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. Glomerular disease usually results in excess __ excretion; whereas tubular disease produce a of ______protein
Albumin; low molecular weight proteins
Cholelithiasis
With a KOH wet mount preparation
Viral infection of the semicircular apparatus

2. What microganism is causing this array of presentations: Mild - crampy - nonbloody diarrhea to life-threatening hemorrhagic colitis complicated by hemolytic uremic syndrome or thrombopenic purpura
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
E. Coli O157:H7
Menorrhagia
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

3. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
Paroxysmal atrial fibrillation or supraventricular tachycardia
Peptic ulcer disease or gastritis

4. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
A 24hr urine protein collection and urine creatinine clearance determination
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
Subarachnoid hemorrhage
Cluster headache

5. HIgh risk pregnant patients should be evaluated for ____ and ____
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
HIV and syphilis
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
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

6. 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
Varicella virus
Acute headache - ataxia - profuse nausea - and vomiting
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
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

7. Where does the development of abnormal cervical cells begin?
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Squamocolumnar junction=most common site of cervical cancer
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
Molluscum contagiosum- pox virus

8. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
S. Aureus
S. aureus- beta hemolytic streptococcus
Less than 3 stools per week
Streptococci

9. How does CHF present on X-ray?
Kids: Rotavirus Adults: Norwalk Virus
Analgesic headache
Hgb - Electrolytes - and TSH
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

10. 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.
Coag disorders
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
Tension headache
With a KOH wet mount preparation

11. Pain in shoulder when throwing - swimming - or serving a tennis ball
Lightheadedness - dizziness - syncope
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Rotator cuff tendonitis
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

12. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
BB or CCB - catheter ablation of identified bypass tract
HPV
Diuretics -BB -CCB -ACEi
S. Aureus

13. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Cholelithiasis
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
Diuretics -BB -CCB -ACEi

14. What are the three types of lice?
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
ACEi - ARBS - thiazide diuretics
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

15. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Increase; 200 g/day
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.

16. 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
Pleurisy
Hypertension - CAD - valvular heart disease
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus

17. What does the classic ring worm lesion have?
A central clear area
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Giardia
High blood pressure - focal neurologic defecit - or papilledema

18. Describe the presentation of angina?
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
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Scabies
24 hour halter

19. What are the signs of cerebral hemorrhage?
Rotator Cuff problem
Acute headache - ataxia - profuse nausea - and vomiting
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Higher filling presure - pulmonary congestion - and decreasd cardiac return

20. What HPV serotypes are most commonly associated with cervical cancer?
Supraspinatus and bicipital tendons
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
Serotypes 16 - 18 - 31 -52 -58
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)

21. Define the patient population typically affected by orthostatic or postural proteinuria
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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

22. Abnormal Vaginal Bleeding: Women over the age of ____ require an endometrial biopsy that considers the possibility of endometrial cancer.
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
24 hour halter
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
35 (exception for postmenopausal women who have recently been started on HRT)

23. Lab testing for heart palpitation
Hgb - Electrolytes - and TSH
Early sexuality and multiple pregnancies (immature cells are more common at menarche and ruing the postpartum period) - hx of STDs - smoking - HIV - current or prior history of condyloma - and previously abnormal Pap smears
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
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

24. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Viral infection of the semicircular apparatus
Analgesic headache
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
Infectious esophagitis

25. What are the consequences of diastolic dysfunction?
Folliculitis
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Anticoag with warfarin to prevent thromboembolism
CT

26. Define proteinuria
>150mg per 24hrs
Lightheadedness - dizziness - syncope
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Medication or chemical esophagitis

27. Although urine dipstick test binds to albumin what - other important protein can it fail to detect?
35 (exception for postmenopausal women who have recently been started on HRT)
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Bence-Jones

28. What lab tests are recommended for newly diagnosed hypertensive patients?
Intermenstrual bleeding
Cellulitis
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Staphylococcal scalded skin syndrome

29. What does orthostatic positional changes that bring on dizziness suggest?
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Varicella virus
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
Dehydration - anemia - cardiac causes

30. What drugs do you use to treat H.pylori + PUD?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Slow progression of cervical cancer changes -Availability of effective early treatment
Nonulcer dyspepsia
Associated with hypotension

31. Palpitations: Which patients warrant hospitalization - monitoring and aggressive eval?
Infectious esophagitis
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Pts with palpitations and dizziness - near syncope - or syncope

32. When do degenerative changes in the rotator cuff begin and what anatomy does this process usually involve?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
EGD
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Medication or chemical esophagitis

33. Initial treatment for Rhinosinusitis
Pleurisy
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse
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

34. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Other brainstem or cranial nerve findings
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
Chest pain during pneumonia or PE
HPV testing -Pos=colposcopy -Neg=repeat pap smear

35. Chest pain can emanate from inflammation or injury to or around the thoracic cavity. Name 3 locations.
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
Bence-Jones
Medication or chemical esophagitis
Variability in the time for follicle development during the proliferative phase

36. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Coronary artery disease/ angina
Warts
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. Why don't ACEi work well for the elderly and African Americans when treating HTN?
These patients are associated with low renin states=less likely to respond to medication
Molluscum contagiosum- pox virus
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Infectious esophagitis

38. What treatments are the cornerstone for treating cases of functional constipation?
Increasing fluid (8 - 8oz glasses of water/day) -fiber
With a KOH wet mount preparation
Scleroderma/polymyositis with secondary gastroesophageal reflux
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

39. 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
Albumin; low molecular weight proteins
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
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
Molluscum contagiosum- pox virus

40. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Possibility of Ischemic colitis
E. Coli O157:H7
Fever with frontal or maxillary tenderness
Bence-Jones

41. Name 4 factors that predispose an individual to develop pneumonia.
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
Rotator cuff tendonitis
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Higher filling presure - pulmonary congestion - and decreasd cardiac return

42. What type of drug is particularly beneficial for CHF and provide renal protection for those with diabetes?
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Serotypes 16 - 18 - 31 -52 -58
ACEi
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

43. What is the caUse of Meniere disease? What are the cardinal symptoms?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
HPV testing -Pos=colposcopy -Neg=repeat pap smear
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
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss

44. When should a patient get a stress test?
Fever with frontal or maxillary tenderness
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume

45. Describes what occurs during squamous metaplasia of the cervix.
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.
Increase; 200 g/day
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Streptococci

46. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
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

47. Regular bleeding at intervals of less than 21 days
Polymenorrhea
S. Aureus
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Hgb - Electrolytes - and TSH

48. Name types of laxatives
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Upper sternal area burning pain - associated with a productive cough
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

49. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
GERD
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

50. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Squamocolumnar junction=most common site of cervical cancer
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
HPV