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. Name the diagnosis of heartburn: severe constant mid abdominal pain
Pancreatitis
Folliculitis
EGD
Less abrupt onset and cessation of palpitations

2. What are the signs of cerebral hemorrhage?
RBC casts and old to moderate HTN
Acute headache - ataxia - profuse nausea - and vomiting
Chest pain during pneumonia or PE
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

3. 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
Menorrhagia
Scabies
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

4. How is constipation clinically defined?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Less than 3 stools per week
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

5. 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
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Other brainstem or cranial nerve findings

6. patients with herpes zoster may experience what symptom before the rash appear?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
A central clear area
Staphylococcal scalded skin syndrome
Pain

7. What are the most common viral causes of diarrhea in kids and adults?
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
24 hour halter
Kids: Rotavirus Adults: Norwalk Virus
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

8. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Dehydration - anemia - cardiac causes
Bulk forming: Psyllium - Methycellulose - Polycarbophil

9. 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
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

10. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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
Pts with palpitations and dizziness - near syncope - or syncope
Bulk forming: Psyllium - Methycellulose - Polycarbophil

11. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
Scleroderma/polymyositis with secondary gastroesophageal reflux
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
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
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

12. Natural history of cervical cancer
Anticoag with warfarin to prevent thromboembolism
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
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
A central clear area

13. 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
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
Warts
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Scleroderma/polymyositis with secondary gastroesophageal reflux

14. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Candida albicans
Increase; 200 g/day
Albumin; low molecular weight proteins
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

15. Name types of laxatives
Coronary artery disease/ angina
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Higher filling presure - pulmonary congestion - and decreasd cardiac return

16. Name the skin lesion: pustule in association with a hair follice
Folliculitis
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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.

17. Name the skin lesion: erythema - warmth - edema - pain - fever
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
Cellulitis
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
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

18. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
100mg; means patient can be trace protein positive and not be detected
Pts with palpitations and dizziness - near syncope - or syncope
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

19. What are the indiciations for neuroimaging?
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
Squamocolumnar junction=most common site of cervical cancer
Coag disorders
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

20. What type of imaging is need for chronic sinusitis?
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
CT
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Irregular bleeding between cycles

21. What the consequences of decreased cardiac output?
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
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Warts

22. Things that need to be included in history of shoulder pain
Non-cardiac causes of palpitations
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
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
BB or CCB - catheter ablation of identified bypass tract

23. What lab tests are recommended for newly diagnosed hypertensive patients?
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
RBC casts and old to moderate HTN
Rotator cuff tendonitis
Irregular bleeding between cycles

24. Name some medications that can cause proteinuria
PE - MI - aortic dissection - pneumothorax
Cellulitis
Loop diuretics (Check serum K+ levels before drug admin)
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

25. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Intermenstrual bleeding
Rotator cuff tendonitis
Candida albicans
HPV testing -Pos=colposcopy -Neg=repeat pap smear

26. Prenatal visit schedule for low-risk pregnancies
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
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Giardia
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

27. What is the caUse of acute larbyrinthitis or vestibular neuronitis?
Viral infection of the semicircular apparatus
Nonulcer dyspepsia
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

28. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Diuretics -BB -CCB -ACEi
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

29. What is the goal of CHF treatment? What drugs should be used?
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Giardia

30. What are the features of glomerular nephritis
Loop diuretics (Check serum K+ levels before drug admin)
RBC casts and old to moderate HTN
Intermenstrual bleeding
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

31. How to NSAIDs contribute to gastritis and ulcer formation?
Pleurisy
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
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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.

32. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Menorrhagia
Medication or chemical esophagitis
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
Upper sternal area burning pain - associated with a productive cough

33. Name the skin lesion: larger fluctuant erythematous lesions that also occur in association with hairy legions
Furucnle
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
Kids: Rotavirus Adults: Norwalk Virus
DM - HTN - DVT - seizures - depression - or anxiety

34. What is considered normal blood loss during a menstrual cycle?
Less than 80 ml of blood
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Bulk forming: Psyllium - Methycellulose - Polycarbophil
CBC

35. Discomfort with abducting the arm past 90 degress
Less than 3 stools per week
Rotator Cuff tendonitis
Non-cardiac causes of palpitations
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

36. Regular bleeding at intervals of less than 21 days
Polymenorrhea
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Loop diuretics (Check serum K+ levels before drug admin)
Cholelithiasis

37. 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
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
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Molluscum contagiosum- pox virus

38. What is an acoustic neuroma?
>150mg per 24hrs
Acute headache - ataxia - profuse nausea - and vomiting
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

39. Describe the presentation of pericardial pain
Impetigo
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

40. Why is the pap smear one of the most effective cancer screening tools?
Increase; 200 g/day
Furucnle
Diuretics -BB -CCB -ACEi
Slow progression of cervical cancer changes -Availability of effective early treatment

41. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bence-Jones
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Regular bleeding at intervals of more than 35 days

42. What are the primary glomerular diseases?
Common problem that resolves spontaneously and is most often seen in children and young adults
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

43. What treatments are the cornerstone for treating cases of functional constipation?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
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
Increasing fluid (8 - 8oz glasses of water/day) -fiber

44. Oligomenorrhea
Loop diuretics (Check serum K+ levels before drug admin)
Pleurisy
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Regular bleeding at intervals of more than 35 days

45. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
ACEi - ARBS - thiazide diuretics
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Loop diuretics (Check serum K+ levels before drug admin)
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

46. Describe the presentation of myocardial pain?
Giardia
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Variability in the time for follicle development during the proliferative phase
Other brainstem or cranial nerve findings

47. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
MSK - pulmonary - GI - or psychological
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Irregular bleeding between cycles
Excessive bleeding in amount - duration - or both at irregular intervals

48. What is the next best step if a patient has two or more positive dipstick tests?
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
A 24hr urine protein collection and urine creatinine clearance determination
ACEi - ARBS - thiazide diuretics
Hgb - Electrolytes - and TSH

49. Pneumonia tx: suitable for healthy adults less than 60
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
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
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
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

50. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Coronary artery disease/ angina
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
24 hour halter