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 drugs do you use to treat H.pylori + PUD?
Intermenstrual bleeding
Less than 80 ml of blood
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Other brainstem or cranial nerve findings

2. What are the medications used to treat labyrinthitis - vestibular neuronitis - and BPV?
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Scleroderma/polymyositis with secondary gastroesophageal reflux
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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.

3. What is an acoustic neuroma?
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Scabies
Polymenorrhea
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

4. 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
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
Molluscum contagiosum- pox virus
Folliculitis
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

5. SE Of Beta blockers?
Temporal arteritis-biopsy of the temporal artery
Loop diuretics (Check serum K+ levels before drug admin)
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
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

6. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Candida albicans
Rotator Cuff problem
High blood pressure - focal neurologic defecit - or papilledema
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

7. What HPV serotypes are most commonly associated with cervical cancer?
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
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
Serotypes 16 - 18 - 31 -52 -58

8. 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.
Tension headache
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
CT
Staphylococcal scalded skin syndrome

9. What medications can cause heart palpitations?
Wolff-Parkinson-White syndrome
Rotator Cuff problem
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

10. Describe the presentation of myocardial pain?
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
ACEi
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

11. What is the mechanism of action for stimulant agents in treating constipation?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Associated with hypotension

12. After treatment of dysplasia - women need Pap smears every...
Hgb - Electrolytes - and TSH
Varicella virus
Irregular bleeding between cycles
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

13. 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
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
ACEi - ARBS - thiazide diuretics
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

14. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Peptic ulcer disease or gastritis
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
BB or CCB - catheter ablation of identified bypass tract
Tension headache

15. What are the signs of malignant hypertension?
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Warts
High blood pressure - focal neurologic defecit - or papilledema
Peptic ulcer disease or gastritis

16. Define nephrotic range proteinuria
>3.5g of protein per 24hrs
Menorrhagia
Variability in the time for follicle development during the proliferative phase
Lightheadedness - dizziness - syncope

17. Initial treatment for Rhinosinusitis
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
A 24hr urine protein collection and urine creatinine clearance determination
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

18. Name the diagnosis of heartburn: associated with signs of connective tissue disease - potential risk of stricture/ dysphagia
Less than 3 stools per week
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Scleroderma/polymyositis with secondary gastroesophageal reflux
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

19. What is afterload?
>150mg per 24hrs
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Candida albicans

20. When should invasive eletrophysiologic study should be considered?
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

21. Things that need to be included in history of shoulder pain
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
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
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

22. What lab tests are recommended for newly diagnosed hypertensive patients?
MSK - pulmonary - GI - or psychological
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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
Viral gastroenteritis

23. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
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
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Scabies

24. Complete the sentence: pericarditis can cause frictional rub and......
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

25. Mainstay treatment for soft tissue inflammation (Shoulder)
24 hour halter
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
100mg; means patient can be trace protein positive and not be detected
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

26. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
Intermenstrual bleeding
Slow progression of cervical cancer changes -Availability of effective early treatment
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

27. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
Bence-Jones
Kids: Rotavirus Adults: Norwalk Virus
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
Pancreatitis

28. Vaccines that should be updated before planned pregnancy
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Generalized Anxiety disorder and panic disorder
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.
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

29. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
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
Cluster headache
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal

30. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Medication or chemical esophagitis
Kids: Rotavirus Adults: Norwalk Virus
Varicella virus
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp

31. 1+ protein level on urine dipstick usually represents how much protein in the urine?
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
Coag disorders
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Tension headache

32. Menometrorrhagia
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
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
Excessive bleeding in amount - duration - or both at irregular intervals
Cellulitis

33. What is the peripheral caUse of vertigo?
Peptic ulcer disease or gastritis
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Viral infection of the semicircular apparatus
Less abrupt onset and cessation of palpitations

34. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
35 (exception for postmenopausal women who have recently been started on HRT)
Possibility of Ischemic colitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses

35. What is the next best step if a patient has two or more positive dipstick tests?
PVC or Premature atrial contraction (PAC)
Varicella virus
A 24hr urine protein collection and urine creatinine clearance determination
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus

36. 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
Pancreatitis
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline

37. At was quantity does urine dipstick test detect elevated protein?
100mg; means patient can be trace protein positive and not be detected
Chest pain during pneumonia or PE
Cluster headache
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy

38. History for Sinusitis

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

39. Treatment for supraventricular tachycardias
Bence-Jones
Less than 80 ml of blood
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

40. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
Less than 3 stools per week
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
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med

41. Describes what occurs during squamous metaplasia of the cervix.
Fever with frontal or maxillary tenderness
Pleurisy
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Peptic ulcer disease or gastritis

42. How does CHF present on X-ray?
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Hgb - Electrolytes - and TSH
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
These patients are associated with low renin states=less likely to respond to medication

43. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
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
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
Coag disorders
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

44. What does treatment for migrans include?
HPV
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
Impetigo
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

45. Lab testing for heart palpitation
Variability in the time for follicle development during the proliferative phase
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Hgb - Electrolytes - and TSH
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

46. What is the preload?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Bence-Jones
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

47. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
These patients are associated with low renin states=less likely to respond to medication
ACEi - ARBS - thiazide diuretics
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

48. What are the most common causes for the common cold?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
CBC
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Wolff-Parkinson-White syndrome

49. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Loop diuretics (Check serum K+ levels before drug admin)
Nonulcer dyspepsia
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
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

50. Regular bleeding at intervals of less than 21 days
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Polymenorrhea
GERD
Slow progression of cervical cancer changes -Availability of effective early treatment