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. patients who present with an MI - unstable angina - or PE should be hospitalization of evaluation
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
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
Associated with hypotension
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

2. 1+ protein level on urine dipstick usually represents how much protein in the urine?
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
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Regular bleeding at intervals of more than 35 days
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

3. What are the two common clinical presentations of acute diarrhea?
Slow progression of cervical cancer changes -Availability of effective early treatment
Irregular bleeding between cycles
Non-cardiac causes of palpitations
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool

4. Menometrorrhagia
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
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
Excessive bleeding in amount - duration - or both at irregular intervals
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin

5. What is the peripheral caUse of vertigo?
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF
24 hour halter
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
>150mg per 24hrs

6. Define proteinuria
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
35 (exception for postmenopausal women who have recently been started on HRT)
Cellulitis
>150mg per 24hrs

7. 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.
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
Repeat Pap after infection treated
Albumin; low molecular weight proteins
Pancreatitis

8. What are signs of pulmonary congestion?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Hypertension - CAD - valvular heart disease
Bence-Jones

9. What type of diuretic is the most widely used for HTN? What are some SE of this drug?
Cervical radiculopathy
Lightheadedness - dizziness - syncope
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids
Slow progression of cervical cancer changes -Availability of effective early treatment

10. Treatment for supraventricular tachycardias
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
GERD
Slow progression of cervical cancer changes -Availability of effective early treatment
BB or CCB - catheter ablation of identified bypass tract

11. Name the skin lesion: honey colored crusts
Viral infection of the semicircular apparatus
Impetigo
S. Aureus
Kids: Rotavirus Adults: Norwalk Virus

12. What should blood work include for suspected heart failure?
Increase; 200 g/day
Dehydration - anemia - cardiac causes
Regular bleeding at intervals of more than 35 days
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

13. Metrorrhagia
Irregular bleeding between cycles
ACEi - ARBS - thiazide diuretics
Meclizine - dimenhydrinate - antiemetics - and benzodiazepines
EGD

14. What are the signs of cerebral hemorrhage?
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
Impetigo
Cluster headache
Acute headache - ataxia - profuse nausea - and vomiting

15. When is a lumbar puncture contraindicated?
Squamocolumnar junction=most common site of cervical cancer
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Regular bleeding at intervals of more than 35 days
Tension headache

16. What does the classic ring worm lesion have?
Non-cardiac causes of palpitations
A central clear area
Echocardiogram
Reserved for pats with hx of traumatic injury or persistent pain despite therapy

17. Describe the history and PE of patient presenting with common cold
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
A 24hr urine protein collection and urine creatinine clearance determination

18. What is considered normal blood loss during a menstrual cycle?
HPV testing -Pos=colposcopy -Neg=repeat pap smear
A 24hr urine protein collection and urine creatinine clearance determination
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
Less than 80 ml of blood

19. Complete the sentence: pericarditis can cause frictional rub and......
Bulk forming agents -Osmotic laxatives -Stimulant laxatives -Stool Softeners -Suppositories -Enemas
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Varicella virus
Common problem that resolves spontaneously and is most often seen in children and young adults

20. How does CHF present on X-ray?
Viral gastroenteritis
Staphylococcal scalded skin syndrome
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
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

21. History for Sinusitis

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

22. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
Lifestyle modification: Salt restriction - weight reduction - regular aerobic exercise
Medication or chemical esophagitis
Peptic ulcer disease or gastritis

23. Diagnosis of HTN
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Regular bleeding at intervals of more than 35 days
Increase BO (systolic >140 or diastolic >90) at least 2 consecutive visits 2 wks apart
Varicella virus

24. Name the diagnosis of heartburn: dysphagia - assoc. with immunocompromised condition
Hydration -OTC decongestants -Topical Nasal decongestant no more than 4 days -Guaifenesin
Infectious esophagitis
Scleroderma/polymyositis with secondary gastroesophageal reflux
Furucnle

25. 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
HIV and syphilis
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
Varicella virus
Presence of proteinuria on at least two separate ocassion

26. Name the microorganism: impetigo - erysipelas - cellulitis - lymphangitis
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Common problem that resolves spontaneously and is most often seen in children and young adults
HIV and syphilis
Streptococci

27. Where does the development of abnormal cervical cells begin?
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.
Squamocolumnar junction=most common site of cervical cancer
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
CT

