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. When does troponin rise following myocardial injury or infarction?
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

2. Name the skin lesion: pustule in association with a hair follice
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Folliculitis
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Increase; 200 g/day

3. What is the mechanism of action for stimulant agents in treating constipation?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Infectious esophagitis

4. Metrorrhagia
Irregular bleeding between cycles
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.
Scleroderma/polymyositis with secondary gastroesophageal reflux
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

5. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Pancreatitis
Squamocolumnar junction=most common site of cervical cancer
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Polymenorrhea

6. Mainstay treatment for soft tissue inflammation (Shoulder)
CBC
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

7. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Echocardiogram
MSK - pulmonary - GI - or psychological
CBC
LH surge triggers ovulation

8. MI - pericardial tamponade - PE - GI bleed - are...
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Associated with hypotension
Nonulcer dyspepsia
E. Coli O157:H7

9. When should invasive eletrophysiologic study should be considered?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Echocardiogram
Cellulitis
Candida albicans

10. Carcinoma in situ is generally referred to a gynecologist and requires ______
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
Intermenstrual bleeding
Polymenorrhea
Other brainstem or cranial nerve findings

11. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Folliculitis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Echocardiogram
Furucnle

12. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Rotator cuff tendonitis
DM - HTN - DVT - seizures - depression - or anxiety
Viral infection of the semicircular apparatus
A 24hr urine protein collection and urine creatinine clearance determination

13. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
Chest pain during pneumonia or PE
Viral gastroenteritis
S. aureus- beta hemolytic streptococcus
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

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

15. Define proteinuria
DM - HTN - DVT - seizures - depression - or anxiety
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
>150mg per 24hrs
Hgb - Electrolytes - and TSH

16. History for Acute bronchitis
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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Medication or chemical esophagitis

17. 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
Staphylococcal scalded skin syndrome
Pancreatitis
Varicella virus
Molluscum contagiosum- pox virus

18. History and PE for Pneumonia
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
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

19. Why is the pap smear one of the most effective cancer screening tools?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Higher filling presure - pulmonary congestion - and decreasd cardiac return
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
Slow progression of cervical cancer changes -Availability of effective early treatment

20. What are the consequences of diastolic dysfunction?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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
Rotator Cuff problem
Higher filling presure - pulmonary congestion - and decreasd cardiac return

21. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
Streptococci
Non-cardiac causes of palpitations
Impetigo
DM - HTN - DVT - seizures - depression - or anxiety

22. What is an acoustic neuroma?
Presence of proteinuria on at least two separate ocassion
Medication or chemical esophagitis
Irregular bleeding between cycles
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

23. Cycle length variabilty is primarily due to what?
HPV
Variability in the time for follicle development during the proliferative phase
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Dehydration - anemia - cardiac causes

24. Things that need to be included in history of shoulder pain
100mg; means patient can be trace protein positive and not be detected
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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
PE - MI - aortic dissection - pneumothorax

25. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Viral infection of the semicircular apparatus
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
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.

26. What the consequences of decreased cardiac output?
Streptococci
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

27. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Colposcopy - Endocervical curettage - and directed cervical biopsy
Intermenstrual bleeding
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

28. What is the difference between a Holter monitor or an event monitor?
Chest pain during pneumonia or PE
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
Peptic ulcer disease or gastritis
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

29. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
A 24hr urine protein collection and urine creatinine clearance determination
S. aureus- beta hemolytic streptococcus
Loop diuretics (Check serum K+ levels before drug admin)
Coag disorders

30. patients with herpes zoster may experience what symptom before the rash appear?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Pain
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure

31. What is the goal of CHF treatment? What drugs should be used?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
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
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Hgb - Electrolytes - and TSH

32. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Medication or chemical esophagitis

33. Name the diagnosis of heartburn: regurgitation - dysphagia
GERD
Rotator Cuff tendonitis
Anticoag with warfarin to prevent thromboembolism
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport

34. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Folliculitis

35. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
A central clear area
Colposcopy - Endocervical curettage - and directed cervical biopsy

36. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
35 (exception for postmenopausal women who have recently been started on HRT)
A 24hr urine protein collection and urine creatinine clearance determination

37. What is most common form of abnormal vaginal bleeding? (give what causes it with answer)
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

38. name the 4 emergent causes of chest pain
PE - MI - aortic dissection - pneumothorax
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Staphylococcal scalded skin syndrome
Pancreatitis

39. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Bence-Jones
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
Staphylococcal scalded skin syndrome

40. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Albumin; low molecular weight proteins
Folliculitis
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

41. How is constipation clinically defined?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Less than 3 stools per week
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

42. What are the common causes for laryngitis?
PE - MI - aortic dissection - pneumothorax
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Common problem that resolves spontaneously and is most often seen in children and young adults
CBC

43. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Analgesic headache
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

44. Difference between Pneumonia and Bronchitis
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
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Presence of proteinuria on at least two separate ocassion

45. What is the Barany maneuver?
Peptic ulcer disease or gastritis
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
Subarachnoid hemorrhage
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

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

47. Name types of laxatives
Menorrhagia
Squamocolumnar junction=most common site of cervical cancer
Upper sternal area burning pain - associated with a productive cough
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

48. What are the signs of malignant hypertension?
Varicella virus
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.
High blood pressure - focal neurologic defecit - or papilledema
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

49. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Scleroderma/polymyositis with secondary gastroesophageal reflux
ACEi
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

50. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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
Pancreatitis
Bulk forming: Psyllium - Methycellulose - Polycarbophil