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. Name the diagnosis: A short PR interval and delta wave on ECG; assoc. with paroxysmal supraventricular tachycardias
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
RBC casts and old to moderate HTN
Wolff-Parkinson-White syndrome
Analgesic headache

2. What hypertension medications should be avoided in the 1st and 2nd trimesters of pregnancy?
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema
Viral infection of the semicircular apparatus
Irregular bleeding between cycles
ACEi - ARBS - thiazide diuretics

3. HIgh risk pregnant patients should be evaluated for ____ and ____
Candida albicans
HIV and syphilis
Pleurisy
Wolff-Parkinson-White syndrome

4. A woman with which medical conditions is at risk for complications for herself and fetus during pregnancy
A tumor of the 8th cranial nerve that compresses the 8th cranial nerve and the brainstem
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
DM - HTN - DVT - seizures - depression - or anxiety
Impetigo

5. Name the diagnosis of heartburn: colicky right upper quadrant pain - with meals - radiation to scapular regions
Repeat Pap after infection treated
Echocardiogram
Cholelithiasis
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

6. Vaccines that should be updated before planned pregnancy
Reflux of acid into lower esophagus -> esophagitis -> pain indistinguishable from cardiac chest pain
Adhesive capsulitis (frozen shoulder): most common in middle age women
Hep B and rubella (if necessary) Note: pregnancy should be avoided up to 1-3 months after rubella and varicella immunizations=live attenuated viruses
Pain

7. 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
Upper sternal area burning pain - associated with a productive cough
Viral gastroenteritis
Menorrhagia

8. What are the signs of malignant hypertension?
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Slow progression of cervical cancer changes -Availability of effective early treatment
EGD
High blood pressure - focal neurologic defecit - or papilledema

9. Four muscles of rotator cuff
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Coronary artery disease/ angina
Regular bleeding at intervals of more than 35 days

10. Pain in shoulder when throwing - swimming - or serving a tennis ball
Rotator cuff tendonitis
Pleurisy
Cluster headache
Dehydration - anemia - cardiac causes

11. What are the physical exam signs of CHF?
Hgb - Electrolytes - and TSH
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
True
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

12. Diagnostic Evaluation of Abnoraml vaginal bleeding
Generalized Anxiety disorder and panic disorder
Age - dominant hand - medications - PMHx - type of work - and activity level - Pain-acute or chronic - Associated trauma (swelling - rendness - laxity - catching - decrease ROM)
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
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

13. Constipation: What are indications for lab testing?
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology
Cluster headache

14. Name the diagnosis: paroxysmal episodes that begin and resolve abruptly.
Aka left ventricular end diastolic pressure; the pressure required to distend the ventricle at a given volume
Less than 80 ml of blood
True
Paroxysmal atrial fibrillation or supraventricular tachycardia

15. Regular bleeding at intervals of less than 21 days
100mg; means patient can be trace protein positive and not be detected
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Polymenorrhea
Usually occurs in individuals over 50 to 60 yo -Involves tendons - bursae - and sometimes entire capusule

16. Describe the presentation tracheobronchitis
Loop diuretics (Check serum K+ levels before drug admin)
Alters mucosal permeability and stimulates the activity of intestinal smooth muscle -Ex: Bisacodyl (dulcolax)
Upper sternal area burning pain - associated with a productive cough
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes

17. 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
Fever with frontal or maxillary tenderness
1. Rhinovirus 2. Coronavirus 3. Others: Influenza - Parainfluenza - RSV - Adenovirus
Erythromycin - Macrolide (i.e. azithromycin) - Doxycyline
Warts

18. What places women at higher risk of getting cervical cancer?
Medication or chemical esophagitis
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
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
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually

19. What imaging is used to assess cardiac anatomy in patients with heart palpitations?
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
PE - MI - aortic dissection - pneumothorax
Echocardiogram
Anticoag with warfarin to prevent thromboembolism

