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 are the common causes for laryngitis?
Streptococci
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Influenza - Rhinovirus - Adenovirus - Parainfluenza
Possibility of Ischemic colitis

2. What is the Nikolsky sign (elicted when a local skin separation occurs after minor pressure) suggest?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Acute headache - ataxia - profuse nausea - and vomiting
Staphylococcal scalded skin syndrome
Supraspinatus and bicipital tendons

3. What is the caUse of benign positional vertigo?
>150mg per 24hrs
Albumin; low molecular weight proteins
Hgb - Electrolytes - and TSH
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.

4. What is the next best step if a patient has two or more positive dipstick tests?
A 24hr urine protein collection and urine creatinine clearance determination
Increase; 200 g/day
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
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

5. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Regular bleeding at intervals of more than 35 days
Colposcopy - Endocervical curettage - and directed cervical biopsy
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

6. Things that need to be included in history of shoulder pain
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma

7. What are the consequences of diastolic dysfunction?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Paroxysmal atrial fibrillation or supraventricular tachycardia
Fever with frontal or maxillary tenderness
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve

8. 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
Adhesive capsulitis (frozen shoulder): most common in middle age women
Scabies
Warts
Analgesic headache

9. Oligomenorrhea
Medication or chemical esophagitis
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Regular bleeding at intervals of more than 35 days
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

10. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Pts with palpitations and dizziness - near syncope - or syncope
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
Medication or chemical esophagitis
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

11. Chronic pain and shoulder stiffness with limited motion
Adhesive capsulitis (frozen shoulder): most common in middle age women
Supraspinatus and bicipital tendons
Acute headache - ataxia - profuse nausea - and vomiting
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

12. A ___ ___ ____records the cardiac rhythm for 24 hours and can detect arrhythmia.
Non-cardiac causes of palpitations
RBC casts and old to moderate HTN
24 hour halter
Streptococci

13. 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.
Dehydration - anemia - cardiac causes
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Non-cardiac causes of palpitations
Tension headache

14. What is HSV1 associated with? What is HSV 2 associated with? What are the two phases of HSV infections? Describe the rash?
Subarachnoid hemorrhage
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Furucnle
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

15. name the 4 emergent causes of chest pain
S. Aureus
Adhesive capsulitis (frozen shoulder): most common in middle age women
Upper sternal area burning pain - associated with a productive cough
PE - MI - aortic dissection - pneumothorax

16. Isolated - extra pounding beats
PVC or Premature atrial contraction (PAC)
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
Anticoag with warfarin to prevent thromboembolism

17. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Bence-Jones
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
These patients are associated with low renin states=less likely to respond to medication
Loop diuretics (Check serum K+ levels before drug admin)

18. Name the skin lesion: honey colored crusts
Rotator Cuff tendonitis
A 24hr urine protein collection and urine creatinine clearance determination
Impetigo
Rotator cuff tendonitis

19. What are the features of nephrotic syndrome?
Albumin; low molecular weight proteins
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Excessive bleeding in amount - duration - or both at irregular intervals
BB or CCB - catheter ablation of identified bypass tract

20. Name the type of headache: severe - unilateral - localized to the periorbital/ temporal area; usually accompanied by one of the following symptoms- lacrimation - rhinorrhea - ptosis - miosis - nasal congestion - and eyelid edema; attacks occur every
HIV and syphilis
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Cluster headache
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

21. Predictors of cardiac etiology
Coronary artery disease/ angina
ACEi
Intermenstrual bleeding
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

22. What is the role of LH in the menstrual cycle
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
LH surge triggers ovulation
Viral infection of the semicircular apparatus
Albumin; low molecular weight proteins

23. 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
Scabies
Repeat Pap after infection treated
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
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

24. How is constipation clinically defined?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
Regular bleeding at intervals of more than 35 days
Associated with hypotension
Less than 3 stools per week

25. Diagnostic Evaluation of Abnoraml vaginal bleeding
Chest pain during pneumonia or PE
Cluster headache
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
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

26. Regular bleeding at intervals of less than 21 days
Less than 80 ml of blood
Presence of proteinuria on at least two separate ocassion
Polymenorrhea
Warts

27. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
Regular bleeding at intervals of more than 35 days
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

28. MI - pericardial tamponade - PE - GI bleed - are...
Associated with hypotension
HIV and syphilis
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Analgesic headache

29. Range of motion testing: How do you tell the difference between joint/ligament involvement vs. muscular and/or tendon involvement?
Paroxysmal atrial fibrillation or supraventricular tachycardia
Acute headache - ataxia - profuse nausea - and vomiting
S. Aureus
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

30. Irregular cycles with excessive flow - duration - or both
Menorrhagia
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
RBC casts and old to moderate HTN
Increase; 200 g/day

31. After treatment of dysplasia - women need Pap smears every...
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
RBC casts and old to moderate HTN
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Pancreatitis

32. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
Subarachnoid hemorrhage
Bence-Jones
Increase; 200 g/day
Peptic ulcer disease or gastritis

33. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
Lightheadedness - dizziness - syncope
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
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

34. What does the classic ring worm lesion have?
A central clear area
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
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

35. How does systolic vs. diastolic heart failure present on the echocardiogram?
These patients are associated with low renin states=less likely to respond to medication
Peptic ulcer disease or gastritis
GERD
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

36. Why is the pap smear one of the most effective cancer screening tools?
Slow progression of cervical cancer changes -Availability of effective early treatment
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule
Rotator cuff tendonitis

37. Pneumonia tx: suitable for healthy adults older than 60
Kids: Rotavirus Adults: Norwalk Virus
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
Increase; 200 g/day
Male - report irregular heartbeat Sx duration >5min - hx of heart disease

38. Name the diagnosis of heartburn: severe constant mid abdominal pain
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Pancreatitis
PE - MI - aortic dissection - pneumothorax
Coronary artery disease/ angina

39. Clinical Manifestations of HTN
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Acute headache - ataxia - profuse nausea - and vomiting
Tension headache

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

41. 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
Squamocolumnar junction=most common site of cervical cancer
Other brainstem or cranial nerve findings
1st enzymes to rise and remain elevated for 5 - 14days; most sensitive and specific for infarct

42. Menometrorrhagia
CT
Excessive bleeding in amount - duration - or both at irregular intervals
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
Rotator cuff tendonitis

43. Name the diagnosis of heartburn: chest pressure - nausea - diaphoresis - palpitations
Scleroderma/polymyositis with secondary gastroesophageal reflux
Coronary artery disease/ angina
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Furucnle

44. Initial treatment for Rhinosinusitis
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Generalized Anxiety disorder and panic disorder
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

45. 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
Hgb - Electrolytes - and TSH
GERD
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart

46. Four muscles of rotator cuff
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
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Albumin; low molecular weight proteins
Tension headache

47. What is the Barany maneuver?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Kids: Rotavirus Adults: Norwalk Virus
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
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

48. Describes what occurs during squamous metaplasia of the cervix.
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
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

49. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Wolff-Parkinson-White syndrome
Other brainstem or cranial nerve findings
Analgesic headache
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

50. How do you define persistent protein uria?
Repeat Pap after infection treated
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Presence of proteinuria on at least two separate ocassion
Less abrupt onset and cessation of palpitations