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. How do you define persistent protein uria?
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
Presence of proteinuria on at least two separate ocassion
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
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting

2. What is the goal of CHF treatment? What drugs should be used?
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
CT
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
Variability in the time for follicle development during the proliferative phase

3. What are the consequences of diastolic dysfunction?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
Higher filling presure - pulmonary congestion - and decreasd cardiac return
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine

4. Name the diagnosis of heartburn: gnawing epigastric pain - nausea - vomiting - bloating
HPV testing -Pos=colposcopy -Neg=repeat pap smear
Enodlymphatic hydrops results in incrased pressure within the semicircular canals and damage to the sensory hair cells? -tinnitus - vertigo - hearing loss
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase
Peptic ulcer disease or gastritis

5. Predictors of cardiac etiology
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Common problem that resolves spontaneously and is most often seen in children and young adults
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

6. Name the skin lesion: honey colored crusts
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
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.
Associated with hypotension

7. Name some medications that can cause proteinuria
CBC
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
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

8. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
Paroxysmal atrial fibrillation or supraventricular tachycardia
Lightheadedness - dizziness - syncope
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day

9. 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
Analgesic headache
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse

10. Who should have Xray testing for shoulder pain?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Viral gastroenteritis

11. What is a markers of CNS vertigo?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
Pain
Other brainstem or cranial nerve findings
Less than 3 stools per week

12. What does treatment for migrans include?
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
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
Coronary artery disease/ angina
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

13. ______ infections cause approximately 95% of bronchitis cases in healthy adults.
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
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

14. Why is the pap smear one of the most effective cancer screening tools?
GERD
Menorrhagia
Presence of proteinuria on at least two separate ocassion
Slow progression of cervical cancer changes -Availability of effective early treatment

15. 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
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

16. 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
Chest pain during pneumonia or PE
Warts
With a KOH wet mount preparation
Irregular bleeding between cycles

17. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Serotypes 16 - 18 - 31 -52 -58
Cholelithiasis
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
Kids: Rotavirus Adults: Norwalk Virus

18. When should a patient get a stress test?
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Impetigo
With a KOH wet mount preparation
When the patient has symptoms in association with exercise or who describe chest pain or pressure

19. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
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
DM - HTN - DVT - seizures - depression - or anxiety
Productive cough and URI symptoms (runny nose - scratchy throat - nasal congestion) - low grade fever - fatigue
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)

20. Define proteinuria
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile
Candida albicans
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
>150mg per 24hrs

21. Name the skin lesion: pustule in association with a hair follice
Anticoag with warfarin to prevent thromboembolism
Hgb - Electrolytes - and TSH
Folliculitis
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

22. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
Upper sternal area burning pain - associated with a productive cough
Excessive bleeding in amount - duration - or both at irregular intervals
Echocardiogram
Squamocolumnar junction=most common site of cervical cancer

23. What are symptoms are CHF?
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Polymenorrhea
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)

24. What are the three major risk factors for heart failure?
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Hypertension - CAD - valvular heart disease
>150mg per 24hrs

25. When is a lumbar puncture contraindicated?
Viral gastroenteritis
Pts with palpitations and dizziness - near syncope - or syncope
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation

26. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Paroxysmal atrial fibrillation or supraventricular tachycardia
Hypertension - CAD - valvular heart disease
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain

27. What should blood work include for suspected heart failure?
24 hour halter
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Slow progression of cervical cancer changes -Availability of effective early treatment
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

28. What are the symptoms of palpitations?
S. Aureus
Vital signs - orthostatic blood pressure (indicating acute bleeding) and pulse - signs of pregnancy - systemic disease - and sterile speculum and bimanual exam)
Lightheadedness - dizziness - syncope
LH surge triggers ovulation

29. Name the type of headache: The patient chronically uses analgesic or antimigraine drugs - esp. those with caffeine
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
HPV
Analgesic headache
Intermenstrual bleeding

30. Name the diagnosis: a ringowrm fungi that infects and survives only on dead keratin (stratum corneum) - the hair and the nails
Dermatophytes - i.e. tinea- funus infection such as tinea captis- fungal infection of the scalp
Viral infection of the semicircular apparatus
A central clear area
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

31. Describes what occurs during squamous metaplasia of the cervix.
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
Pleurisy
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin

32. Natural history of cervical cancer
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
Varicella virus
Furucnle

33. What are the secondly causes of glomerular disease?
Post-streptococcal glomerular nepritis; systemic diseases such as SLE or a drug related effect on the glomerulus
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
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
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

34. What are the features of nephrotic syndrome?
CBC
Viral gastroenteritis
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

35. Hyperthyroidism - pheochromocytoma - anemia - dehydration - hypovolemia are...
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Non-cardiac causes of palpitations
GERD
The luteal or secretory phase begins - the corpus luteum develops - and pregesterone levels increase

36. What are the signs of cerebral hemorrhage?
Analgesic headache
BB or CCB - catheter ablation of identified bypass tract
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
Acute headache - ataxia - profuse nausea - and vomiting

37. What is the difference between a Holter monitor or an event monitor?
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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
>150mg per 24hrs
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM

38. What does orthostatic positional changes that bring on dizziness suggest?
Excessive bleeding in amount - duration - or both at irregular intervals
Hypertension - CAD - valvular heart disease
Dehydration - anemia - cardiac causes
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

39. How does CHF present on X-ray?
Excessive bleeding in amount - duration - or both at irregular intervals
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines

40. Four muscles of rotator cuff
Hgb - Electrolytes - and TSH
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Bulk forming: Psyllium - Methycellulose - Polycarbophil
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

41. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Adhesive capsulitis (frozen shoulder): most common in middle age women
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.
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
Coag disorders

42. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Colposcopy - Endocervical curettage - and directed cervical biopsy
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
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

43. What is the leading caUse of parasitic diarrhea that presents as foul - greasy - bulky stools with associated weight loss or neuropathy?
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
EGD
Giardia
Bradycardia - fatigue - insomnia - sex dysfxn - and adverse effects on the lipid profile

44. Clinical Manifestations of HTN
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
MSK - pulmonary - GI - or psychological
Temporal arteritis-biopsy of the temporal artery
Variability in the time for follicle development during the proliferative phase

45. 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
A central clear area
Scabies
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema

46. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Streptococci
Impetigo
Squamocolumnar junction=most common site of cervical cancer
Rotator Cuff tendonitis

47. Regular bleeding at intervals of less than 21 days
Lightheadedness - dizziness - syncope
ACEi
Nonulcer dyspepsia
Polymenorrhea

48. Whats the diagnosis: Watery stools accompanied by a low-grade fever - headache - nausea or vomiting - and achiness
Viral gastroenteritis
Echocardiogram
Anticoag with warfarin to prevent thromboembolism
NSAIDs - combined with ice or heat - and brief periods of rest followed by PT (maintaining ROM - flexibility - strength) -Severe: Cortisone shot

49. What places women at higher risk of getting cervical cancer?
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
Every 3 years after 2 negative smear 1 year apart. Screening may be discontinued after age 65 provided that previous testing has been normal
Hypertension - CAD - valvular heart disease
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

50. Pneumonia tx: suitable for healthy adults less than 60
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Serotypes 16 - 18 - 31 -52 -58
PE - MI - aortic dissection - pneumothorax
Presence of proteinuria on at least two separate ocassion