20. Patient presents with aching shoulder - which becomes acutely painful with overhead activity
Folliculitis
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
Rotator Cuff problem
High blood pressure - focal neurologic defecit - or papilledema

21. When does the MB fraction of creatinine phosphokinase rise following myocardial injury or infarction?
Anticoag with warfarin to prevent thromboembolism
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
Apprehension test: abducting the arm to 90 degrees - rotating it externally - and then applying anterior traction to the humerus
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

22. What should preconception counseling include?
Rotator cuff tendonitis
SITS: Supraspinatus - Infraspinatus - Teres Minor - Subscapularis
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin
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

23. Name the skin lesion: pustule in association with a hair follice
Generalized Anxiety disorder and panic disorder
Folliculitis
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Consider AB:1st line: Amoxicillin - Cefuroxime Penicillin allergy: clarithromycin - azithromycin - trimethoprim/sulfamethoxazole 2nd line: amoxicillin/clavulanic acid - levofloxacin - gatifloxcin

24. What is a markers of CNS vertigo?
Other brainstem or cranial nerve findings
Theophylline - Digoxin - B agonists - OTC stimulants (pseudophedrine) - antiarrhthymic med
Rotator Cuff tendonitis
Non-cardiac causes of palpitations

25. Describes what occurs during squamous metaplasia of the cervix.
100mg; means patient can be trace protein positive and not be detected
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Columnar cells are replaced by squamous cells and creates the squamocolumnar junction (where squamous metaplasia is most active)
CBC - UA - electrolytes - BUN - creatinine - albumin - TSH-BNP: elevated in CHF

26. What are the features of nephrotic syndrome?
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
With a KOH wet mount preparation
Coronary artery disease/ angina
Wolff-Parkinson-White syndrome

27. 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)
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
Pain
ACEi - penicillin - cephalosporin - cyclosporine - NSAIDs - heavy metals - aminoglycosides - sulfonamides

28. 1+ protein level on urine dipstick usually represents how much protein in the urine?
300mg/dl protein excreted in the last 24hrs; 4+ indicates over 1g/dl per day
FSH released by the pitu stimulates a primary ovarian follicle to release estrogen - which stops menses and stimulates the endometrium
CT
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

29. Who should have Xray testing for shoulder pain?
Reserved for pats with hx of traumatic injury or persistent pain despite therapy
Less than 80 ml of blood
EGD
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

30. How is constipation clinically defined?
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Less than 3 stools per week
Massive proteinuria and edema - hypoalbuminemia - hyperlipidemia - lipiduria
Adhesive capsulitis (frozen shoulder): most common in middle age women

31. 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
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
ACEi - ARBS - thiazide diuretics
Occurs in overlying chest wall - and aggravated by breathing and coughing - sudden - sharp - unilateral - pleuritic - associated with SOB

32. What are signs of pulmonary congestion?
Folliculitis
Refractory constipation - a new onset of constipation in an older individual - heme-positive stools - and situations in which the etiology is unclear or the clinical evaluation suggests underlying pathology
Slow progression of cervical cancer changes -Availability of effective early treatment
Orthopnea - paroxysmal nocturna dyspnea - rales - jugular venous distention - and edema

33. 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
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
Molluscum contagiosum- pox virus
A 24hr urine protein collection and urine creatinine clearance determination
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

34. 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
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
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
Chest pain during pneumonia or PE

35. What procedures should be performed on women with low-grade and high-grade intraepithelial lesion on pap smear?
Adhesive capsulitis (frozen shoulder): most common in middle age women
Squamocolumnar junction=most common site of cervical cancer
Cholelithiasis
Colposcopy - Endocervical curettage - and directed cervical biopsy

36. What is the caUse of benign positional vertigo?
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
24 hour halter
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.
Rotator Cuff tendonitis