28. Uterine bleeding between regular cycles
When the patient has symptoms in association with exercise or who describe chest pain or pressure
Slow progression of cervical cancer changes -Availability of effective early treatment
Intermenstrual bleeding
Thiazide (useful in patients without renal impairment) -SE: sex dysfxn - dyslipidemia - hyperglycemia - and elevation in uric acids

29. Pain in shoulder when throwing - swimming - or serving a tennis ball
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Increase; 200 g/day
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
Rotator cuff tendonitis

30. Which diuretic is best for HTN patients with renal impairment? What should be checked before administered?
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Pancreatitis
Loop diuretics (Check serum K+ levels before drug admin)
When the patient has symptoms in association with exercise or who describe chest pain or pressure

31. What are the 2 psych disorders most commonly associated with palpitations?
EGD
Generalized Anxiety disorder and panic disorder
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing

32. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
HIV and syphilis
ACEi - ARBS - thiazide diuretics
Chest pain during pneumonia or PE

33. What is the next best step if a patient has two or more positive dipstick tests?
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
A 24hr urine protein collection and urine creatinine clearance determination
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
High blood pressure - focal neurologic defecit - or papilledema

34. Name the diagnosis of heartburn: severe constant mid abdominal pain
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
In syncopal or near syncopal patients iwth heart disease and those iwth suspected ventricular tachycardia or heart block
Hx: High fever - dyspnea - chills - chest pain - develop hypoxia or cardiopulmonary failure - PE: Abnormal Vital signs (fever - tachypnea - tachycardia) - Lungs (localized rales - bronchial breath sounds - wheezing - signs of consolidation-dullness t

35. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Increase; 200 g/day
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
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions

36. What lab tests are recommended for newly diagnosed hypertensive patients?
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
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Slow progression of cervical cancer changes -Availability of effective early treatment
CT

37. What test done in PE measures instability of shoulder?
S. aureus- beta hemolytic streptococcus
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
Streptococci

38. Whats the diagnosis: Severe abdominal pain in an elderly individual accompanied by acute diarrhea
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
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
Possibility of Ischemic colitis

39. What does treatment for migrans include?
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
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
Intermenstrual bleeding
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

40. Hyperinsulinemia can increase vascular tone by what 4 mechanisms?
Higher filling presure - pulmonary congestion - and decreasd cardiac return
RBC casts and old to moderate HTN
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
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

41. What is the standard tool used for diagnosis of GERD?
EGD
Persistent purulent discharge - facial pain exacerbated by leaning forward - maxillary tooth ache - 'double sickening'=relapse
Peptic ulcer disease or gastritis
When the patient has symptoms in association with exercise or who describe chest pain or pressure

42. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Wolff-Parkinson-White syndrome
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB
High blood pressure - focal neurologic defecit - or papilledema
Pleurisy

43. 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
1. Watery - noninflammatory diarrhea 2. Inflammatory diarrhea with the presence of either blood or WBC in stool
Increasing fluid (8 - 8oz glasses of water/day) -fiber
4 to 6 mo until 3 consecutive normal smear have been obtained *subsequent abnormal smear=colposcopy should be performed
Cluster headache

44. What should be considered in younger patients with menorrhagia
Coag disorders
True
Regular bleeding at intervals of more than 35 days
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

45. Name some medications that can cause proteinuria
Folliculitis
Substernal chest tightness or pressure - that radiates to the left arm - shoulders - or jaw. Patients may also describe: diaphoresis - SOB - nausea - vomiting
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

46. Diagnostic Evaluation of Abnoraml vaginal bleeding
Serotypes 16 - 18 - 31 -52 -58
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
The resistance against which the heart contracts and is clinically reflected by systolic blood pressure
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia

47. 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
When an increase in intracranial pressure is suspected because it can lead to brainstem herniation
Common problem that resolves spontaneously and is most often seen in children and young adults
ACEi - ARBS - thiazide diuretics

48. Describe the presentation tracheobronchitis
Echocardiogram
Upper sternal area burning pain - associated with a productive cough
Variability in the time for follicle development during the proliferative phase
Presence of proteinuria on at least two separate ocassion

49. Name the diagnosis: epidermal warts; transferred by touch and occurs at sites of trauma
>3.5g of protein per 24hrs
Menorrhagia
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
HPV

50. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Increasing fluid (8 - 8oz glasses of water/day) -fiber
Cervical radiculopathy