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. Pain in shoulder when throwing - swimming - or serving a tennis ball
Tension headache
Fever with frontal or maxillary tenderness
Rotator cuff tendonitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

2. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Cholelithiasis
Pts with palpitations and dizziness - near syncope - or syncope
Warts

3. Name types of laxatives
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
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

4. 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
CT
Varicella virus
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

5. What are the physical exam signs of CHF?
Rotator Cuff problem
Furucnle
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
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

6. What is an acoustic neuroma?
Analgesic headache
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
PVC or Premature atrial contraction (PAC)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

7. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
EGD
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

8. What should blood work include for suspected heart failure?
Pleurisy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
E. Coli O157:H7
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

9. Define nephrotic range proteinuria
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
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
Analgesic headache
>3.5g of protein per 24hrs

10. Describe the presentation of pericardial pain
Colposcopy - Endocervical curettage - and directed cervical biopsy
Candida albicans
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
MSK - pulmonary - GI - or psychological

11. Initial treatment for Rhinosinusitis
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
Giardia
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Slow progression of cervical cancer changes -Availability of effective early treatment

12. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Possibility of Ischemic colitis
Varicella virus
A 24hr urine protein collection and urine creatinine clearance determination

13. What are the features of glomerular nephritis
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
RBC casts and old to moderate HTN
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

14. What are the most common causes for the common cold?
Furucnle
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Scleroderma/polymyositis with secondary gastroesophageal reflux

15. Where does the development of abnormal cervical cells begin?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Squamocolumnar junction=most common site of cervical cancer
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Fever with frontal or maxillary tenderness

16. Predictors of cardiac etiology
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
True
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

17. What is the standard tool used for diagnosis of GERD?
EGD
S. aureus- beta hemolytic streptococcus
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

18. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
ACEi - ARBS - thiazide diuretics
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Anticoag with warfarin to prevent thromboembolism
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.

19. 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
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
DM - HTN - DVT - seizures - depression - or anxiety
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
True

20. Name the diagnosis of heartburn: severe constant mid abdominal pain
Subarachnoid hemorrhage
Variability in the time for follicle development during the proliferative phase
Pancreatitis
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

21. What should preconception counseling include?
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
35 (exception for postmenopausal women who have recently been started on HRT)
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
HIV and syphilis

22. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Medication or chemical esophagitis
Wolff-Parkinson-White syndrome
CT

23. What is the Epley maneuver?
Pts with palpitations and dizziness - near syncope - or syncope
MSK - pulmonary - GI - or psychological
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.
Tension headache

24. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
PVC or Premature atrial contraction (PAC)
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
True
Scleroderma/polymyositis with secondary gastroesophageal reflux

25. Isolated - extra pounding beats
MSK - pulmonary - GI - or psychological
PVC or Premature atrial contraction (PAC)
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
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

26. At was quantity does urine dipstick test detect elevated protein?
100mg; means patient can be trace protein positive and not be detected
CT
CBC
Medication or chemical esophagitis

27. 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
Nonulcer dyspepsia
Variability in the time for follicle development during the proliferative phase
CT

28. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Albumin; low molecular weight proteins
Kids: Rotavirus Adults: Norwalk Virus

29. Metrorrhagia
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Polymenorrhea
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Irregular bleeding between cycles

30. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Generalized Anxiety disorder and panic disorder
Loop diuretics (Check serum K+ levels before drug admin)
Streptococci
Menorrhagia

31. What are the signs of cerebral hemorrhage?
Acute headache - ataxia - profuse nausea - and vomiting
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
Increase; 200 g/day
CT

32. Oligomenorrhea
Regular bleeding at intervals of more than 35 days
Possibility of Ischemic colitis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

33. What are the three major risk factors for heart failure?
Infectious esophagitis
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Hypertension - CAD - valvular heart disease
A 24hr urine protein collection and urine creatinine clearance determination

34. What is benign transient proteinuria?
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
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
Loop diuretics (Check serum K+ levels before drug admin)

35. HIgh risk pregnant patients should be evaluated for ____ and ____
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
HIV and syphilis
Non-cardiac causes of palpitations
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

36. What HPV serotypes are most commonly associated with cervical cancer?
Nonulcer dyspepsia
Scleroderma/polymyositis with secondary gastroesophageal reflux
Serotypes 16 - 18 - 31 -52 -58
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

37. 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.
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
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Repeat Pap after infection treated
Adhesive capsulitis (frozen shoulder): most common in middle age women

38. What are the most common viral causes of diarrhea in kids and adults?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Kids: Rotavirus Adults: Norwalk Virus
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

39. Difference between Pneumonia and Bronchitis
Lightheadedness - dizziness - syncope
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
Associated with hypotension
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed

40. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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.

41. History for Sinusitis

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

42. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Diuretics -BB -CCB -ACEi
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Squamocolumnar junction=most common site of cervical cancer

43. Name the type of headache: mild to moderate intensity; located in the bilateral occipital-frontal areas; dull or band-like; lasts for hours; often assoc. with stress.
Viral gastroenteritis
Tension headache
Intermenstrual bleeding
Cholelithiasis

44. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
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.
Intermenstrual bleeding
Medication or chemical esophagitis
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

45. In addition to cardiac disease - chest pain could be attributed to 4 other causes. Name them
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
Echocardiogram
MSK - pulmonary - GI - or psychological
HPV

46. What are the two common clinical presentations of acute diarrhea?
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Pts with palpitations and dizziness - near syncope - or syncope
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

47. The degenerative process that results in bursitis - tendonitis - and shoulder impingement often begins in the _____ or ____ tendons - which have a poor blood supply and are often under stress.
PE - MI - aortic dissection - pneumothorax
Supraspinatus and bicipital tendons
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
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

48. PE for a patient getting an abnormal vaginal bleeding work up
Pain
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Pancreatitis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

49. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Staphylococcal scalded skin syndrome
These patients are associated with low renin states=less likely to respond to medication
Irregular bleeding between cycles
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

50. What is the next best step if a patient has two or more positive dipstick tests?
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Squamocolumnar junction=most common site of cervical cancer
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
A 24hr urine protein collection and urine creatinine clearance determination