37. Name the diagnosis: isolated extra or pounding beats; often disappear with excertion
LH surge triggers ovulation
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
Premature ventricular contractions (PVCs) or premature atrial contractions (PACs)
Adhesive capsulitis (frozen shoulder): most common in middle age women

38. Describe the Hx for a patient getting an abnormal vaginal bleeding work-up
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
Ligament involvement: Pain with Active ROM and Passive ROM -Muscular and/or tendon injury: Pain with ONLY Active ROM
Scleroderma/polymyositis with secondary gastroesophageal reflux
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

39. Predictors of cardiac etiology
Dyspnea - orthopnea - paroxysmal nocturnal dyspnea - nocturia - edema - weight gain - fatigue - chest pain - abdominal pain - anorexia - mental status changes
Male - report irregular heartbeat Sx duration >5min - hx of heart disease
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
True

40. When should a patient get a stress test?
When the patient has symptoms in association with exercise or who describe chest pain or pressure
4 mo for 1yr - then every 6 mo for another yr. If remain normal for 2 years=screening can occur annually
Mild dysplasia--> Carcinoma in situ-->Invasive carcinoma
DM - HTN - DVT - seizures - depression - or anxiety

41. Name the diagnosis: older patient with pain or palpation of the temporal artery? What is the definitive diagnosis?
Temporal arteritis-biopsy of the temporal artery
Pulsus paradoxus (abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration)
Persistent - sharp - severe - relieved by sitting up; aggravated by breathing - laying back - coughing
Supraspinatus and bicipital tendons

42. Name the diagnosis of heartburn: dysphagia - assoc. with ingestion
Cardiomeagly -redistribution of vascular markings -prominent interstitial markings -Kerley B lines -perihilar haziness -pleural effusions
MSK - pulmonary - GI - or psychological
S. Aureus
Medication or chemical esophagitis

43. How do you know if heart palpitations are due to stimulant or medication use?
Less abrupt onset and cessation of palpitations
Clarithromycin - amoxicillin - metronidazole PPI: cimetidine - ranitidine - famotidine - nazatidine
24 hour halter
Dehydration - anemia - cardiac causes

44. What is the Epley maneuver?
Inflammation - stimulation - or destruction of the hair cells of the eighth cranial nerve
Streptococci
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.
Fasting serum glucose - K+ - serum creatinine - UA - lipid profile - serum Ca2+ - uric acid

45. Pneumonia tx: suitable for healthy adults older than 60
Fever with frontal or maxillary tenderness
Rotator Cuff problem
Fluoroquinolone with good activity again Pneumococcus (levofloxacin) - Macrolide - 2nd generation cephalosporin
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

46. Diarrhea is defined as an ____ in stool weight to more than ____g per day
Increase; 200 g/day
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Pleurisy
These patients are associated with low renin states=less likely to respond to medication

47. What are the primary glomerular diseases?
Focal glomerular sclerosis - membranous glomerular nephripathy - IgA nephropathy
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
Temporal arteritis-biopsy of the temporal artery
Repeat Pap after infection treated

48. What are the four classes of medications that are most commonly used for 1st line agents in HTN?
Common problem that resolves spontaneously and is most often seen in children and young adults
Viral -Non viral causes: Chemical irritation - Mycoplasma - and Chlamydia
Diuretics -BB -CCB -ACEi
Regular bleeding at intervals of more than 35 days

49. Name 4 factors that predispose an individual to develop pneumonia.
Ischemic heart disease - stroke - peripheral vascular disease - renal insufficiency - retinopathy characterized by exudates and hemorrhages - and - in severe HTN - papilledema
1. Abnormal host defenses 2. Altered consciousness 3. Ineffective cough 4. Abnormal mucociliary transport
Polymenorrhea
35 (exception for postmenopausal women who have recently been started on HRT)

50. Name the skin lesion: erythema - warmth - edema - pain - fever
Cellulitis
Rotator Cuff problem
Temporal arteritis-biopsy of the temporal artery
EGD