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. Treatment for supraventricular tachycardias
Generalized Anxiety disorder and panic disorder
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Coag disorders
BB or CCB - catheter ablation of identified bypass tract

2. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Rotator Cuff problem
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
>150mg per 24hrs
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

3. Chronic pain and shoulder stiffness with limited motion
Tension headache
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Increase; 200 g/day
Adhesive capsulitis (frozen shoulder): most common in middle age women

4. What is the role of LH in the menstrual cycle
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
LH surge triggers ovulation

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
GERD
Regular bleeding at intervals of more than 35 days
Cluster headache

6. What does treatment for migrans include?
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
Scabies
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)

7. What places women at higher risk of getting cervical cancer?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
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
Associated with hypotension
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

8. 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.
Rotator Cuff problem
Supraspinatus and bicipital tendons
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
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

9. PE for a patient getting an abnormal vaginal bleeding work up
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Diuretics -BB -CCB -ACEi
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

10. Vaccines that should be updated before planned pregnancy
BB or CCB - catheter ablation of identified bypass tract
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
Pancreatitis

11. _____ _____ _____ are high in fiber and increase stool volume by absorbing water given to patients with constipation.
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Pancreatitis
Folliculitis

12. What is the caUse of benign positional vertigo?
Peptic ulcer disease or gastritis
Chest pain during pneumonia or PE
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.
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

13. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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

14. What is the preload?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Dehydration - anemia - cardiac causes

15. Cycle length variabilty is primarily due to what?
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Variability in the time for follicle development during the proliferative phase
>150mg per 24hrs
RBC casts and old to moderate HTN

16. 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.
Repeat Pap after infection treated
Possibility of Ischemic colitis
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Influenza - Rhinovirus - Adenovirus - Parainfluenza

17. When does troponin rise following myocardial injury or infarction?
PE - MI - aortic dissection - pneumothorax
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

18. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
HPV
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
Excessive bleeding in amount - duration - or both at irregular intervals
DM - HTN - DVT - seizures - depression - or anxiety

19. What is benign transient proteinuria?
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Pain
Common problem that resolves spontaneously and is most often seen in children and young adults
When the patient has symptoms in association with exercise or who describe chest pain or pressure

20. Isolated - extra pounding beats
Viral gastroenteritis
PVC or Premature atrial contraction (PAC)
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus

21. What are the three types of lice?
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
A central clear area
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Pediculus humanus capitis- head louse - P. humanus corporis- body louse - Phthirus pubis- pubic or crab louse

22. SE Of Beta blockers?
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
S. Aureus
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

23. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
Pleurisy
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

24. Pain from inflammation or irritation is detected only by the parietal pleura - the parietal pleura is the source of...
Chest pain during pneumonia or PE
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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

25. Describe the presentation tracheobronchitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Upper sternal area burning pain - associated with a productive cough
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Bence-Jones

26. What are the signs of malignant hypertension?
High blood pressure - focal neurologic defecit - or papilledema
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
Polymenorrhea
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem

27. Diarrhea from custard filled pastries
S. Aureus
Analgesic headache
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

28. What are the indiciations for neuroimaging?
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.
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
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
S. Aureus

29. At was quantity does urine dipstick test detect elevated protein?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
100mg; means patient can be trace protein positive and not be detected

30. Diagnostic Evaluation of Abnoraml vaginal bleeding
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
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Streptococci
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas

31. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
24 hour halter
100mg; means patient can be trace protein positive and not be detected
Possibility of Ischemic colitis
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

32. Things that need to be included in history of shoulder pain
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Analgesic headache
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)

33. An alternative method for stratifying risk for cervical cancer in women with atypical squamous cells of undetermined significance (ASCUS)
Bulk forming: Psyllium - Methycellulose - Polycarbophil
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
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Supraspinatus and bicipital tendons

34. What does the classic ring worm lesion have?
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
100mg; means patient can be trace protein positive and not be detected
BB or CCB - catheter ablation of identified bypass tract
A central clear area

35. What is the Barany maneuver?
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
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
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

36. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
BB or CCB - catheter ablation of identified bypass tract
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
Loop diuretics (Check serum K+ levels before drug admin)

37. Who should have Xray testing for shoulder pain?
True
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
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
S. aureus- beta hemolytic streptococcus

38. Name the microorganism: folliculitis - cellulitis - furuncles (abscess/ boil) - bullous impetigo and staphylococcal scaleded skin syndrome
S. aureus- beta hemolytic streptococcus
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
MSK - pulmonary - GI - or psychological
HPV

39. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Common problem that resolves spontaneously and is most often seen in children and young adults
Molluscum contagiosum- pox virus
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Streptococci

40. Natural history of cervical cancer
These patients are associated with low renin states=less likely to respond to medication
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Pleurisy

41. Mainstay treatment for soft tissue inflammation (Shoulder)
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
CT
Repeat Pap after infection treated

42. Diarrhea is defined as an ____ in stool weight to more than ____g per day
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Increase; 200 g/day
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block

43. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Viral gastroenteritis
Infectious esophagitis
Possibility of Ischemic colitis

44. Diagnosis of HTN
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Adhesive capsulitis (frozen shoulder): most common in middle age women
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Molluscum contagiosum- pox virus

45. What is the difference between a Holter monitor or an event monitor?
Furucnle
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Pain

46. What are the two common clinical presentations of acute diarrhea?
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
With a KOH wet mount preparation
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Generalized Anxiety disorder and panic disorder

47. HIgh risk pregnant patients should be evaluated for ____ and ____
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
HIV and syphilis
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Pts with palpitations and dizziness - near syncope - or syncope

48. Shoulder pain with pain radiating to elbow
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
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.
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Cervical radiculopathy

49. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
Nonulcer dyspepsia
S. Aureus
Acute headache - ataxia - profuse nausea - and vomiting

50. 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
Intermenstrual bleeding
Possibility of Ischemic colitis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines