polymenorrhea
Dehydration - anemia - cardiac causes
CBC
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise

45. Describe the presentation of angina?
Pts with palpitations and dizziness - near syncope - or syncope
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
Coag disorders
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

46. Menometrorrhagia
Generalized Anxiety disorder and panic disorder
Common problem that resolves spontaneously and is most often seen in children and young adults
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Excessive bleeding in amount - duration - or both at irregular intervals

47. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
HIV and syphilis
Albumin; low molecular weight proteins
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Bulk forming: Psyllium - Methycellulose - Polycarbophil

48. Diarrhea is defined as an ____ in stool weight to more than ____g per day
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Increase; 200 g/day
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

49. What are the three types of lice?
Anticoag with warfarin to prevent thromboembolism
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
S. aureus- beta hemolytic streptococcus
Adhesive capsulitis (frozen shoulder): most common in middle age women

50. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Loop diuretics (Check serum K+ levels before drug admin)
Viral infection of the semicircular apparatus
Lightheadedness - dizziness - syncope